ADVERTISEMENT

Re: Health insurance

Anachnoid

Graduate Assistant
May 10, 2003
5,585
0
0
With the brain trust and independent business owners on this board, any recommendations for health insurance coverage companies in Richmond? I have been with BCBS/ANTHEM for over 25 years- very much a love hate relationship and now in the midst of hate. Do people just really believe what they try to tell you on the first brush off? I hope the people here don't. You have to stay on them. So far it's taken them 7 weeks to "upload" a waiting period waiver that was promised early May. Folks in Roanoke are nice. Minn, StL, and Colo wear red, have horns and carry pitchforks. It's a part time job dealing with these people. All suggestions are appreciated.
 
have never figured out your prob with your health insurance, guess it is your hate of business, corporations more than anything else. if going through roanoke, must be an individual policy so you can go on google and find many individual companies who are licensed in VA. why, if you have been with them for 25 years are you having to do anything with waiting periods?
 
WS that was my first question and then it was down the rabbit hole. They do not offer any real assistance without asking"where in the policy is the language that supports your decision?" "Hold please let me get a supervisor." .and on it goes. I was once with a "group" and it too was out of Roanoke but there were no cost savings or additional benefits, and same run around. And M, Anthem was like this before the ACA, now they just have more layers of delay. I feel for those folks who might be too sick to fight and just accept the inane responses/decisions. And WS you are right, I don t care for big wasteful corporations who live off the protective laws of the government to the detriment of us. OWS-ers may be in the right direction.
 
anthem, at least before wellpoint, was one of the best run health corps around. so you were in a group plan, then went individual with no time lost in between? is the prob you have with a claim or just coverage? do you have an agent? an agent, if he or she is a good one, can cut through a lot of the crap you seem to be facing. don't think you pay anymore in premiums for having an agent so find one to help you out with this. still don't understand what your prob is but if you can explain it, will try and find a SPID who might be able to help you. know it is frustrating and sorry you are going through something you should not be.
 
I administer our company plan with Anthem. Generally find them to do a good job in providing coverage and paying what they are supposed to. That said, anytime we have to add someone, make a change when someone wants to add a spouse/new child, it is a needlessly long process for them to process what should be an easy change. Government is not the only entity that can be a bureaucratic nightmare.

As Spinner said, I use our agent in such situations. He is usually good at getting things straightened out faster than I am.
 
97, one thing anthem and other insurers need to do is make a pretty big capital investment in their computers, they need new not upgrades. the prob now is they have no idea how long they are going to be in business so a move of that magnitude is put at the bottom of the list.
 
Obamacare has been a boon to the health insurance industry, how many more enrollees do they have than last year, 8 million plus now.
 
the end game here is a single payer, the government, it is just about how long it takes to get there. these people know that and doubt you will see much spending on infrastructure or anything else of meaning. in addition, how many of the new enrolled are on medicaid, not sure that 8 million new people have signed up with a commercial carrier.

This post was edited on 6/23 9:53 AM by WebSpinner
 
Spinner, I believe the 8 million are people who signed up for a private plan and not through Medicaid expansion. Although not 100% on that.

The health insurance companies basically wrote the ACA though, they knew it would be a boon for them and I doubt they would have been complicent in crafting a law that would lead to there own demise. Yes, they will talk a big game about the end of times of single payer, but please, they are loving the ACA.

And single payer is probably decades away if it ever occurs. Dems would need the same super majority in Congress, plus the Presidency to pass and also have the political will to go after single payer. Given the "fury" over ACA, which was basically the conservative solution to healthcare less than 20 years ago, I doubt there is any movement towards single payer for the foreseeable future.
 
not sure what will actually happen in the long run but know i did listen to an obama speech to a union where he stated that the goal is one payer and that would be the government and that it will take steps and a few years to accomplish. they have started the steps and we will see how it plays out. not sure if signing up people is a boon, does not mean you make money only that you may collect money, your loss ratio and expense ratio, mainly claims, determine if you lose, break even or make money. a boon is when you are guaranteed to make money not just collect it. still waiting until this fall to see how the employer mandate works, this is where most of america, sans medicare/medicaid, is covered.
 
Insurance companies rates are set to ensure profit, so as long as they did their actuarial homework on setting rates, than I think they are pretty much assured of a profit. The plans on the ACA are no different than a private plan they would offer an individual, except that the government may be paying some of the bill.
 
HA, the only thing that is certain is that acutaries do their best but far from being right all the time and what will make this thing sink or swim is ACTUAL claims not projected claims. insurance companies just like any other company out there, lose money sometimes, they miss it. now if the government is guaranteeing them that if they lose money, they will make it up then that is a guarantee but also not how business should work or be operated in this country.
 
