SUBMITTED: Saturday, January 14, 2006
POSTED: Saturday, January 14, 2006
It is amazing the ignorance of the Previous "Sales Men"! Because you are obviously not a very good one! You were not trained properly and obviously did not realize that you can sell more than the health choice plan. But I'm guessing that you were trained properly but choice to sell on price and not value, and that is to your own detriment. Most people don't care if they pay more as long as they know they are going to get exactly what they pay for. I personally only sell the PPO unless it comes down to absolute cost for a client and they can't afford anything else other than a basic hospital plan. If you really new how insurance worked and compared our PPO plan with the others in the country, you might have had a long and prosperous carrer here, although I doubt it with that attitude & Ignorance. This is what I put in an earlier post on why we are the best....
I just want to start out by saying, that it all starts with the agent. The larger that an insurance company gets, the more exposure it has to the public and the more chance there is for mis-representation. However, the other bigger factor, is how a customer wants to interpret their coverage versus what they chose to discount during the "building" of their insurance plan. 1st of all, Will you hit it right on the head that NASE and Mega are tied at the hip. So What! Is this supposed to be a crime! If so, please tell me then we can have McDonalds arrested for selling toys in happy meals, Walmart for giving you 3 cents off at the pump if you pre-buy their gift card my local supermarket who will not discount my groceries on the special buys unless I use my Kroger card.
What I'm trying to say is simply this; The whole reason for the National Association For the Self Employed (NASE) was formed, was to help provide a place where self employed people could join and use their group size to get discounts to business services as well as access to affordable health insurance. They don't try to hide this fact in any fashion that you cannot have the health insurance through Mega unless you join the association. I tell all of my prospects this up front and have no prolem with it. In fact, it is a selling point for us. The way individual health insurance is setup today is through risk pooling. When you enroll in an insurance plan with other independant insurance companies, you have usually a 12 month period before that particualar plan is closed off. Once that plan closes, no one can ever enter that same exact plan again. Not to mention that you are usually confined to a small group based on your zip code or region. So when you take a plan with xyz, you may have 6,000 more people that signed up for the same plan during the enrollment period. So what happens when these people starting getting sick, having heart attacks and major surgeries? The rates of even the healthy people are increased. And they continue to increase each year. Ever have this happen? The fact that NASE is an association (group), we have over 500,000 members. Now Mega is the only health insurance provider we offer because we want to keep all of our business and it's large members with one company so that we can get great discounts on the health insurance. This is no different than Wal-mart using it's massive sized to get a great group rate for all of it's employees.
Now here's something else I bet you didn't know; With 99% of all the other individual helath plans out there, they pay benefits based on Usual Customer and 'Reasonable' charges. The reasonable part of that phrase, is the biggest word in the insurance industry that can wipe you out. I was at a customers home last night and they had a policy with a certain company and they were paying $270 a month with a $5,100 family deductible with 100% coverage after that. My program that I offered to them was a $7,500 deductible PPO program per person with an additional $4,500 total out of pocket maximum, for $312 per month. Now which program do you think you would rather have? That other plan they had with a lower deductible, 100% coverage after and cheaper monthly, or my program with a total out of pocket exposure of $12,000? It's not a trick question initially. Heck, I would rahter have their plan than mine, if i DIDN'T understand insurance!
Here is the biggest thing:
When a company includes the words 'reasonable' in terms of how they pay, that means that they have the right to dertermine how much of the hospital bill is considered reasonable under the benefit plan. The National average of how much a company using this payment method cosiders reasonable, is 63%. So although you may have a plan that 'claims' they are going to pay 100% after your out of pocket maximum is met, that doesn't mean that is all YOU will pay. So if this client would have kept their old plan, and had a $100,000 hospital bill, they would have been responsible for the first $5,100 of the bill which would reduce the bill to $94,900. Now this company actually had to have in writing but hidden in legal jargon that they cover in the 60th percentile for reasonable charges. This is code for 60%, a little less than the national average. So 60% of $94,900 is $56,940 which they consider 'Reasonable' charges. So what happens to the other $37,960 that was not covered? Oh, YOU are held responsible and you better hope the hospital gives you a break and reduces that 50%! And if you pull that miracle off, that is still a grand total of $24,080 total out of pocket that you paid. Imagine if the bill was higher!
Our plan says in writing, we cover for Usual and Customery charges. We don't use the word 'Reasonable'. So what this means is if you had a total hospital of $750,000 with our program, you would pay your $7,500 deductible and your total out of pocket of $4,500 which comes to a grand total of $12,000 and that's it! We cover absolutley 100% after you pay these amounts, no questions asked!
Also, it showed in their policy in writing, that the insurance company can raise their rate at any time as long as they provide a 30 day written notice. They also said they can raise the rates based on the claims ratio in the schedule of benefits which means, "the more you use your insurance, the more we will increase your premium".
My policy says in writting "You cannot be individually picked out for a rate increase".
So in the end, you know why my client signed up with me, for a higher premium with a higher deductible. Because we protect our people! We are not designed to cover every little sniffle or cover 100% of all your testing and doctors visits. We are designed to help keep you from losing every thing you own if you had a serious catastrophic event. We are Dream Keepers!
However, if you want to pay a little more premium for these things, we can offer doctor's visits for $20 co-pays, $10 for generic medication (automatically included with any health plan. We can help you with the big testing such as MRI's and Cat Scans with a deductible of $500. We have the best indemnity products in the country for the money which includes: Accident, Critical Illness, Income Protection, Life Insurance and Income for each day that you are hospitalized. And we also offer Dental and Vison which most companies don't offer anymore.
So in conclusion (finally) I am very proud to be a NASE field represtative and a licensed agent for the Mega Life & Health insurance company. I truly take time with each client to explain in full detail, everything I explained in this letter and exactly how each of our benefit options work. Then I let them decide what is important to them in their plan. So we may not be the 'cheapist' insurance company in the country, but we darn sure are the best! Chao'