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Pulled the trigger
Old 02-23-2011, 11:32 AM   #21
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Pulled the trigger

Well, we submitted our application to UHC yesterday. Now we have to just wait and see. Hopefully, everything works out ok and we get the insurance at the premium quoted. (All this for a 10,000 deductible! Hopefully, we won't have to actually use it before we are eligible for Medicare in 10 years.)

I will glad when this is finally over. I can't believe that people are actually protesting to keep this system. Totally, unfair for someone unlucky enough to get sick or in an accident or so busy with the business of life that they accidently let their insurance lapse (my SIL falls in this category. SHe has sleep apnea and got the expiration date of her COBRA mixed up when her sister (and room mate) got stage 4 breast cancer. She is paying $849 a month.)
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Old 02-23-2011, 12:26 PM   #22
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And not only is it difficult to get insurance, it can also be difficult to keep it. We have automatic checking withdrawal for our premiums ($1100 a month for DH, $350 for me), but every month I only rest easy when I see it has actually been deducted. I was paranoid about this since we started since I knew that insurance companies could drop someone for an unpaid premium, but even more so after hearing about the Colorado veteran who had his insurance stopped in the midst of undergoing cancer treatment because his wife had accidentally underpaid the premium by two cents!

http://www.theinsurancenation.com/ge...-by-two-cents/

I completely understand that insurance companies require premiums to be paid in full. They're not charities. But two cents short? It seems that most people who can pay $328 a month would also be able to come up with two pennies more, so they obviously weren't trying to stiff the company. But is the company trying to stiff the patient...and save money by no longer covering him and his expensive cancer treatments?
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Old 02-23-2011, 02:48 PM   #23
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Thanks for sharing that article. I had forgotten how terrible the rules are on paying premiums on time. You know the COBRA co had 30 days after the deadline to tell them about the 2 cents before the insurance was canceled. I wonder if they get a commission on the ones that make mistakes like that.

THe company administering my health insurance when I was let go (not COBRA but part of my severance) let three months go by before they told us we were a few cents off. They were threatening to cancel us the day before we were going on vacation for a month.

I guess having UHC deduct the premium from our account has some advantages after all. Now, since we are setting up a different checking account for it, we will have to make sure it's funded!

I have heard the new law has some consumer protections to avoid this silliness. I hope it's correct.
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Old 02-23-2011, 04:20 PM   #24
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Well, we submitted our application to UHC yesterday. Now we have to just wait and see. Hopefully, everything works out ok and we get the insurance at the premium quoted. (All this for a 10,000 deductible! Hopefully, we won't have to actually use it before we are eligible for Medicare in 10 years.)
Good luck. Thought about applying elsewhere - just in case?

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I will glad when this is finally over. I can't believe that people are actually protesting to keep this system. Totally, unfair for someone unlucky enough to get sick or in an accident or so busy with the business of life that they accidently let their insurance lapse (my SIL falls in this category. SHe has sleep apnea and got the expiration date of her COBRA mixed up when her sister (and room mate) got stage 4 breast cancer. She is paying $849 a month.)
I think the folks that want the current system don't want this, they just don't really believe it is such a problem. Just look at the responses at this thread and the article you referenced, and the numerous other threads 'round here you have posted in.

I did read somewhere that the insurance industry has agreed to stop canceling policies once people get sick. Hope it's true.
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Old 02-23-2011, 09:36 PM   #25
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I don't understand why insurance companies are not mandated to have a single pool of insured - ie. per company. Why should individual health be a separate pool from group insured? The delta risk per individual is much lower if the pool is larger.
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Old 02-23-2011, 11:26 PM   #26
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I don't understand why insurance companies are not mandated to have a single pool of insured - ie. per company. Why should individual health be a separate pool from group insured? The delta risk per individual is much lower if the pool is larger.
Because nobody would pay the rates that it would cost if they had a single large group. How many healthy, not-currently-pregnant 25 year olds would sign up for health insurance at $400-500/month? If they won't sign up now for $100/month, I'll guess that the answer would be not many...
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Old 02-23-2011, 11:27 PM   #27
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I did read somewhere that the insurance industry has agreed to stop canceling policies once people get sick. Hope it's true.
The rules now are basically the same as before. Health insurance is guaranteed renewable in every state I've seen (Martha has posted that one or two states may have an exception, but never seen it in action). The "new" rules still allow insurance companies to rescind policies for intentional misrepresentations, they just make it harder for the insurance company to jump through the hoops to do it...

For those reference the article about the COBRA payment being two cents off - insurance companies have nothing to do with COBRA administration. They are handled by third parties and the systems are automated so if the full payment is not received, they will automatically terminate. Seen the same thing happen before....the problem is if you give one exception, where does the line stop? When they are two cents short, two dollars, twenty dollars, two hundred dollars? Just playing devil's advocate here.
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Old 02-25-2011, 12:00 PM   #28
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"For those reference the article about the COBRA payment being two cents off - insurance companies have nothing to do with COBRA administration. They are handled by third parties and the systems are automated so if the full payment is not received, they will automatically terminate. Seen the same thing happen before....the problem is if you give one exception, where does the line stop? When they are two cents short, two dollars, twenty dollars, two hundred dollars? Just playing devil's advocate here."

dgoldenz,
I see your point. I agree that some people will do it on purpose, like not signing the check, etc.