Re: What I have learned ...thus far

Quick bullets and based on conversations with people in health insurance business:
1. Being self employed there is no available group although there may be some possible benefit through an association.
2. Va state legislature passed a bill to remove pediatric dental care requirement. Why they couldn't go on and put the exchange in place was not nice to Virginians, but I guess the former governor was too busy (his latest disclosed undisclosed benefit was a $23k visit to Kiawah courtesy of Bill Goodwin). I haven't found a confirmation of the removal-just haven't had time to look.
3. I have to wait for open enrollment.
4. Anthem was supposed to migrate all long time policy holders past the waiting period block back in January but still hasn't done so and so they seem to now enjoy a case by case process with end result being a waiver if the insured sticks with it long enough.
5. Bon Secour and Anthem are at odds and at this time Bon Secour will not be in network for Anthem for the coming year.
6. Rates are determined in part by your zip code.
Here's an aside. Couple of years ago we were changing plans within Anthem and had to provide our health histories. So we had to order all our records from Anthem to provide them to Anthem, because the Anthem we were applying to did not have access to our then current Anthem and the policies were not very different.
 
Re: What I have learned ...thus far

know this is a personal issue so do not wish to probe or ask too many questions. just am confused as to whether this is about you having coverage or having a waiting period on certain conditions or just what. don't think you have young kids or what this has to do with dental or if that is the prob? things may have changed but if you have had continuous coverage, no breaks, you should have coverage, no probs. VA is one of numerous states which fought obamacare both the exchanges and the medicaid for a lot of reasons, the biggest being money, the feds are going to pony up some money for the first year or two and then the states are on their own after that and that could be painfully expensive though it sounds good at first. if the feds had just made some alterations, fine-tuned instead of this mess, we ALL would have been better off now and in the future. i hope that you have coverage, there should be no question of that at all.
 
Re: What I have learned ...thus far

Not only personal to me but any boulder I can remove to smooth the road ahead for others I am willing to do.
Also a hint when calling Anthem, to bypass their primary interest how would you,like to pay your premium and they ask if you are a subscriber just say insured a term not recognized by their computer and you will be sent to a body. Really, howmany people know the meaning of a subscriber?
Also WS I received a threatening letter from one of their third party contractors that I needed to call them or I would not receive in network benefits. Of course I called and asked them to point out in my policy contract where they are allowed to send me letters,with such threatening language...let me get a supervisor...upaduhupaduupadu, And then the Bulverism began.
 
Re: What I have learned ...thus far

Regarding whether Virginia should or should not have adopted an exchange:


"Like Nevada, Oregon and Massachusetts took steps to join the federal exchange in recent weeks. Maryland, too, scrapped its system but opted to borrow Connecticut's technology to salvage a state-run system. It's unclear if the Obama administration will approve that decision."[/B]
[/B]


Nevada Scraps Exchange
 
Re: What I have learned ...thus far

wellpoint/anthem is now a public company, for profit but all the plans under their umbrella were all once non-profit blue cross/shield plans and back in the day subscribers was used not insureds which is more a commercial, for profit, insurance company usage. not sure if that is such a big deal but when you are mad, it all seems worthless and useless. it sounds like you received a letter warning you about the usage of out of network providers which can be a disaster so better to call them than throw it in the waste basket if just a friendly note. will not take up for them and still don't know what you are facing, usage of out of network providers, coverage, a claim but whatever, change carriers if it is so bad, you have choices now but maybe not in the future when you are upset and there is nowhere else to go but washington and they are always helpful, see irs, dmv, for example. hope you get your probs resolved and sometimes we all feel like we are bashing our heads against the wall and nobody understands our problem and nobody takes ownership of our problem and it is frustrating. as sam kinison, the now deceased comedian once said about the people in ethiopia living in the desert and had no food or water, MOOOOOOOOOVE! have to say to you, CHAAAANGE!
 
Re: What I have learned ...thus far

Well WS, here's an update. I received a letter for the waiver which should not have been an issue in the first place-the letter misspelled my name and did not include my subscriber so it was really worthless. I received my benefits booklet for the medical portion last week 2 months after current policy went into effect. I have yet to receive my dental benefits booklet. I did receive a survey today regarding the dental coverage which I answered truthfully and also gave them my name and number and invited them to call me. As to the requested procedure, it has been submitted by the provider who advised Anthem takes 4-6 weeks to respond. And yes WellPoint is one of those companies sitting on a boatload of cash and no plans to use or distribute it. And my provider is in network. I am told I cannot change until Nov. I just expected Anthem to be run better as the major insurance player in this market, and it's not.

