Thursday, March 10, 2005

Putting the middleman back in?

No kidding.
But this article focuses on an area that, until recently, hasn’t had a lot of media play: personal health care advocates. These folks will help you make sense of the bill you just got from the hospital, or help you determine whether you need a referral for that knee surgery. And the service costs just $400 a year for a family.
I looked through their website, and they seem to offer a great array of these types of benefits. Basically, they become your personal HR department.
I have mixed feeling about this. On the one hand, as a professional agent, I expect that my clients will call me when they have questions on their bills, or an issue about coverage. So on that level, I resent that they’re paying someone else to do my job.
On the other hand, clients who use this service cease being my service problem, and I can devote more time to sales (which is how I earn a living). It’s not that I mind doing the service work – I don’t – but hey, this takes some pressure off of me, and they’re not really my competition.
But there’s a part of me that is concerned that, if and/or when there comes a major claim dispute, or a substantial coverage issue, I’m going to have to become involved anyway, but I’ll have no knowledge or records of what has transpired thus far, thereby severely hampering my ability to help resolve the problem.
I’m going to noodle on this one a while…

2 comments:

  1. Interesting you should post that . . .

    Just the other day I spent most of the morning "solving" a claim problem for a client who wondered why they had almost $2500 OOP for a relatively "minor" claim.

    For the most part (if not entirely) the claim was paid correctly. The only area of potential dispute was a 15% discount on in network services that I felt should have been greater. Of course I am not privy to the particulars of the PPO contract, so that was just a "gut" reaction.

    Of course Patient Care is subject to the same issues involving PHI as we (agents) are, so there is presumably some sort of release form that has to be completed before the carrier will discuss claim details.

    $400 seems high and I wonder how many folks will chip in $400, over and above their premium, UNTIL they have a problem?

    Is the service of value?

    Certainly. Especially for those who purchased insurance without the benefit of a knowledgeable agent.

    However, if they have an agent, it is that agents responsibility to be their advocate.

    Bob Vineyard, CLU

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  2. It does seem unlikely that most folks would pop for the $400 on their own, but I noticed that they also market this as a voluntary group add-on (much like legal, vision, and "The Duck").

    At about $7.50 a week, it's not improbable that a lot of folks might go the payroll deduction route.

    OTOH, aren't the services touted in the plan the responsibility of a company's HR department? Heck, at the rates they're quoting, I wonder if we won't see employers out-sourcing HR to plans like this.

    From an agent's perspective, I'm still not sure whether this is a "good thing" or not. Certainly, it would take away some of the service workload. And they're not really competing for my business. OTOH, it seems somehow twisted that a client should have to pay for what is, really, my responsibility.

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