On the other side, when we were a few cents off, the third party administering the account (which just happens to be the same one that administers the COBRA) worked with us to fix it. It just seems downright mean to cut people off when they have made an honest mistake instead of telling them they made a mistake.

WHen they sent the COBRA coupons, they made a few cent error in the amount (it was a little higher) and kept telling us we had overpaid. We called them and asked for new coupons because we knew the rules on underpaying COBRA. THey sent out us new coupons very quickly ... with the same wrong amounts. WE just keep overpaying the few cents.
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Old 02-25-2011, 12:02 PM   #29
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dgoldenz,
I see your point. I agree that some people will do it on purpose, like not signing the check, etc.

On the other side, when we were a few cents off, the third party administering the account (which just happens to be the same one that administers the COBRA) worked with us to fix it. It just seems downright mean to cut people off when they have made an honest mistake instead of telling them they made a mistake.

WHen they sent the COBRA coupons, they made a few cent error in the amount (it was a little higher) and kept telling us we had overpaid. We called them and asked for new coupons because we knew the rules on underpaying COBRA. THey sent out us new coupons very quickly ... with the same wrong amounts. WE just keep overpaying the few cents.
I agree that it's harsh. As you mentioned, the "oops I forgot to sign the check" is another one people try to play games with. Have had the same thing happen on life insurance policies a few times. Interesting how when that happens it's the people who are having money trouble 90% of the time. Some COBRA administrators are more helpful than others though, that's for sure.
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Old 03-03-2011, 09:41 AM   #30
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just an effort to get coverage in a country where employer based coverage is regulated but individual is not.
Don't know about your state, but in Cali we elect a state insurance commissioner. Health care insurance for individuals is regulated Individual Health Rate Fillings

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Insurance is a collective initiative to share financial risk. Life, home, umbrella – these are good examples. What we call health care insurance is really health care intermediation – the intermediary is taking from providers and customers and exploiting both.
I used to work for UnitedHealth Group, America's largest health care company. Providers and suppliers accept UHG covered patients after they come to an agreement with UHG about compensation. How is that taking?

UHG's 94 billion in revenue last year seems staggering, but the net was only 4.9% of that. Whoever they're taking from, they're not very good at it.
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Old 03-04-2011, 01:29 AM   #31
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The rules now are basically the same as before. Health insurance is guaranteed renewable in every state I've seen (Martha has posted that one or two states may have an exception, but never seen it in action).
I'm not a lawyer, nor an insurance salesman, so I'm not an industry expert, I just know what it's like to try to buy individual health insurance.

I have had private health insurance yanked away (Mutual of Omaha sent me a letter saying, sorry charley, we're pulling out of your state entirely). So I had one month's notice to find another carrier who will take a middle-aged woman? After several denials, I found the State high-risk insurance pool with a premium I couldn't really afford, for a $15,000 deductible policy. If I wasn't one of the fortunate State employees who could eventually get retiree health insurance, I could never have ERed, or retired, period. The premium for the insurance I get for free, that State employees who started work later than me have to pay for, is approaching TWICE my pension check.
So when someone says they should let the free market take care of the health insurance problem, I just shake my head. Walk a mile in my shoes, buddies.
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Old 03-04-2011, 01:38 AM   #32
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I'm not a lawyer, nor an insurance salesman, so I'm not an industry expert, I just know what it's like to try to buy individual health insurance.

