My vent to Blue Shield

[Guest]

This is my vent to Blue Shield, sent to the regional sales woman. It won't help, but it made ME feel better. I'm 'sick' of health insurance companies and their UWs. Getting into annuities and/or the GI senior market can't come soon enough for me!!!

Dear XXXX:

Have a case (53 year old woman) pending now with BS sent for APS for going to ob-gyn for 'hot flash' and getting 0.3 mg of PremPro 1/day. And you wonder why no one wants to send you guys any business? Your UW couldn't do a phone call and take care of this in 2 minutes, the way Aetna does?

Hey, Nationwide has some butt-kicking rates for one of their HSA plans. I don't know their UW, but it has to be better than BS! I just sent in my appointment papers.

I'm just frustrated with BS underwriting and about ready to give up on BS. Underwriters and home-office staff have zero idea how hard it is to make a sale and/or money in this business. They are all on salary... makes no difference at all to them if cases are approved, declined, or pended. They get paid no matter what.

A single payor (Sheila Kuhl) gov. system with private sector G.I. supplements (as done in Medicare) is looking darn good to me (and a lot of agents) right about now!

I talk to a lot of agents throughout CA and they all say the same... Blue Shield is becoming a "Why bother!"

APS for hot flashes and PremPro? That's UW out of control. And that's how I will explain it to client... as I urge her to put in an app with Blue Cross or Aetna.

Thanks for the vent. I know it's not your fault... but the HO might listen to you... no way anyone in San Francisco would listen to me!

Al

 

[Crabcake Johnny]

Carefirst in MD is the same. If there's a pre-ex condition it's an APS. "Allow 4 to 6 weeks for underwriting." I've had BC cases go three months. It is what it is. When I do BS it means I cannot put them anywhere else. As it stands right now GR gets 1st dibs, then Coventry, then Assurant, then Aetna and BS brings up the rear.

 

[BKrocko]

John - When did GR move up to 1st place with you? I knew Coventry came out with a co pay plan that you liked and dropped Assurant down a notch.

Coventry is not in CO and GR is a middle of the road player here (HSA is competitive). As you know, Assurant has priced itself out of most of our market for now (good for maternity).

Is GR still represented as an association based plan there?

al3 - underwriting is a PITA no matter what industry. P&C/Life/Health/Senior Market/Mortgate etc. I think the HR Dept. in the corporate world is staffed with ex underwriters. They are there to cover the interests of the company and themselves. I know it feels better but don't cut off your nose to spite your face. Underwriters always seem like a cowardly bunch to me, but like John said - it is what it is.

 

[K-Dub]

This is my vent to Blue Shield, sent to the regional sales woman. It won't help, but it made ME feel better. I'm 'sick' of health insurance companies and their UWs. Getting into annuities and/or the GI senior market can't come soon enough for me!!!

Anthem BCBS here in Colorado is no picnic either! If there are ANY pre-x's I will look at another carrier. If there are no pre-x's I will STILL look at another carrier. Their customer service is lacking, plans are lacking, and billing and claims are REALLY lacking!!

Bottom line....I'm just glad their rates are NOT competitive when it comes to the Colorado market!! Give me a reason not to present them!

 

[senior-advisor-indiana]

Senior market med supps are great. Its either issued or declined. No rate ups(except smoking) or pre ex.I haven't had an app declined in 2 years. You know before you finish the app if they qualify. LTC on the other hand is probably worse than Major med.

 

[CHUMPS FROM OXFORD]

Oddly...if you have a pre-x including diabetes (non-insulin)...BC is the best carrier around here (sometimes Aetna).

 

[SME]

Senior market med supps are great. Its either issued or declined. No rate ups(except smoking) or pre ex.I haven't had an app declined in 2 years. You know before you finish the app if they qualify. LTC on the other hand is probably worse than Major med.

LTC can be tough. When I sold it I told the applicant that this was a Hurry, Hurry, Wait game. You hurry to take the app, you hurry to get the exam and then you wait for the underwriter to want something else.
As John said it is what it is.

 

[Guest]

Today Blue Shield APSd another case. I sent the rep an email titled "No soup for you."

Dear XXX:

Another case is APSd, this time for a sprained ankle on a 32 year old male... two years ago... where the 'prescription' was ice and rest... and there has been no other problems with it. He went to an ER (happened at night). Do you know how long it will take the ER doctor to find the records and send them to WFI? Probably a month.... maybe never! What agent needs THAT!

"No soup for you." I'm not sending any more business your way until you folks get your underwriting under control. Your company is making me look bad in that it is MY recommendation that they apply to you in the first place. No more. I have Blue Cross, Aetna, and as of Friday, Nationwide to write for.

I know it's not your fault XXX, but what do you want me to do? How do I make a living writing for Blue Shield?

You didn't respond to my last letter, so I assume no one in BS-CA cares anyway.

Respectfully,

Al

 

[Crabcake Johnny]

Blue Cross in CA just got hammered with a 1 million dollar fine for post-claims underwriting. I imagine their response to that is just get an APS.

 

[Crabcake Johnny]

John - When did GR move up to 1st place with you? I knew Coventry came out with a co pay plan that you liked and dropped Assurant down a notch.

Coventry is not in CO and GR is a middle of the road player here (HSA is competitive). As you know, Assurant has priced itself out of most of our market for now (good for maternity).

Is GR still represented as an association based plan there?

al3 - underwriting is a PITA no matter what industry. P&C/Life/Health/Senior Market/Mortgate etc. I think the HR Dept. in the corporate world is staffed with ex underwriters. They are there to cover the interests of the company and themselves. I know it feels better but don't cut off your nose to spite your face. Underwriters always seem like a cowardly bunch to me, but like John said - it is what it is.

Assurant's getting kicked to the curb since they've jacked the rates each quarter in MD for the last three quarters. Not like they weren't already about 15% higher then their competitors here - which I could live with. Now they are 50% higher which is a no-go.

On top of that they changed the coinsurance options so not only are they higher, but they've structured the rates to be competitive with a $3,500 OOP.

You want apples to apples now? Male 40, female 40, 2 kids, standard.

MD zip code 21113 - $2,500 deductible, 80/20 $2,000 OOP

Assurant Max w/copay: $698
GR Select: $417 (include RX buy-up)

Assurant Max w/0 copay: $519
GR Plan 80: $253

Assurant HSA: $405
GR HSA: $340

I'd still not a rider fan but GR assured me that in MD they are not doing any more riders for HBP - just an increased deductible.

Drugs will be dilemma for me. Say I have a client on two meds and GR wants to take away med coverage. However, if it's $200 a month or more to get Assurant and the meds covered the obvious question is "are they on $200 a month worth of meds."

I also have to look into whether or not when GR takes away med coverage that means they don't get any meds, even for a new condition. In that case I'll have to find a plan B.