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Insurers Taking Advantage of Rising Healthcare Cost

Healthcare costs are rising at alarming rates. Many employers are cutting back on the types and coverages of insurance they offer to employees, forcing many to obtain insurance from outside sources. Unfortunately, many consumers find the process daunting and the rates overburdening.

A recent independent study conducted by the Commonwealth Fund found that:

  • Insurance in the individual market is often impossible to obtain or unaffordable. Nearly nine of 10 people who explored obtaining coverage through the individual market never bought a plan, citing difficulties finding affordable coverage or being turned down.
  • More than half of adults with coverage through the individual market have annual premium costs of $3,000 or more, compared with one of five covered by employer plans.

Insurers are realizing this and are taking advantage. Several insurers, including MEGA Life and Health Insurance Company Midwest National Life Insurance Company of Tennessee, Company have been advertising to consumers about their products and are starting to see more and more lawsuits being filed against them.

Consumer attorneys explain that primarily they sell through a group of agents who sell the policies as well as memberships in two organizations, primarily, one called NASE, which stands for the National Association of Self-Employed. Another is called Alliance for Affordable Services.

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The way these insurance products are marketed are through these agents, that, in order to sell the policies, advise insurance consumers that if they join either the NASE or the Alliance for Affordable Services, they’re joining large groups of insurance consumers, and therefore, they’re able to obtain group-like insurance at group-like premiums. They never advise the insureds, the potential insureds, the consumers, that these so-called not for profit, or profit entities, these groups, are controlled by Health Markets and their subsidiaries, Mega and Mid-Life, Midwest.

How Can They Do This?

While every state has an insurance department and commissioner who oversees insurance practices, insurers have found loopholes in state laws that allow them to be “less than honest.” But, is it legal? Consumer attorneys say it is. However, in California and several other states, a group like this cannot be set up for the sole purpose of selling insurance and we take the position that the way these organizations were set up was specifically to sell insurance, which is illegal.

Several advocate groups are demanding better protection for consumers when purchasing healthcare insurance. However, until changes are made, consumers should make sure they know who they are dealing with and contact an attorney who specializes in insurance matters to look at the policy first so that you don’t have to contact them to litigate later.

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