Retired Bell South Employee - MAPD

[jdeasy]

If you remove this person(s) from their group coverage you are doing them a disservice.

Pay for the sup out of the allowance and pay separate for the other supplemental benefits.

Taking them out from AON they cannot get that coverage back.

The people are already removed from group coverage. The companies are getting rid of their coverage. They are paying an allowance towards the retiree coverage. They have to do something. They cannot stand pat.

The companies are bringing in a 3rd party to supposedly assist with the changeover. AON, One Exchange, etc.

Most of them have a deal with those 3rd party companies that their employees have to purchase something from that 3rd party in order to receive their reimbursement.

I've dealt with 3 of these, AT&T, Whirlpool and GE. GE uses One Exchange. They have been the easiest of the 3. But all of them claim that they represent all of the companies available. That is simply not the truth. In this area Aetna and Equitable have the best rates and none of the exchanges offer either.

It is a lot of work as you have to get the forms for the reimbursements and get them in on time. But you do gain many clients if you understand how it works and get it handled for them just as though they went through the exchange. That is the only thing the exchange does for them, convenience. If you don't match that convenience they will just use the exchange and pay more.

It looks like I'm about to deal with another if this Peabody Coal scam they pulled with Patriot is allowed to be implemented. I'm hoping that gets settled though.

The worst users were the Whirlpool workers. I think Newby experienced the same thing. They would use the independent agent to get educated on their choices and then go back to the company and enroll there. I stopped meeting with the Whirlpool time wasters.

 

[myinsurebiz]

Just got off phone. You are correct - they have to enroll in at least one product from the Exchange to be eligible for the MSA. Going to look at the Dental and Vision options for that " one " product.

Also - they have $4200 a year to spend and unspent rolls over to a certain amount.

But it is so close to Dec 7th - here is my plan - please critique:

Switch them both to the Aetna MAPD.

Aunt really wants a Med Sup and MSA can most def fund it. So - during MA Disenrollment - apply for MS and if she passes UW - switch her to MS and get a PDP. If not - stay where she is . . .

Uncle is super healthy - no doctors, drugs, etc. He can stay on MAPD and use the MSA to cover any costs MAPD doesn't cover . . .

Thoughts?

The people are already removed from group coverage. The companies are getting rid of their coverage. They are paying an allowance towards the retiree coverage. They have to do something. They cannot stand pat.

The companies are bringing in a 3rd party to supposedly assist with the changeover. AON, One Exchange, etc.

Most of them have a deal with those 3rd party companies that their employees have to purchase something from that 3rd party in order to receive their reimbursement.

I've dealt with 3 of these, AT&T, Whirlpool and GE. GE uses One Exchange. They have been the easiest of the 3. But all of them claim that they represent all of the companies available. That is simply not the truth. In this area Aetna and Equitable have the best rates and none of the exchanges offer either.

It is a lot of work as you have to get the forms for the reimbursements and get them in on time. But you do gain many clients if you understand how it works and get it handled for them just as though they went through the exchange. That is the only thing the exchange does for them, convenience. If you don't match that convenience they will just use the exchange and pay more.

It looks like I'm about to deal with another if this Peabody Coal scam they pulled with Patriot is allowed to be implemented. I'm hoping that gets settled though.

The worst users were the Whirlpool workers. I think Newby experienced the same thing. They would use the independent agent to get educated on their choices and then go back to the company and enroll there. I stopped meeting with the Whirlpool time wasters.

 

[jdeasy]

Just got off phone. You are correct - they have to enroll in at least one product from the Exchange to be eligible for the MSA. Going to look at the Dental and Vision options for that " one " product.

Also - they have $4200 a year to spend and unspent rolls over to a certain amount.

But it is so close to Dec 7th - here is my plan - please critique:

Switch them both to the Aetna MAPD.

Aunt really wants a Med Sup and MSA can most def fund it. So - during MA Disenrollment - apply for MS and if she passes UW - switch her to MS and get a PDP. If not - stay where she is . . .

Uncle is super healthy - no doctors, drugs, etc. He can stay on MAPD and use the MSA to cover any costs MAPD doesn't cover . . .

Thoughts?

I'm always going t prefer med sup over MA. Especially when someone else is paying for it.

Dec 7 has nothing to do with this situation.

 

[myinsurebiz]

I'm always going t prefer med sup over MA. Especially when someone else is paying for it.

Dec 7 has nothing to do with this situation.

If they want to switch MAPD's they have to do it by Dec 7th correct? They don't have a SEP. She stands a 50 / 50 chance of not passing UW for Sup.

 

[jdeasy]

If they want to switch MAPD's they have to do it by Dec 7th correct? They don't have a SEP. She stands a 50 / 50 chance of not passing UW for Sup.

No, not correct. This is not their AEP. This is an SEP. It's a loss of creditable coverage SEP. They are all GI for med sups and the company will give them letters to that effect. Whenever the coverage ends, assuming Dec 31?, they will have 63 days to get a sup, an MA plan, a PDP or an MAPD.

Now I'm going to give you some advice that you probably won't like, don't deal with this. Pass this on to someone that does know how to handle this. Maybe offer them a split and go to the meeting with that person.

 

[myinsurebiz]

No, not correct. This is not their AEP. This is an SEP. It's a loss of creditable coverage SEP. They are all GI for med sups and the company will give them letters to that effect. Whenever the coverage ends, assuming Dec 31?, they will have 63 days to get a sup, an MA plan, a PDP or an MAPD.

Now I'm going to give you some advice that you probably won't like, don't deal with this. Pass this on to someone that does know how to handle this. Maybe offer them a split and go to the meeting with that person.

How is this loss of credible coverage? The MAPD they are on is still in network - they just want to switch plan to a better plan which is a different carrier?

 

[jdeasy]

How is this loss of credible coverage? The MAPD they are on is still in network - they just want to switch plan to a better plan which is a different carrier?

No such thing as credible coverage. There is such a thing as creditable coverage.

We must be talking two different situations? When AT&T stopped providing medical coverage for their retirees and let a 3rd party, AON, handle the changeover they were all given loss of creditable coverage letters. We had to send those letters to the companies with the applications.

 

[myinsurebiz]

No such thing as credible coverage. There is such a thing as creditable coverage.

We must be talking two different situations? When AT&T stopped providing medical coverage for their retirees and let a 3rd party, AON, handle the changeover they were all given loss of creditable coverage letters. We had to send those letters to the companies with the applications.

Yea - they didnt lose coverage. Just want to switch plans for a better deal.

 

[jdeasy]

Yea - they didnt lose coverage. Just want to switch plans for a better deal.

So this is their 2nd or 3rd time around?

That is different. You will have to get the form to AON for them in order to continue to get reimbursed if they change.

For the lady wanting a sup just enrolling in a part D thru AON will knock her out of her MAPD. You won't have to disenroll her.

 

[myinsurebiz]

So this is their 2nd or 3rd time around?

That is different. You will have to get the form to AON for them in order to continue to get reimbursed if they change.

For the lady wanting a sup just enrolling in a part D thru AON will knock her out of her MAPD. You won't have to disenroll her.

Not the first time . . . She has the forms for reimbursement for the MSA.

They are going to do the vision and dental with Aon. Going to wait till January to apply for the Sup since she waited till the last minute . . .

thanks for the advice. Always appreciated.