helpful_agent
New Member
- 6
Hi, all -
Thanks again for offering such a fantastic forum. I can't begin to tell you how much I've learned here. I apologize in advance, as this post is going to fall into the "venting" category!
I'm writing to see if my recent experiences are just a string of bad luck or if they are the norm in the independent health market.
I took over my father's business when he passed away and have worked with a local GA to revisit his active clients who've had rate increases and need to change carriers. My first few experiences with this were ideal -- relatively healthy people who were easily accepted by their new carrier.
In the last month, however, I've run into several road blocks and am starting to get extremely frustrated with "the system." I'm not necessarily mad at the carriers -- insurance is called "insurance" for a reason, and it makes sense that they'll decline people with health issues. I'm more upset with the powers-that-be who allow corporate employees to enjoy guaranteed approval while small business owners fret over a sinus infection for fear of being locked out of good coverage.
Here are the specific examples that are driving me nuts:
1) Forty-ish year old man had open-heart two years ago. Won't be able to re-apply with any carrier until 2009. Vulnerable to soaring rate increases until then.
2) Forty-ish husband and wife. Husband had successful hernia surgery in November '06 and wife has history of depression including one hospitalization and daily medication. They'll get accepted with the new carrier, but both conditions will be ridered. Currently weighing whether it's worth it to switch providers given these restrictions.
3) Sixty-ish husband and late-fifties wife. Husband sailed through underwriting without a problem, despite the fact that he hasn't been to the doctor in ten years. (In theory, he could have all sorts of undiagnosed medical issues, but the carrier did not request a physical.) Wife had high cholesterol results at a health fair last summer, went to her primary care physician, and was tossed into a month-long series of unnecessary and misread tests. Carrier requested her medical records and found she has cholesterol of 260 (refused treatment), marginally high b.p. (controlled with moderate meds), liver and kidney cysts (her doc says "everyone" has these), moderately high blood glucose levels, and GERD. Automatic decline, and my GA says no carrier in their right mind will touch her. She's now stuck with her old plan and its doubled-rates. Despite being a very kind woman, she's now VERY mad at me because I'm not able to reverse the Decline. Her stance: "Everyone at my age has these problems." The trick is -- she's pretty much right. We'll probably switch her husband to the new policy, but they'll pay a combined $700/mo. for high-deductible plans.
4) New renewal notice that I haven't touched yet -- will probably break down and call this afternoon. Forty-ish couple who's rates doubled from $350/mo. to $700/mo. with Assurant at renewal. I'm sure I'll make that call to the client and find out they've accumulated 10 new medical problems between them and aren't touchable by any other carrier. Wanna bet?
So, after all that, here's my question: is it that difficult to find healthy small-business owners who are capable of getting through underwriting? Is it normal to have four-in-a-row in the "problem-children" category? These aren't random #'s out of a phone book. They're all clients who had at some point been healthy and have had coverage through my Dad for 5-10 years. They're good people, and it literally sickens me to watch them pay $700/mo. (and rising) for high deductible plans that don't really offer much bang for the buck.
Thanks in advance for any little bit of inspiriation (or commiseration) you can share! And, thanks for listening :?
Thanks again for offering such a fantastic forum. I can't begin to tell you how much I've learned here. I apologize in advance, as this post is going to fall into the "venting" category!
I'm writing to see if my recent experiences are just a string of bad luck or if they are the norm in the independent health market.
I took over my father's business when he passed away and have worked with a local GA to revisit his active clients who've had rate increases and need to change carriers. My first few experiences with this were ideal -- relatively healthy people who were easily accepted by their new carrier.
In the last month, however, I've run into several road blocks and am starting to get extremely frustrated with "the system." I'm not necessarily mad at the carriers -- insurance is called "insurance" for a reason, and it makes sense that they'll decline people with health issues. I'm more upset with the powers-that-be who allow corporate employees to enjoy guaranteed approval while small business owners fret over a sinus infection for fear of being locked out of good coverage.
Here are the specific examples that are driving me nuts:
1) Forty-ish year old man had open-heart two years ago. Won't be able to re-apply with any carrier until 2009. Vulnerable to soaring rate increases until then.
2) Forty-ish husband and wife. Husband had successful hernia surgery in November '06 and wife has history of depression including one hospitalization and daily medication. They'll get accepted with the new carrier, but both conditions will be ridered. Currently weighing whether it's worth it to switch providers given these restrictions.
3) Sixty-ish husband and late-fifties wife. Husband sailed through underwriting without a problem, despite the fact that he hasn't been to the doctor in ten years. (In theory, he could have all sorts of undiagnosed medical issues, but the carrier did not request a physical.) Wife had high cholesterol results at a health fair last summer, went to her primary care physician, and was tossed into a month-long series of unnecessary and misread tests. Carrier requested her medical records and found she has cholesterol of 260 (refused treatment), marginally high b.p. (controlled with moderate meds), liver and kidney cysts (her doc says "everyone" has these), moderately high blood glucose levels, and GERD. Automatic decline, and my GA says no carrier in their right mind will touch her. She's now stuck with her old plan and its doubled-rates. Despite being a very kind woman, she's now VERY mad at me because I'm not able to reverse the Decline. Her stance: "Everyone at my age has these problems." The trick is -- she's pretty much right. We'll probably switch her husband to the new policy, but they'll pay a combined $700/mo. for high-deductible plans.
4) New renewal notice that I haven't touched yet -- will probably break down and call this afternoon. Forty-ish couple who's rates doubled from $350/mo. to $700/mo. with Assurant at renewal. I'm sure I'll make that call to the client and find out they've accumulated 10 new medical problems between them and aren't touchable by any other carrier. Wanna bet?
So, after all that, here's my question: is it that difficult to find healthy small-business owners who are capable of getting through underwriting? Is it normal to have four-in-a-row in the "problem-children" category? These aren't random #'s out of a phone book. They're all clients who had at some point been healthy and have had coverage through my Dad for 5-10 years. They're good people, and it literally sickens me to watch them pay $700/mo. (and rising) for high deductible plans that don't really offer much bang for the buck.
Thanks in advance for any little bit of inspiriation (or commiseration) you can share! And, thanks for listening :?
