Nest Egg Raided by Limited Benefit Texas Health Insurance Plans

Interesting article Article in the Business Section of today’s Dallas Morning News. The article speaks of personal finances and what to do when you find yourself behind the financial crisis eight ball. Not a bad article but there was one thing mentioned in the story about a Texans recent experience that caught my Texas health insurance eye.

 It appears that Cynthia Johnston had a bad little accident back in January when North Texas got hammered with our ice storm. Ms. Johnston apparently slipped and busted up her femur bone. Seems the doctors had to preform surgery and insert a rod in her leg to assist in the repair. All I guess seemed fine with Ms. Johnston situation except for the broken leg. Looks like she had a Texas health insurance policy, so I’m sure she thought everything would be taken care of. According to the DMN story her hospital bill alone was about $51,000. Wow! Wonder how much her surgeon billed her in addition to the $51 thousand. Wonder if that amount included the anesthesiologist? How much will the therapy run after the hospital stay?

If the DMN story is accurate her surgeon, anesthesiologist and therapy will all bill separately. Those grand totals will most likely run another $20,000. Now, why all this talk about some lady that broke her leg? Simple. The story mentions that her Texas health insurance company would only pay for “room and board”. Meaning Ms. Johnston was probably hotter than a goat eating a blow torch when she got notified of the Texas health insurance companies claim payment plan. I know I would have been. Now, why did this happen. Well, it appears she was on some type of limited benefit Texas health insurance plan. Don’t reallyknow what company sold the policy without looking at it and doing an analysis. But you can take it to the bank it was not a Major Medical Texas health insurance plan.

Listen, we as consumers need to stop purchasing these gimmicks. I see them all the time. I was up late last night watching TV and Cynergy Health was running adds like crazy. Of course the TV add made me believe it was a full coverage plan, heck, I almost wanted it, however, with the great little pause button on my Tivo I read the fine print. Limited Benefit Policy. Point blank, right in front of my eyes, everyone should be able to see it, right? Well, you can if you pause the TV right before the advertisement ends, hop up off the couch, get 1 foot away and have a 55 inch HD plasma like I do, then you will see it.

Just like in the commercial, the facts are sometimes hidden by both Texas health insurance agents and Texas health insurance companies. You as a consumer have a responsibility in this battle, one is to do your homework on each policy or find a respectable experienced health insurance in Texas broker that just has to much at stake to write these mickey mouse policies. I promise you one thing, I will never, ever promote one of these policies. Ever! I am just to scared of them. At the present time I don’t even allow these policies to be quoted on my client driven website at Peeler Insurance. I also know for a fact that I am one of the few Texas health insurance agencies that will not allow a client to review these plans that are not a PPO Doctor Co Pay Plan without personally speaking to me. I don’t think I have one client on these type of Texas health insurance plans. I would prefer the client just go to another broker, at least I don’t wake up at night in a cold sweat worrying if I will get sued the next day.

These Limited Benefit plans will always get action in a depressed economy due to their somewhat lower pricing, and that’s unfortunate. They look great at time of sell, but have one claim and you could be facing financial destruction the likes you have never seen. Is it really worth saving $10 or $20 a month for these limits? I heard this once when I served in politics. You can put a pig in a dress, bottom line, it’s still a pig!

If Texas health insurance consumers are looking for quality Major Medical PPO Doctor Co Pay, Catastrophic or High Deductible HSA plans, then Peeler Insurance is for you. Take a look by getting your Texas health insurance quote, but do so knowing this, i only promote and sell what we call full coverage policies where in Ms. Johnston’s case there would have been a reasonable deductible and then the policy would pay up to about $3 or $5 million dollars. This would have been an easy case for her and her retirement nest egg would be salvaged.

Unicare Could Become Player Again in Texas Health Insurance

Unicare parent company Wellpoint sold it pharmacy division last week and in my view this could position them for another run on the Texas health insurance market. For some 10 years Unicare far and away offered the most affordable health insurance in Texas, however over the last year they have dropped to the back of the pack in the market for individual health insurance policies.

Wellpoint convinced Express Scripts to pay them almost $4.7 billion for the pharmacy division making Express Scripts number two in all the land for administering pharmacy benefits. Now, how does this help Unicare become more competitive? Simple, drug prescription coverage is far and away the biggest killer for insurance companies at claim time. With all the high dollar drugs on the market today a consumer can flat out destroy the profitably of insurance companies. With so many drugs being advertised on the airways costing hundreds of dollars a month how can a Texas health insurance company be competitive?

At present Unicare offers the best product benefit wise in all the health insurance in Texas market with their Enhanced Fit portfolio that is loaded with out-patient benefits. Problem with the policy is it’s a killer on the monthly premium. Most times Unicare prices out about 25% over market, folks, that just wont get it done in today’s super competitive price sensitive Texas health insurance playing field. One new drug prescription will most times equal the monthly premium of a policy and with that a company just can’t remain competitive.

Peeler Insurance has also learned through sources that Unicare will be introducing a new product portfolio soon that will have more competitive pricing. Hopefully that will supply additional market share.

All in all this move by parent Wellpoint should give Unicare some much needed breathing room to jump back into the Texas family health insurance market. I also hope that this transaction will allow them the ability to offer rate relief on their super benefit rich Enhanced Fit products. Stay tuned.

To find out if Unicare offeres your family the lowest rate get your free no hassle online Texas health insurance quote today.

