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GA Medicare Expert
5000 Post Club
Which carriers seem to do the best job of underwriting individual health?

I have an app with a major carrier on a 35 year old male, non-smoker, 6' 1" + 230# and hypertension contolled with one med. The app was submitted on 10/25. Two weeks later underwriting decided to order an APS. Doctors records were sent on 11/17 and logged in to the carrier on 11/27. Called today and was told the underwriter should have a decision by the end of next week.

I stopped writing business (attempting to write) over a year ago because of underwriting issues.

Yesterday I took an app on a couple, ages 62 & 61. He has GERD, HBP & asthma (2 meds). She has MVP & GERD.

This couple was working with another agent + me. They liked us both and decided to let me submit the application to GR and the other agent to Time, despite the fact I represent both.

Obviously I would rather be the agent regardless of the final outcome, but they made their decision and not much I can do about it.

I expect to have a decision within a week from GR with riders on all pre-ex conditions.

My guess is Time will take upwards of 6 - 8 weeks, come back with a waiver on the MVP and asthma + rate up for GERD & HBP. If they rate it the way I think they will it will be +50% on both in addition to the riders. That will put the premium for Time around $300 more than GR.

I did pre-screen them with both carriers and all Time would say is 25% for HBP and rate for the meds on the GERD (which run $120/month each). I figure that is worth another 25% on each policy. They said either a 25% rate up on the MVP or a waiver.

Aetna, BX, Humana & KP have all indicated they would reject the wife due to MVP. My feeling at this point is, the GR offer will be the best.

Comments & feedback?
Aetna, no questions asked, end of discussion..... If it can't get issused with Aetna then you don't need them. However, I wont write the client you discussed, to many health problems. I would much rather do something else than dick with underwriters so...
Aetna turned the wife down in pre-screen. I figure GR is their best bet.

I don't waste time on folks that can't be helped, but I do pick up a lot of business, and referrals, by taking on the cases folks like you pass on. It really isn't that difficult once you understand the rules and how the game is played. I have been playing this game for over 30 years and know what an underwriter will do before they do.
I got the same auto decline from Aetna for a client with MVP (pretty common in taller women). I ended up submitting with Nationwide after a pre-screen and crossed my fingers. Client did not use antibiotics for prophylaxis except when visiting a dentist, which was acceptable according to underwriting. App was approved but rated up 50% and client grudgingly took the policy. I think she knew she was still getting a good deal to at least get covered.
I have had MVP clients (no treatment) accepted at standard before with other carriers. Depends on a lot of factors, but several carriers seem to consider a benign MVP without treatment as no big deal (as well they should).