Assurant on CBS news tonight

[NHB_MMA]

STM = short term medical

Although some will disagree, there is a market for the product. I don't write a lot but will write 20 - 30 cases per year. Good when other products don't fit and especially if the person is in between group cover.

As for being a one trick pony, there are NO carriers that can fit all your clients needs. With Time, if they don't want the One Deductible you really have nothing else of value to offer.

STM policies are great for the right market. The ideal market is college grads right out of school that are having difficulty finding decent work with benefits right away. Beyond that, you might be looking at a person beyond college age, but if you get into 45+ or whatever, I'd be very hesitant unless they've not seen a doctor for most of their life.

 

[STIBROKER]

if I sell a STM it is for the sole purpose to preserve hippa credits.....I tell my clients don't even try to use it....so I do not see all this stemming from the STM market....but it looks like it assurants time in the spot light.....wellpoint has just been there and done that......but man some of the comments....


Slaadams ... apparently you're missing the point that the insurers are denying THE ORIGINAL CLAIMS; thereafter we BECOME uninsurable! You know, this is just one of those things where you do not appreciate the life-and-death nature of a thing until it HAPPENS TO YOU. Fortis/Assurant was manipulative, deceptive and insulting for two entire years. They were masters of putting things off, hoping you'd go away or die. They ruined my life. Without the love of family and friends I would have wound up on the street. I believe in karma, even the corporate variety; I hope it comes around in time for me to see it.



I think John IS on the case from DL already.......

I have been in the health benefits business for over 20 years, I have spoken nationally and been published multiple times on topics ranging from ehealth, disease management to consumer directed healthcare. During my career I have processed claims, investigated claims, written benefit plans, performed data analysis on millions of healthcare records, sold large group and individual health insurance, and consulted with physician and hospital groups. I have experience with every facet of health insurance, and there aren't many people who can match my experience or accomplishments in this space.

During my career, I have never seen someone declined coverage for routine acne or athletes foot from a reputable health insurance company. Also, Assurant is a quality company who probably has one of the best customer service departments I have ever worked with.

Every carrier has a fraud or claims investigation unit. It is their job to make sure that claims are not being paid on policies where someone did not honestly answer the medical questionnaire. What the report fails to mention is that this practice keeps premiums affordable for those of us who get coverage when we are healthy.

People who lie on their application and purchase coverage after they get sick make health insurance much more expensive for all of us. As a consumer, I am glad the insurers protect honest and responsible people who know they have to buy insurance when they are healthy.

 

[TheSalesWolf]

Rush Limbaugh? I heard that they didn't cover him because of his pre-existing PAINKILLER addiction.

That report sucks for Assurant however I'm sure they could have put in Insurance Carrier on a dart board and come up with the same report.

 

[NHB_MMA]

INDIVIDUAL HEALTH
​

Individual health is a great product for the right person. Many people can't even get group coverage through other means. Here in PA, I don't believe we have a state risk pool, but Highmark has guaranteed issue plans. Thank God people that have health issues can get this coverage, however expensive it may be. I think there is a period of time where pre-existing conditions are not covered, but are covered after like 6 or 12 months. It's also good that self-employed individuals and others that have no access to group coverage can purchase individual health plans. There is a real market for these plans.

That being said, there are only two areas where individual plans are better than group: price and ability to customize. Although the price and customization are significant, individual health actually sucks in every other aspect. Individual health plans will always be cheaper. This is often a non-issue with someone that has access to group, because an employer will usually be paying at least 50% or so of the premium. Yet, if partners Billy Bob and Jed want to get coverage for them and their families, there is no question they would be save money with two individual policies rather than forming a group plan. People have different ways of thinking too. Some want the high deductibles and others don't like the idea of paying out of pocket, preferring low deductibles. Most individual health plans have many options available and are good in that regard. Although, I must say, I've never worked for an employer that didn't offer at least 3 or 4 different options, including both traditional and HMO plans.

What is a huge difference between individual and group is the ability for insurers to put a tremendous amount of exclusions in the individual plans. The guidelines for group are pretty much established and standardized, but individual plans put so much stuff in their policies that they could potentially make an argument against almost any claim. The beauty of my group coverage is that if my upcoming backyard fireworks show goes bad, at least I know they'll pay to get those fingers sewn back on. If I break a leg on a stupid, drunken dare, it will be covered. Individual plans would deny those in a heartbeat. My personal favorite has to be the woman that does not bother paying for maternity since her intended family is complete, and then has an "opps" baby later. Or how about the teen daughter that gets knocked up? Maternity coverage is not even available for such cases. I would, any day of the week, gladly pay more money for group coverage. In fact, if I ever go indy and see individual health among my products I personally will probably join the chamber of commerce to get group coverage for myself.