I have had private health insurance yanked away (Mutual of Omaha sent me a letter saying, sorry charley, we're pulling out of your state entirely). So I had one month's notice to find another carrier who will take a middle-aged woman? After several denials, I found the State high-risk insurance pool with a premium I couldn't really afford, for a $15,000 deductible policy. If I wasn't one of the fortunate State employees who could eventually get retiree health insurance, I could never have ERed, or retired, period. The premium for the insurance I get for free, that State employees who started work later than me have to pay for, is approaching TWICE my pension check.
So when someone says they should let the free market take care of the health insurance problem, I just shake my head. Walk a mile in my shoes, buddies.
Guaranteed renewable only applies if the insurance company is still doing business in your state. If they pull out of the state altogether, they do not have to renew the policies. Same thing just happened here in VA with Unicare. Assuming you have no other coverage available and you meet other HIPAA qualifications, you would have been HIPAA eligible....unless your state does not allow companies to offer HIPAA plans and forces you into the risk pool. That would be an issue to take up with your state legislature.
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Old 03-04-2011, 07:41 AM   #33
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The rules now are basically the same as before. Health insurance is guaranteed renewable in every state I've seen (Martha has posted that one or two states may have an exception, but never seen it in action).
Just to be clear, policies are guaranteed renewable under federal law. The issue is whether the premiums can change based on experience, which is a matter of state law. The "guaranteed renewable" concept has other holes. For example, insurers pulling out of a state, like what happened to Too Frugal, or an insurer phasing out a particular plan so the new healthy customers apply for new plans, leaving the people in the plan seeing higher costs as the healthy abandon the plan.
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Old 03-04-2011, 09:05 AM   #34
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Just to be clear, policies are guaranteed renewable under federal law. The issue is whether the premiums can change based on experience, which is a matter of state law. The "guaranteed renewable" concept has other holes. For example, insurers pulling out of a state, like what happened to Too Frugal, or an insurer phasing out a particular plan so the new healthy customers apply for new plans, leaving the people in the plan seeing higher costs as the healthy abandon the plan.
Right. IIRC it is a broad federal mandate with state implementation. My own experience (NY) the guaranteed renewal is specific to policy type/group. In this way the insurer can have multiple offerings for the same customer base that are similar in coverage and retain the ability to drop one if it becomes problematic in any way - with no obligation to pick up the newly uninsured in any other group unless mandated to do so.
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Old 03-04-2011, 11:10 AM   #35
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Right. IIRC it is a broad federal mandate with state implementation. My own experience (NY) the guaranteed renewal is specific to policy type/group. In this way the insurer can have multiple offerings for the same customer base that are similar in coverage and retain the ability to drop one if it becomes problematic in any way - with no obligation to pick up the newly uninsured in any other group unless mandated to do so.
Unless NY's wacky regulations say otherwise, insurance companies can't just drop one subset of policyholders and keep all others. That only works if they drop all policyholders and stop selling insurance in the state. In any case, NY is guaranteed issue anyway, so what's the difference? I've never met someone who actually bought individual health insurance in NY....sure have talked to a lot of people that couldn't afford to though.
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Old 03-04-2011, 01:25 PM   #36
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Unless NY's wacky regulations say otherwise, insurance companies can't just drop one subset of policyholders and keep all others. That only works if they drop all policyholders and stop selling insurance in the state. In any case, NY is guaranteed issue anyway, so what's the difference? I've never met someone who actually bought individual health insurance in NY....sure have talked to a lot of people that couldn't afford to though.
Well, Independent Health dropped my individual policy and all those that pertained to whatever group it pertained. We're talking somewhere around '00 or so. It continued to offer other individual and group policies. Many insurance policies in the US are segmented into groups that give the issuer an escape clause if they need to avoid renewal.

As for NY State guaranteed issue, the terms are better than nothing, but not by much. Limited coverage, high price, low limits. The price wasn't the problem for me, but the lousy coverage was.
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Old 03-04-2011, 01:38 PM   #37
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Yes, this was one of my main reasons for leaving contracting. I had a lucrative career being paid high$$$ per hour for my services. Once my costs were clicking close to the 17k mark for premiums, and $5000 in deductibles per person X 3, I decided it was time to go back with a company and get group benefits. It was ridiculous. In 5+- years I never had them pay 1 cent towards care as I never hit the deductible per person. Yet every year I was getting 20-25% increases in premium. When I was in California, I did switch to Kaiser. They have a great HMO plan and I was paying 528 a month for the three of us. Unfortunately when I came back to Georgia, I had no choice but to go back with my previous insurer, for more rip off premiums.

Oh, well this year my costs are about $660 a month for 80/20 coverage. Much cheaper, although so am I in terms of income costs.
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Old 03-04-2011, 02:33 PM   #38
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Well, Independent Health dropped my individual policy and all those that pertained to whatever group it pertained. We're talking somewhere around '00 or so. It continued to offer other individual and group policies.
It's possible they may be allowed in NY since other coverage is already guaranteed-issue. I don't know anything about NY health insurance other than it's GI and ridiculously expensive.

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As for NY State guaranteed issue, the terms are better than nothing, but not by much. Limited coverage, high price, low limits. The price wasn't the problem for me, but the lousy coverage was.
There's a reason the coverage in NY is lousy and the price is sky high. You can probably guess what that is...
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Old 03-04-2011, 02:49 PM   #39
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There's a reason the coverage in NY is lousy and the price is sky high. You can probably guess what that is...
Inadequate regulation and unbridled profit?
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Old 03-04-2011, 02:54 PM   #40
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Inadequate regulation and unbridled profit?
NY has inadequate regulation? There's a laugh...NY has no competition and sky high prices because they have regulated the market to the point where nobody will buy anything. Health insurance in NY is guaranteed issue and a healthy person in their 20's pays the same rate as a 64 year old smoker with diabetes and heart problems. What kind of healthy young person would pay over $1000/month for health insurance? My brother is 26 and for him to buy an individual policy with limited coverage from an HMO (no PPO plans available) was $1100/month. Fat chance.
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