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Who hasn't heard of coronavirus? But how many people know the story of the folks who live in Wuhan (Hubei Province), China where health care is free . . . but overwhelmed?

China’s Hubei province, the landlocked region of 60 million people where the new coronavirus dubbed 2019-nCoV was first identified in December

Hubei -- known for its car factories and bustling capital Wuhan -- is paying the price, with the mortality rate for coronavirus patients there 3.1%, versus 0.16% for the rest of China.

If the province was not sealed off, some people would have gone all around the country to try to get medical help, and would have turned the whole nation into an epidemic-stricken area - Bloomberg


Free isn't always a good thing.

#coronavirus

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"Irony can be pretty ironic sometimes:"

The 10,000 people who work for Maximus at ACA call centers to sign us all up for health care can't afford health care themselves. How dystopian are things now? https://t.co/3AWNKbfE4O

— Amy Shefrin (@AmyShefrin) February 3, 2020

 NB: They're  not signing anyone up for health care.

Coverage ≠ Care.

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*For certain values of "Brilliant:"

So I recently submitted an app with a (relatively-new-to-me) carrier for a small case that seemed like a good fit. My client (whom we'll call Suzy) is a very sweet, mild-spoken woman in her late 60's, looking to make sure that, when the time comes, her final expenses won't be a burden for her children.

Okay, no worries: rate calculated, app competed and submitted, now just wait for approval.

Except I receive this in email this morning:

The above mentioned application has been received; however, processing cannot continue until the following items are received:

• Cover Memo: Please see attached, complete and return.

• Premium Verification:  The application quoted a premium of $49.89; however, we have calculated the premium at $86.52. Our calculation was based upon a 69/Male/non-tobacco/Premier/$10,000. Unfortunately, this difference in premium is significant and we are unable to draft without written consent of the policy owner and payor. If not received prior to policy issue, the needed premium will be requested upon delivery of the policy contract.

Hunh.

Perhaps it wasn't quote clear on the app?

Oh:

[click to embiggen]

Hunh.

I immediately notified them of their (egregious, obvious) error (there may or may not have been some snark involved) and will breathlessly*  await their reply.

(*Full Disclosure: I will not, in fact, be holding my breath)

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The good news is that I've moved from seething to very disappointed.

Regular readers may recall my post this past Spring on the subject of life insurance policy claims:

"In consulting with colleagues around the country, it seems that I am a bit behind the times on insisting on delivering the claim check personally (where possible). And I'm okay, albeit disappointed, with that."

My primary carrier's default position on the subject has long been to send the check to the beneficiary unless directed otherwise by the agent. I don't like this, but they've also built in a process where, if I tell them upfront to send it to me, they will.

Except: they didn't. And then they compounded it:

A long-time (and I mean long time: 30+ years) client passed away recently of natural causes.

It happens.

I met with his son (he beneficiary) and we completed and submitted  the paperwork, on top of which I stapled my customary memo reminding the claims folks to send the check to me.

Some weeks go by, and I email the claims department for a status update (what's taking so long?). Here's their reply:

"The claim has been processed. I do apologize the check was sent directly to the beneficiary on 1/24/2020 instead of sending to you for delivery."

And when, exactly, were they going to inform me?

(Spoiler Alert: That would be the 12th of Never)

So I replied to her (and my field rep):

"I’m sorry, but this is completely unacceptable.

I specifically requested in the cover letter that the check come to me, and I had already discussed this with your department.

And you didn’t notify me that it was sent.

I am VERY unhappy."

Now the truth is that they don't really care that I'm unhappy, they're likely more concerned that they've been caught out. My field rep happened to be in the home office as all this transpired, and he called to let me know that they didn't do this on purpose (which I knew) but that it just didn't matter to them (I know this because he was shown the folder, which had bright yellow highlights confirming that the check was to be sent to the agent). It reflects a culture that doesn't understand (or, apparently, care) that these are my clients, not theirs.

So why am I not naming the carrier? After all, we've done that many, many times for egregious violations (as this most certainly is).

The only reason I'm demurring here is because, sadly, this is apparently not only wide-spread industry practice, but apparently also enjoys robust agent support. That is, most agents apparently don't want to be part of this process (and thereby completely bail on an explicit promise to their client). So how can I blame the carriers for acceding to their agents' wishes?

So as disappointed as I am with the carrier(s), I am disgusted with what seems to have become of the agent force.

#Shanda

(Oh, perhaps I'm being too harsh in claiming above that they just don't care? No, it's pretty simple: had they cared, they would have realized that they'd screwed up, and reached out to apologize to me at the time)

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Shot:

Offering health insurance benefits to employees can help small business owners find and keep the best employees. Unemployment rate is low - competition for quality workers is high.https://t.co/H6keG1B9hR#smallbusinessowners #EmployeeEngagement #Obamacare pic.twitter.com/2lBC3qUgFi

— Steve Downey (@DowneyInsSvc) January 30, 2020

Chaser:

Just had a longtime business owner client (individual health, BOE and DI) call me:

"Just lost another valued employee to a competitor that offers benefits. Help?"

We discussed the pro's (quality employee recruitment and retention) and the cons (additional expense and administrative duties). We also talked about ACA (Guaranteed Issue, Community Rating) vs Association (underwritten, potential significant cost saving) plans.

Workin' on it.

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It's officially been a decade-and-a-half, and over 9,000 posts since our first blogging baby steps.

Along the way, I've been blessed to have been joined by the best co-bloggers and readers.

Thank you all so much, and here's to the next 15 years!

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Sometimes you just have to share some advice with those who don't ask for it...

There are at least five options Ms. Bruenig could choose yet her solution to changing jobs is that we need Medicare for All.

1. COBRA - While the costs could be too high for her, this could be the best option for one wanting comprehensive coverage. Her insurance through The Washington Post (prior employer) would provide the least change. The plan she had the day she was last employed would continue. There would be no change in benefits or network. However, she would lose the employer contribution. Paying full boat is eye opening for most who leave employment and see their COBRA notice.
2. Special Enrollment Period (SEP) - Under PPACA a loss of coverage constitutes a qualifying event. She could easily create an account through the DC Exchange and purchase a plan. If her income is low enough (doubt it) then she could potentially qualify for an Advanced Premium Tax Credit.
3. Short Term Medical - This could be an affordable option. In DC these plans are limited to 90 days and have to cover pre-existing conditions. This could be viable because her new plan has to start on or before the 90th day of employment.
4. Christian Sharing Ministry - While she would have to apply and could be denied, it's still an option that could have appeal. Her bio says she's Christian so I would assume that she can meet the requirements for participation. The costs are low and with the limited amount of time she needs coverage this platform could fit the need.
5. Pay out of Pocket - Here's a novel idea...based on what premiums and benefits could cost it might make sense to pay for her healthcare costs directly to the physicians, labs, facilities, and pharmacies she uses during her period of time without coverage. Immunizations and a visit to the closest "minute clinic" for an ear infection may be less expensive than paying a month of premiums for COBRA or an individual plan. 

Maybe she should have consulted her health care reporter colleague Sarah Kliff? Or maybe not? Just sayin'.

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