Thursday, December 22, 2011

Stupid Broker Trick: Selling a Group Plan where the Main Local Hospital is OUT of network

So, S. Mart rides his bike to work.  Everyday.

BOOM!  A car smashes into S. and he's whisked to the local emergency room by ambulance.  S. had no CHOICE as to the ER since, um, well, HE JUST GOT HIT BY A CAR!!!!!!!! 

His group insurance carrier informed him that since the hospital was Out-of-Network, he'll have to pay the difference.  (This typically doubles to quadruples your out of pocket...)

Technically, since it was an emergency, and S. had no choice, the out-of-network rates should not be applied.  In fact, the carrier did agree, and is reviewing the submitted bills from the hospital.  Good on them.

Here's the Stupid Broker Trick:  Selling a group plan where the Area's MAJOR ER was Out-of-Network.  "I'll bet it was the cheapest," interjected my friend in HR, KRE.  So, this guy made the sale, but failed to inform a rather key piece of info.

Luckily, S. is okay, and will pedaling again soon.  I wish I could say the opposite for the broker.

No comments:

Post a Comment