Individual Texas Health Insurance Now Option With Independent Contractors

Back in the mid 90’s during our last economic pothole I remember more and more of the Texas workforce was pushed over to contract labor. Companies, mainly those involved in the technology and telecommunication sector, were looking for ways to shave cost, and utilizing independent contractors was an easy way. Most Texas employees don’t realize the yearly cost of benefits provided by their employer, heck, most Texas health insurance brokers don’t, but since I had the honor or serving the citizens of Arlington in a local political capacity I saw the enormous cost associated with employing people. I remember the cost of benefits and other expenses amounted to about 75% of the yearly salary of the employee. The numbers are astonishing and what is the quick fix? Independent contractors, that’s what.

This time around I feel that it will be more than the technology sector getting squeezed out, I feel all sectors of our workforce is subject to the squeeze. I know this sounds scary, being a contractor, but if you just follow a few simple steeps you will be fine.

First off, you need to secure Texas health insurance benefits, and fast. You can not allow a lapse of greater than 63 days to take place, otherwise pre-existing condition limitations will most likely come into play. I have found most Texans migrating to a contractor position are used to the super rich Texas health insurance benefits that were offered by their employer. With that being the case I would advise going with a Texas doctor co-pay plan, these plans best resemble the traditional health insurance offered by group insurance.

These plans will differ in just a few areas, mainly with the yearly deductible choices. There are few if any plans that offer deductibles as low as most group plans. The traditional deductible on an individual health insurance plan in Texas is about $2000. In regards to co-pays, you should be able to find one at about $25 per office visit. Most legitimate doctor co-pay plans in Texas will offer some type of out patient prescription drug coverage with a co-pay.

Now, where do the big differences come in? Underwriting. All individual health insurance in Texas must pass through medical underwriting, only group health insurance plans mandate guaranteed issue. This is the single biggest misconception floating around out there. So many Texans leaving employment contact me for Texas health insurance and get very argumentative with me when I inform them medical underwriting will factor into getting a policy issued. Sorry, federal law doesn’t require individual health insurance in Texas to provide you with coverage.

Now, after getting a policy approved what can you expect? Well, for starters lower Texas health insurance premiums. The rates are all over the map depending on the deductible and benefit choices, but most often there will be substantial savings. The easiest way to find out is to simply get a Texas health insurance quote online from my site.

I know loosing the comfy security of working for a large company that provided benefits is spooky but don’t fret, individual health insurance in Texas brokers are here to help. We deal with this stuff all day every day, it’s just a walk in the park. I promise! See for yourself by getting a free instant Texas health insurance quote right now!

Texas Health Insurance Consumers Avoid Rate Increases Again

Thank god its over for another year. Goodness it was a brutal month and a half but Texas health insurance consumers that have the policy with Peeler Insurance avoided the brutality of April renewals.

Yes, this scene gets played out every year. Texas health insurance companies with no regard to the present economy blister the rates every year and I scramble to run rate comparisons to determine if we should explore other affordable health insurance in Texas options. This year I am proud to report we had a 90% success rate in providing lower cost options over their current Texas health insurance policy.

Some individual health insurance in Texas agents differ with my business approach. They think I’m crazy to run new rates for existing clients. These agents feel I should just leave a current client on their current policy and when the client calls in complaining just tell them that’s the way it is or just take the easy way out and raise the deductible to offset the higher monthly premium. To me that’s a load of garbage. The only way you keep clients long term and build a strong client base is to always be in a position to offer similar coverage from different companies. That is one of the major reasons I am appointed to sell with all the major players in the Texas health insurance market.

OK, now with my twins due any day, this month was by far the most stressful and long. I think I slept on average 4 hours per night and was in my office working about 18 hours a day. That is one big reason this Texas health insurance blog has not had as many post as I would like but, duty calls and my clients must be taken care of. Period!

This month Aetna, Humana, Unicare, World and Blue Cross & Blue Shield decided it was high time for a rate adjustment, andadjust they did. I found that on most accounts Cigna Health Insurance offered the best option for existing Texas health insurance consumers to migrate to. Cigna has a very respectful PPO doctor co pay plan and offered much the same benefits to consumers that had both Aetna and Humana. From the high deductible front Blue Corss and Blue Shield was found to offer the best movement option. They really seem to control the HSA and catastrophic health insurance in Texas market . For some reason Unicare, once the only player on price in Texas, is getting left in the dust.

Now, form the underwriting side of things I experienced no major roadblocks. Cigna really stepped up to the plate and offered what I felt were fair decisions and I only had a limited handful of Texas health insurance clients that were affected negatively to their underwriting actions. Blue Cross & Blue Shield has always been somewhat fair and they delivered as expected. So, overall, any client that wanted to lower their monthly Texas health insurance premiums or avoid a monthly increase did just that.

It seems that Cigna Health Insurance was preforming very well price wise in both North Texas and down Houston way, I found that in other parts of the state they can be a challenge from a premium standpoint. In the hill country areaI found Blue Cross & Blue Shield making a strong foothold.

There are still more rate increases for some of my clients that will come off rate guarantees throughout the year and I will handle them in much the same way as I did the 2nd quarter rate increases but at least they don’t all come at once as is always the case in April.

There is still a few housekeeping and administrative maneuvers I must preform for my clients but for the most part, it’s game over.

If you are not a Texas health insurance client of Peeler Insurance and you found that little rate increase letter in the mail and didn’t act upon it, either visit my website or call me for your free Texas health insurance quote today. We may not be able to get that April 1st effective date but May 1 is coming fast.

 

So, there you have it. Another year we dodged the Texas health insurance rate increase bullet. Now I can get some much needed rest before my lovely wife says… honey, it’s time to go to the hospital and we accept the arrival of Andreas and Natalie.