This post was edited on 7/7 8:52 PM by Anachnoid
 
Re: What I have learned ...thus far

A, don't think blue cross, blue shield of VA, trigon, has ever been run as well as when it was local. with the anthem takeover, they let them do their own thing because, quite frankly, they were better run than anthem but when wellpoint became involved, local management was let go and they now are managed out of ny. just never the same and sorry you are having so many probs, know it is frustrating and hang in there and hope all gets taken care of for you. have to ask, what is a waiver and why if you have been with the same insurer for 25 years are you going through this, were you forced to change to something else, what is going on with this??

This post was edited on 7/8 7:26 AM by WebSpinner
 
Re: What I have learned ...thus far

WS did you talk to Anthem and kill my secret bypass? they no longer offer subscriber as an option but neither do they offer the name "insured". I am a member! I need to video my calls to them and post them . So today I took a deep breath and put on my big boy pants to call and request a copy of my dental benefits booklet in anticipation of the next fight. So I call dental and they referred me to medical who then transferred me back to dental who referred me back to medical. Finally I got a nice young lady in Richmond, (always happy to get Richmond or Roanoke), who assisted me previously as she remembered, and as a bonus she told me my pediatric dental was cancelled. ( all in all about an hour plus of calls and holding). So if there is anyone out there carrying pediatric dental (BW? ) and it's not needed call your insurance co. I think this is the little bone thrown to us by our legislators.
The waiver was for a one year waiting period for certain benefits to kick in. They would have grandfathered our policy for an additional 8 months at the previous monthly premium and an additional chunk ( about 20-25%) of cash per month. I don't know why the waiting period except that it might be in place to increase their profits from people, oops members who,don't question them.
 
Re: What I have learned ...thus far

again, you are not a child, assume you do not have children of this age and wonder what this is all about? this is about dental, not medical? this is about dental for children? what is going on, am more confused than anthem on this but again, know it is personal and not attempting to get into something not of my business. hope this is about laws and not the industry.
 
Re: What I have learned ...thus far

Our firm just received our renewal for next year. 20 covered individuals. Young healthy(ish) group.

Up 39% for next year.
 
Re: What I have learned ...thus far

M hope you can shop your group around and can try to get a couple of companies negotiating for your business. No information about insurance companies complaining about the ACA.
 
Re: What I have learned ...thus far


I retired 3 weeks ago and have therefore lost my insurance through the state (my employer). Luckily, I'm old (66) and can go on medicare. My wife, however, is 62 and needed insurance. The coverage I could get her through the state (same as we had before) would cost her $560/month. She can get "substandard" (according to Obamacare as there's no coverge for contraceptives or maternity) insurance with a high deductible for $180/month. Because the feds deem it substandard, we have to pay a penalty (the feds call it a tax), but it still works out to be less than the standard kind offered through the state. What's wrong with this picture? What has happened to the free market?
 
Re: What I have learned ...thus far

very laughable, the point should be that individuals should be able to choose what they want and are willing to pay for not what the government demands. plus what good does a policy do if it has all of these bells and whistles but you have a $6000 deductible which means you don't get the bells and whistles.......too funny. and then you have people like lois lerner at the irs in charge of your healthcare, thinks she gives a hoot about you or me?

This post was edited on 8/1 10:41 PM by WebSpinner
 
Just received the renewal premium quote for my small company of 45 employees, for the young rank and file the increase was only 9%. The bad news, for my business partner, his wife, my wife, me, and the two others over 55 the increase was 225%!
 
Our experience seems to be different than most, for three years prior to ACA our premiums jumped average double figures each year -- last year dropped about 12%. After second year of increases we had to reduce coverage for staff to be able to continue to offer coverage. I think its all over priced. Insurance, medicine, health care providers, top to bottom. Met a woman recently, very nice lady, lowest level (basically a bed pan changer) earned $65K per year. Not blaming her for accepting the position or income. When I compare that to what we pay our teachers, firemen, police, soldiers, I fell something is out of line.
 
although medicare, like all other programs, is basically broke, if they really wanted to do something, should have just said, all americans are now on medicare, including our legislators, military, ALL AMERICANS. one program, all people, period. of course, we cannot afford it but to really be fair and have one payer, the simple solution.
 
What is sad is that all in power in DC knew a healtcare reform program was going to eventually be a reality and the party that prides itself on fiscal responsibility did not present any alternative but NO. No doctors or insurance companies are complaining. They know that us folks that they can squeeze will continue to pay the high premiums for our families for pediatric dental care and maternity coverage for the post menapausal.
As an aside, I foresee some interesting 'alliances' in the upcoming elections, similar the the tea people and the crossover voters kicking out Cantor. How about the tea people and African-Americans on closing the borders? Heck toss the crossovers in that mix and we are about at 75-80 percent who want to enforce the standing immigration laws......oh. I can't find any local politician who can answer if Chesterfield would have had to raise their relaxes or Henrico impose meals tax if the illegals here had invested their hard earned American dollars back I to the community where they live instead of sending billions home. And no one at city hall has ever answered why we and our real estate tax payments and parking ticket fees to atlanta to be processed. Don't we need jobs Richmond?
 
