Complaint Review: Mega Life Health Markets UICI - Norh Richland Hills Texas

I spent two years with the Cornerstone agency, hired on from another career. I was excited, loyal, eager to learn and to help folks. And I did. The more I sat with people and compared plans and costs, read and reviewed policies, I discovered the flaws. We were trained that there was 100% coverage, not to worry the company would do the right thing. We had a client with chemo treatment owing 140,000 because of the scheduled benefits of $1,000 a day. Have a client with any king of transplant, better be approved. Better not need those drugs to combat rejection for the rest of your life, becuase it is hard to pay for the with a $1500 a year limit and 0 to 4 doctors office visits. Try and find an out of pocket limit to any of thier plans, there isnt one. We were taught to sell the Platinum and Premiere plans as they had caps or stop loss for hospital. They do. But the rest of the plan does not. When you run out of the scheduled benefits, you run out of coverage, there is not limit to the cost for the customer. This is not a major medical plan, it is a scheduled benefit hospital surgical plan and there is a difference, buyer beware. While this information is in the plan, it is not stated and is not advised to the consumer and agents are trained to avoid. I sat with a lady two weeks ago who had just signed with a Midwest agent. She was bipolar and heavy meds and had just cancelled her coverage based on the agents gaurantee that he could get here approved. She was concered about meds and consultations 2-3 times a week. The plans dont cover her even if she would have been approved. I showed her in her own brochure the limits and concerns, she said the agent had been in the business for years and was a trainer. We checked the DOI, license issued last October. She was fortunate, I was able to get her reinstated, to which she was grateful when she recieved her decline letter. However the agent was paid and that is all he wanted. They have major producers with 45-50% taken rates. Meaning only 50% of the policies written ever go into place, or if the do they don't last a month. So they write more in order to make more as their advance goes down with the taken rate. Then they cant quit, because they now owe the advances given and that were never paid by premium. Dont worry just sell more, dont ask to understand the process. They lied to me and trained me to do the same, Nieve I was. I learned when my coverage wasnt the best, I learned when there was a 35 state investigation, fines paid and state licenses threatened. Was told we had corrected those issues, Bull. the commission report could have been written on yesterdays business not two years ago. I am proud of my profession, I can now say I've closed over 95% of my sales, I listen to the needs and find the plans that work, I've not had one customer leave in the last year. Cornerstone taught me a lot of things, both in sales and insurance, the plans are what they are, they need to be sold that way. There is a place, folks need to be told what they are getting. Mine are, now!

I have been both a captive agent for another company and now I am an Independent Broker. I have to say that I do not and never would I ever represent Mega Life. I have met many individuals that have purchased policies from Mega Life and I have replaced them every time because of the lack of benefits. These people thought they had a good policy until they had to use it. I would love to have a list of their policyholders because my prospecting would be so much easier. It is great that you love your job but the truth is Mega has no business in the health insurance market. Their policies are horrible. I would suggest finding another company that has credibility in the health insurance market. Then when you write a policy at least you will feel good in the fact that you actually helped someone out rather than knowing deep down inside you just took advantage of someone that didn't understand the language used in a health insurance policy.

I read your posting and I am right in your own backyard. I had a brief unpleasant experience with Mega Life about 20 years ago and from what I saw, they are a pack of liars. What I saw were the reps pushing the association benefits, then the health insurance. The manager would get in front of the reps and tell them "say anything - just get the check and app." Their main pitch was they were offering "100% coverage". Of course that was true, but it was 100% up to their schedules. At that time their top surgical schedule was $3000 for a heart bypass operation when local charges for that surgery were running more than $20,000. Their hospital room rate was topped at $125.00 a day when local semi private room rates were almost three times that rate. Their selling method was a "one call close" and their line was "we aren't going to be back in this area for a couple of months" or "the open enrollment period is closing soon". Those were bald faced lies told only to get the application right away. I was raised by my family to believe that if any deal was so good that it wouldn't be around the next day or the next week or the next month, then it was too good to be true. Unless there is an age change (which will affect the price) or the health changes, this is needless pressuring and most sophisticated buyers can see right through it. I have been in the insurance business more than thirty years and have refused to use that kind of pressure. I want happy satisfied clients where I can walk back in their homes or businesses a couple months (or years) later and be greeted by a smile and a handshake instead of an angry fist. Those clients have given me many referrals because they like how I conduct business and that they trust me. Mega Life wants their reps to become lead junkies so they are dependent on the company and don't even think of selling any other product. Where I used to work, we had an expression for that called "mushroom farming". "Mushroom farming" uses a lot of organic fertilizer (manure) and is done in the dark, so in the business world you feed them a lot of ***t and keep them in the dark. Just because someone has insurance doesn't mean that they are covered. Very often that gives a false sense of security which is worse than being completely uninsured. If you have a $50,000 hospital bill and your insurance only pays $10,000 of it (as I have seen some statements from Mega Life policyholders), I don't think that the hospital will forgive the $40,000 not paid by the insurance. Every public hospital in this area (yes even Parma Hospital) will offer a financial rating to those uninsured based on their ability to pay. Physicians at MetroHealth will do the same thing through the financial office, so if someone cannot afford health insurance, they can still receive top quality care priced on their ability to pay. If they have children, the children can be enrolled in the OCHIP program if their family income is within the standards (as much as $62,000 for a family of four). If someone does want a comprehensive health insurance plan with lower premiums and doesn't mind self insuring the "small stuff", then sell them a high deductible plan with a corresponding health savings account. Even a $5000 deductible policy with an HSA offers at least a cap on the cost and in the worst case scenario, it is much easier to make arrangements to pay off a $5000 deductible than it is to go around with a health insurance policy that will pay $10,000 on a $50,000 hospital bill. Giving someone a false sense of security is worse than not having any security at all.

So how to you explain the recent Maine 1 million dollar fine? This was nothing agents did - it's Mega: http://www.maine.gov/tools/whatsnew/index.php?topic=INS-PressReleases&id=53499&v=Default Or if that link doesn't work visit the Maine DOI website. I'll await your response.