None of that even begins to address the underwriting issues, which are a huge problem with individual plans. It varies by company, obviously, but some plans are so ridiculous in their underwriting requirements, as was featured on CBS news the previous night. I mean, companies asking if a person has EVER had a headache...that should never be allowed.

Individual health is a good product, but it has to be used for the right market and definitely need some regulatory oversight added in some areas.​

 

[J.R.]

Rush Limbaugh? I heard that they didn't cover him because of his pre-existing PAINKILLER addiction.

That report sucks for Assurant however I'm sure they could have put in Insurance Carrier on a dart board and come up with the same report.

HaHa, good one. I agree with you. If you think about it folks, the media is a very powerful medium for any social issue. The problem arises when people take the news at face value w/out employing critical skills. These are the same people who go ape $#$# when the price of gasoline goes up and jam back the station while I have to wait 30 fricking minutes. Here is an idea.....get the gasoline late at night (same technique works for grocery shopping) or fill up once or twice like the rest of us. Alright, I'm done... Borat Out!

 

[NHB_MMA]

Rush Limbaugh? I heard that they didn't cover him because of his pre-existing PAINKILLER addiction.

I wonder if the EIB network got Lloyds to insure the "golden microphone" for a billion bucks or something? Maybe they insured the talent "on loan from God" too.

 

[NHB_MMA]

During my career, I have never seen someone declined coverage for routine acne or athletes foot from a reputable health insurance company. Also, Assurant is a quality company who probably has one of the best customer service departments I have ever worked with.

I'm sure those are exceptions too. The questions on the app bother me about a company potentially denying a claim more than these odd cases that the Wed. report spoke of. I mean, an insurance company is just losing money, I would think, if the only reason for a denial is acne or athletes foot.

Every carrier has a fraud or claims investigation unit. It is their job to make sure that claims are not being paid on policies where someone did not honestly answer the medical questionnaire. What the report fails to mention is that this practice keeps premiums affordable for those of us who get coverage when we are healthy.

People who lie on their application and purchase coverage after they get sick make health insurance much more expensive for all of us. As a consumer, I am glad the insurers protect honest and responsible people who know they have to buy insurance when they are healthy.

Yes, but if they have a persons medical records and previous insurance applications what can possibly be an excuse for something major slipping through. If the insurance company has the records and something slips through, that should be on them.

 

[STIBROKER]

individual health actually sucks in every other aspect.​

If you understand that individual health insurance is a membership card to get you into a private club they call a hosp..... and if the hosp. is fixing to lay out $100,000 worth of work on you they know they are going to get a big chunk of that back they will give you the best treatment available.... and individual health is not the comprehensive up front fist dollar benifit plan that it use to be or like some group plans and you can help your clients understand this the better off everyones going to be..( IN TODAYS MARKET IF YOU CAN GET MOST OF IT PAID THE REST IS NEGOTIABLE )..and guys flopping your clients every year is not in your clients best interest.......because after 2 years a health company CAN NOT DENY A CLAIM....no matter how the application was filled out.....so in my book I keep my clients away from association plans that will run off clients in a heart beat after two years with rate increases and try to stay with co's that age band their rates.....
​

 

[J.R.]

because after 2 years a health company CAN NOT DENYA CLAIM....no matter how the application was filled out.....

I have heard this before. What law, regulation, etc. is that under so I can research it? thanks...

 

[STIBROKER]

I have heard this before. What law, regulation, etc. is that under so I can research it? thanks...

http://www.answers.com/topic/non-contestability-clause
Non-Contestability [Incontestability] Clause


a provision in an insurance policy that precludes the insurer from disputing the validity of the policy on the basis of fraud or mistake after a specified period. If the insurer wishes to contest the policy on any grounds that would justify rescission of it, it must do so within the prescribed period, either by suing to cancel the policy or by asserting fraud or misrepresentation as a defense in an action instituted by the policyholder or beneficiary. 237 P. 2d 510, 512. The purpose of the clause is to require the insurer to investigate the accuracy of the information provided by the policyholder with reasonable promptness. It prevents the insurer from lulling the policyholder into a sense of security during the time when facts could best be ascertained, only to litigate them belatedly. Couch, Cyclopedia of Insurance Law §72.1 (3d ed. 1995).