A, to be fair, when obama called the summit and both parties met somewhere, looked like a hotel, in washington, he basically told them, no, he actually told them, "you lost so shut up, we are not going to listen to you". that was really a smart way to open the discussions and to get some info from the other side. they knew what they wanted to do and they were not interested in anything anyone else had to say. if one wants free healthcare and dental and all of it, move to cuba, at least michael moore says so.
 
'noid, I think you are right about the strange bedfellows coming in this election and maybe future ones. That's a good thing as far as I am concerned. It will mean people are not just blindly following one party or another but actually thinking for themselves and realizing that it is possible to agree with some things one party promotes and some things another party promotes. Hopefully it leads to more bipartisanship, but I know that's just wishful thinking.

The immigrant thing must be addressed. I feel bad for the kids who are here and potentially suffering, but if we keep funding their parents, they're going to keep coming illegally. I welcome anyway who wants to come legally. If you break the law to get here, then don't expect to get anything from our government.
 
have no proof but would suggest that this entire children/border deal has been orchestrated, planned and carried out. this is not a spontaneous action but we have kind of put up a billboard that says we are open, come on in.

This post was edited on 8/2 2:23 PM by WebSpinner
 
WS what about the years after the Clinton's tried to push through a healthcare bill? I don't doubt Obama did that.
immigration- recent article in NYorker about two Iraqi men who helped us and want to come over for now serious safety issues and their papers have been held up for two years or so. One of the men is surrounded by ISis territory and now doubts he will leave or survive. I'm for a big electric fence.
This post was edited on 8/2 2:23 PM by Anachnoid
 
A, take an honest look at it. the dems have wanted national healthcare for decades, not reform, national healthcare and they have always been the ones pushing for that. the republicans have not wanted anything to do with national healthcare and to enter into any kind of bill/debate, would have initiated national healthcare action. they let it be rather than hitting the hornet's nest. why get it started but once it was, they wanted reform and were shut out. you wanted it, you are going to get it but wish it was just you and your buds rather than all of us.....

This post was edited on 8/2 8:21 PM by WebSpinner
 
Yes, the, datburn democrats have wanted national healthcare for a long time. Let's see, since then there have been six GOP presidents and five dems. Who has had their Head planted in the sand? Those of you who have a voice in choosing a healthcare plan shop, shop shop and play them against each other. It's the start.

HST
 
would assume since the majority of americans were happy with their health insurance, why mess it up? the dems don't want to make it better, they just want another huge government program which does not equal "now healthcare is excellent", it equals another broke, inefficient government program which the country cannot afford. need to do what is best for americans and solving a problem for a few will mess it up for the rest. if the dems wanted to do something, take care of the few, thought medicaid was designed for that and leave the rest alone, don't force everyone to do what they think is best. almost everything in washington is about controlling the money and increasing voting bases by giving stuff away to them about huge government vs controlled smaller government. the prob is most legislators in washington want, need, big government so they have power, money, etc. and the only way, it seems, that our out of control spending will stop is if we go down the tubes which nobody wants but may happen.

in addition, "heads planted in the sand"?? the truth is the people did not want this, never have, the democrat party has wanted it and if you think it is because they wanted improved healthcare, you have your head in the sand. this is all about bigger government, period.
This post was edited on 8/3 2:41 PM by WebSpinner
 
Re: Health insurance-renewal

Don't forget , if you may be affected, that Anthem and BonSecour, to my pea brain knowledge, do not have a contract and BonSecour,unless a contract is reached, will not be an in network provider for anthem.

Anthem v BonSecour
 
Re: Health insurance-renewal

the purpose of a contract between an insurer and a provider is to give the provider customers and for the provider to give a discount to the insurer. if they do not agree, then they have no contract and if an insured chooses to go to that provider anyway, he or she receives less. these contracts are a way to help reduce costs but not every hospital or doctor is in a specific network. not sure why this is a big deal, just business and am sure there are many hospitals in richmond, the state, to choose from that are "in network".
 
Re: Health insurance-renewal

I am surprised at your argument for socialized medicine. Just pick the nearest in network provider and make an appt...just like Canada. What will be interesting is as of 11/7 or whatever the date and anthem pulls rug from insureds using BS. as their in network providers will the law suits fly like in California where folks signed up for anthem based on anthem published in network providers only to find that the information was not accurate, a mere oversight anthem contends?
 
ADVERTISEMENT
ADVERTISEMENT