New Golden Rule Plans...

[CHUMPS FROM OXFORD]

Effective in Ohio June 14th...and I assume some other States as well.

$35 copay on Copay Select instead of $25

Preferred/Standard 1 and Standard 2 rating tiers

Tobacco is no longer a rating class

X-Ray and Lab fees now covered at 80% (up to $300) on Copay Select.

RX capped at 3K per year (I kid you not!) But...there is a buyup to eliminate the cap

option to increase lifetime max to 5 mill.

Single parents and Divorcees rated up 20%

$5000 Ded. now available with Copay plans.

Buyup from 2-4 office visits on Saver plan.

Motorcycling adds 20% to rate.

And by the way...just kidding about the Single Parent/Divorcee change!

I haven't checked the new rates yet. I think there are going to be a lot of policies sold without the RX buyup. That will spell trouble...

 

[Crabcake Johnny]

And into the crapper goes GR.

 

[J.R.]

Effective in Ohio June 14th...and I assume some other States as well.

$35 copay on Copay Select instead of $25

Preferred/Standard 1 and Standard 2 rating tiers

Tobacco is no longer a rating class

X-Ray and Lab fees now covered at 80% (up to $300) on Copay Select.

RX capped at 3K per year (I kid you not!) But...there is a buyup to eliminate the cap

option to increase lifetime max to 5 mill.

Single parents and Divorcees rated up 20%

$5000 Ded. now available with Copay plans.

Buyup from 2-4 office visits on Saver plan.

Motorcycling adds 20% to rate.

And by the way...just kidding about the Single Parent/Divorcee change!

I haven't checked the new rates yet. I think there are going to be a lot of policies sold without the RX buyup. That will spell trouble...

Is the Rx cap on ALL plans?

 

[CHUMPS FROM OXFORD]

The Copay Select is the only one with the 3K cap. But, of course, some of the other policies do not cover RX (such as HSA Saver and Saver 80). Regular HSA and Plan 100 seems to be unaffected.

 

[CHUMPS FROM OXFORD]

Just noticed that a 6-0 male weight max went from 257 to 279 (Standard 2 rating).

Manute Bol still would not be able to get coverage though.

 

[somarco]

No changes for GA.

I never sell copay plans so it really wouldn't affect me any way. I have been pushing for an increased LT max, so it is good to know they finally came around on that. The higher deduct on the copay is something they needed to do as well.

Kinda surprised at the Rx cap. I don't see much of that here except the Saver & "Right" plans.

Interesting that Aetna is finally removing their Rx cap as of July 1.

Of course Time still wants to keep a copay + coinsurance on their Max & Core plans. I see no need to offer that kind of plan to my clients who want a copay when there are other solid carriers that don't play that kind of game.

 

[CHUMPS FROM OXFORD]

Aetna still has the RX cap in Ohio with the July 1 change. They talked about removing it, but I guess decided against it.

 

[Crabcake Johnny]

Well I've had some inside info about a few months that GR is in trouble. Take it with a grain of salt since this is all hearsay but word is their claims are going nuts and brokers sales are way down since '05 when they took away the advance to agents directly. Also, it used to be 50 apps to get a Key Broker deal, now up to 150 which also hurts.

IMHO if this $3,000 cap happens the "buy up" will price the plans out of range. Not a good sign that they're looking to raise rates and lower benefits. Normally the sign of huge internal problems. I don't write for 'em anyway so I'm not affected.

Also IMHO if GR doesn't pull their weight then watch for UHC to drop them like a hot potato.

 

[trvlnut]

If UHC drops them, then maybe UHC will come to AZ with it's own individual plan instead of having the FACT association.

 

[Crabcake Johnny]

Golden Rule was an "also ran" before UHC picked them up. If sales/profits are off UHC is simply too large of a company to babbysit. Golden Rule is far too reliant on their call centers who are not the most ethical of agents. Word is their persistency is absolutely horrible.

Also, too many deals off the books long-term. Insurance companies take a loss on the 1st year wiht marketing, underwriting and commissions and count on future years on the books for profits. GR in the past has relied on a ton of new business sales to make up for a lack of people sticking around. When new business sales drop and persistency is bad that spells trouble - hence the raise in rates and caps on meds.

You take Assurant, and the deductibles on copay plans go up to $25,000 and the OOP can go up to $7,500. That's important for renewals so people can stay on the books for years and years. As years go by and rate climbs up there Assurant allows clients to raise their deductible or OOP without re-underwriting. GR does not allow that nor would it matter since the deductible is $2,500 max and OOP is fixed. That means no options are renewal which means everyone's off the books. That also why I don't put any more cases with GR - they erase your entire block of business over the course of 2 to 3 years and you start from scratch. No thanks.