Agents Make Me Sad

[Dave020]

Last I checked small group was not guarantee issue in most states, maybe cali is different. I have not written it in a while, though.

Yes, in CA 2-50 is guaranteed-issue if they meet the requirements and can only be rated 10% above standard cost at the the highest risk adjustment factor. That is why I asked.

 

[Josh]

@joshua: one of the links in your signature is broken.

 

[HomeService]

Yes, in CA 2-50 is guaranteed-issue if they meet the requirements and can only be rated 10% above standard cost at the the highest risk adjustment factor. That is why I asked.

I don't think we have that in TX, we might, I dunno, it's been a while. But if this is the case, Obama lied in all his healthcare speeches where he said all insurance companies are bad and millions cannot get coverage. And he lied about them raising rates through the roof, for no reason.

 

[DS4]

It is a small business with a couple full-time employees..... I live in Huntington, Indiana

GI down to 2 in Indiana,
http://coverageforall.org/pdf/matrix/IN_Matrix.pdf

 

[VolAgent]

GI down to 2 in Indiana,
http://coverageforall.org/pdf/matrix/IN_Matrix.pdf

Maybe one day this woman will meet a real agent who can actually help her solve her problems.

 

[DS4]

I had a telephone call the other day.
Business owner on Medicare with one FT EE. EE's wife is 6 months pregnant.
The owner had spoken to seveal other agents trying to secure coverage for EE. No luck other that PCIP for EE.

ME: Why not write a group health plan for your business?.
Owner: We don't qualify because of only one EE.
ME: What???
Owner: The other agents told me I would also need to enroll in order to get to 2 ee's.
Me: The other agents are all F@#king idiots!
Me: Because you have Medicare, that is a valid waiver. You still count as one EE. Your EE enrolls. Pregnancy is covered.

 

[Dave020]

I had a telephone call the other day.
Business owner on Medicare with one FT EE. EE's wife is 6 months pregnant.
The owner had spoken to seveal other agents trying to secure coverage for EE. No luck other that PCIP for EE.

ME: Why not write a group health plan for your business?.
Owner: We don't qualify because of only one EE.
ME: What???
Owner: The other agents told me I would also need to enroll in order to get to 2 ee's.
Me: The other agents are all F@#king idiots!
Me: Because you have Medicare, that is a valid waiver. You still count as one EE. Your EE enrolls. Pregnancy is covered.

I have a few of those. When 1 of 2 EEs went to Medicare (but continued in the business) broker told them remaining EE they had to buy HIPAA. We talked, I BOR'd the case and kept the group in place on the 1 EE.
- - - - - - - - - - - - - - - - - -

GI down to 2 in Indiana,
http://coverageforall.org/pdf/matrix/IN_Matrix.pdf

As I suspected, GI 2-50 same as CA. Cases like this are bad targets for IFP with List Bill when you have any EEs who are uninsurable. This could have been re-written as a small group plan with the new agent and the lady could have major med on a GI basis.

 

[DS4]

Cases like this are bad targets for IFP with List Bill when you have any EEs who are uninsurable.

And not just because of an uninsurable ee.

I had a recent lead from an employer with 14 FT ee's.
No group health plan.
The employer told me he would gave all his FT EE's $150/mo for health insurance.
7 EE's had group coverage from their spouses. They declined.
5 EE's had individual plans with various carriers.
The other 2 EE's declined.
I asked the employer how he worked the $150 credit worked? He told me that when the EE's rec'd their premium statements, they would bring them to the employer. The employer would write a company check for $150, the employee wrote a check for the balance.
This was all fine and dandy until a recent IRS audit.
IRS retro disallowed the $150 monthly write off to the employer.
Worse yet, the EE's that rec'd the $150 pymt? IRS went back and retro added the $150 monthly payment to each of their gross incomes. The EE's were left with large retro tax burdens.
So, don't comingle employer monies with individual health plans.
I should also note.... I gave this lead to the group guy in my office who was able to write a group health plan for the employer.
I quit doing group health several yrs ago as Medicare business now keeps me busy.

 

[Dave020]

Sounds like we are of the same mind. We should meet up someday and talk insurance

And not just because of an uninsurable ee.

I had a recent lead from an employer with 14 FT ee's.
No group health plan.
The employer told me he would gave all his FT EE's $150/mo for health insurance.
7 EE's had group coverage from their spouses. They declined.
5 EE's had individual plans with various carriers.
The other 2 EE's declined.
I asked the employer how he worked the $150 credit worked? He told me that when the EE's rec'd their premium statements, they would bring them to the employer. The employer would write a company check for $150, the employee wrote a check for the balance.
This was all fine and dandy until a recent IRS audit.
IRS retro disallowed the $150 monthly write off to the employer.
Worse yet, the EE's that rec'd the $150 pymt? IRS went back and retro added the $150 monthly payment to each of their gross incomes. The EE's were left with large retro tax burdens.
So, don't comingle employer monies with individual health plans.
I should also note.... I gave this lead to the group guy in my office who was able to write a group health plan for the employer.
I quit doing group health several yrs ago as Medicare business now keeps me busy.

 

[DS4]

Sounds like we are of the same mind. We should meet up someday and talk insurance

Rick told me I wouldn't like you.