Insurance Agent Forum

[al3]

And people wonder why I like to write GI voluntary supplements, or why I want to go into life or annuities, as opposed to IFP.

I really worked this case well. I told her that we could change things, etc. She was in UW for a month (age 33!). Was rated from tier 1 to tier 3!!

Some days you get the bear... and some days the bear gets you!**

-Al

From: A. Canton
Sent: Monday, August 06, 2007 8:42 PM
To: Jenny XXXXX
Subject: Blue Shield letter yet?

Hi Jenny:

You must have received the BS letter since I got one about you...
Except my copy does not have any medical information about why you
Were rated.

Are you OK with whatever they told you?

Al

Reply:

Hi Al,

No, I'm not ok with what they told me. I'm actually irritated. (I got my cards by the way).

They listed the following issues: (1)Me seeking treatment for tendonitis of my thumb. (2) Anna being treated for a UTI (which 2 days later lab results showed she DIDN'T have - not sure why the charts weren't updated) (3) Rich saw the doctor for migraines (and the dr. gave him some RX samples, but according to BS they think this is an ordered prescription - not true - he just takes Advil). (4) Rich has seasonal allergies (who doesn't?). (5) Rich's cholesterol was slightly elevated last year (which he didn't even know about and he's lost weight since then so I bet it's lower again).

So there you have it... that's why they rated us up. Petty things in my opinion. I know I can dispute this, and have a couple of the items removed/corrected, but I'm not dealing with this anymore. I'm upset at the way they've handled us, I don't like being rated up and I cancelled the policy yesterday (I'm getting a full refund of the deposit they took in
June).

My dad put us on a Kaiser plan, and their rates are better. I don't have a problem with Kaiser - it may not have been my first choice, but it's beating Blue Shield at this point.

I'm sorry I cancelled after all you have done for us. That was the most troubling part for me - knowing how much time you have spent helping us. But I'm relieved this is finally done and we have coverage; I don't have to keep filling out medical forms explaining every time I sneeze. And I don't have to keep waiting for approval letters, etc.

Thanks for your help, Al. I will be in touch as usual... and keep referring your name out accordingly.

Jenn

[arnguy]

Wow, al, I feel your pain. BTW, a NJ State Trooper said that quotation about the bear to me after a hearing at which I appealed a speeding ticket.

[Dave020]

In this case, the bear was very generous. I'm sorry but given this family's health history, T3 was a gift. That's standard + 25%. Not a bad offer for a guy with three major health issues.

I know I've said this before and I don't want to be a broken record, but T1 with Shield CA is 80% RAF, not the standard rate. Only the most healthy can get T1 rates. T2 is the standard rate at 100% RAF. If you quote T1, you may get burned to T2 from time to time.

Migraines are generally treated with Imitrex, go to drugstore.com and price a 30-day supply of those puppies. Allergy medications? Bet he takes something "seasonally" like maybe Allegra? Ongoing tendonitis is an unresolved medical condition that could require future surgery.

This case would have been a decline with Health Net, Pcare and should have been a decline with Kaiser. If they got a Kaiser plan, there is no way they disclosed all of this on the application if it is IFP.

I get these all the time, "I am perfectly healthy" and turns out they have a BMI of 39!

I'm sorry but the offer from BSC was very generous. Cross would have gone Level One +50 or +75 on this one. These are not petty things. UTI is petty, but the rate up was not for the UTI, it was just an additional on points - the parents pushed it to T3.

[Dave020]

Low dose Imitrex at Drugstore.com:

9 Tabs (25 mg) - $202.75

That's $22.74 per tablet! And that is the older medication for
Migraines. I am sure the newer stuff costs even more. 100 mg tabs are a better deal, only $19.91 per tab.

[salpro22]

1. What was the family paying before you helped her select the proposed plan?
2. What was the new rate?
3. Were you able to conduct a pre-screen? If BC or BS is anything like Anthem in VA you pretty much get a "it could fall anywhere between Tier 2-Tier 4 but we don't know the exact rate-up until we get the case!"
4. Is the ladies father an insurance agent?
5. What made her select KP?
6. Do you think you built up enough value in the plan you proposed?

This is the kicker that got me..........

My dad put us on a Kaiser plan, and their rates are better. I don't have a problem with Kaiser - it may not have been my first choice, but it's beating Blue Shield at this point.

I had a prospective client sign up on a plan at around $150 p/month about a week ago with Assurant. He did not verify his information via the Assurant website after 2 days and that is a red flag to me. I called the guy and he informed me that he changed his mind and submitted an application with KP that was around $250 p/month. Now keep in mind that $150 was at the top end of his monthly budget. He incorrectly assumed that I was calling in regards to the KP plan he picked out. Red flag number 2.

I talked to him and tried to find out the reasoning behind switching. He indicated during the 1st call that his sister recommended KP (she is not an agent). I would have sold him a KP had he been that adamant about it, but even the cheapest plan was $100 more a month than he could afford (see above figures).

Long story short, his sister got on the phone with me and decided that she would vent her feelings and discontent for my line of questioning. I pretty much was called every name in the book, even though I was the affable person at the time.

In the end, I highly doubt he will get covered as I found out he lied to me about his application (I took it out of underwriting), so I felt inclined to explain to both of them what WILL happen if they falsify information.

Live and learn...