Hello. My name is Jeff XXXXXXXX and I was referred to you by XXXXXX XXXXXX, who works with me. Here is my situation. I am 51 and going through a divorce. I am required t furnish health coverage for my soon to be ex-wife. She is also 51 and has no medical issues. I want the absolute worst possible coverage with the highest deductible you can find. I am not required to furnish office visit or prescription coverage. Just major things. Please call me at your earliest convenience. I'm located about an hour and a half from you in Westerville, so perhaps you could mail me all of the forms with your recommendations. Thanks Jeff
Funny...but sad. Anyhow, after speaking with him and documenting that this is truly what he wants, I sent him the paperwork on a $93 monthly policy from Aetna that has a $ 5 mill cap and a $3000 deducible. Preventive coverage is even included, although he won't like that.
I attached a short disclaimer for his wife to sign as well.
How did it compare with a Core Med with $10k deductible or Max with $25k?
It is their P&H Care 3000 plan.
The Assurant Core Med ($10K ded. 80% with no facil fees or office visits) was $85. He thought about that one, but must have softened up a bit and bit the bullet for the extra 8 bucks per month. The Max plan was $68 but he again, didn't want the high ded.
And John...I understand your feelings on that one. I thought about passing, but when he softened up a bit, I figured he was all talk.
I'm always thinking about potential liability and my brother is an attorney so I think along those lines also. If you really did give "the worst" coverage to spite the wife that's not only an ethical violation, possible an insurance violation but also a slam dunk lawsuit if the wife were even to find out that you colluded with the husband to design a poor plan.
That being said, it is funny as hell.
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I'm always thinking about potential liability and my brother is an attorney so I think along those lines also. If you really did give "the worst" coverage to spite the wife that's not only an ethical violation, possible an insurance violation but also a slam dunk lawsuit if the wife were even to find out that you colluded with the husband to design a poor plan.
That being said, it is funny as hell.
After 26 years in the business, believe me...I am always thinking about liability issues. Most of you aren't as involved in the Financial Planning side of the business as I am. There are plenty of NASD and SEC regulations that keep you on your toes.
Ironically, the policy I offered was clearly not one of the worst, but one of the least expensive. I'm not aware of any collusion to design a poor plan. Perhaps you misunderstood my wording.
I could have totally sold this guy a family HSA ....with the point that yes even though you have to furnish health insurance .......but your also on the hook for half of your sons out of pocket expenses that the health insurance puts toward any deductible and expenses not cover.......
[quote=CHUMPS FROM OXFORD;11136]Bizarre...but true...
I received this email late last week:
The ex-wife is the client not -the husband -and your duty is to her and she needs to speak directly with you. If the husband wants to talk to you to get an idea of what is out and about for policies so that he can know what his options might be, since he has to pay for it, then I suppose there is room for that but you can't be colluding with him to provide inferior coverage and at the same time working in the best interests of the client. I assume that the court order orders him to pay for her reasonable health insurance coverage costs rather than ordering him to be a policy owner for her which would be bizarre. If he is not the policy owner and only a reimburser then she is the client and the duty is to her best interests and full disclosure to her.
As I mentioned, I dont think it is inappropriate for him to be asking and learning about what the options are to minimally meet his court ordered requirement. The poor bastard may not even be able to afford coverage for himself after the divorce so I dont bring any judgement to him or for his anger but that is why she needs to be attended to by someone on her side. It is all a matter of intent. If you sell her a policy that leaves a gap in an area where she thinks she is covered or entitled to more it will be no defense to say that the hubster didnt want that. In fact, that will hang you because it shows that you were taking orders from him. Be careful.
Great post. This all goes potentially south when you get the ex-wife on the phone...which you have to do not only to explain the coverage but also conduct the health history. If it's not a plan she likes then it turns into a nightmare.
Keep in mind...that she is the one that will be signing the application. She also signs a statement indicating that she has received the accompanying brochure that explains her policy as well as other available policies.
Standard op in cases like this.
I'm comfortable with this one. The ex-hubbie to be actually gets a decent policy for her and he pays less than $100 per month.
I dont see any liability issues. The guy paying the premium is not your client. I would consider giving the wifey a chance to upgrade out of her pocket.
The post where the wife is the client is the correct post. The ex-husband has nothing to do with this aside from providing his billing information. The agent must go through all the plans and details with the ex-wife, not the husband so there are no ethical issues here at all.
The Worst Possible Policy...
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