Insurance, Guidestone, ObamaCare–Does it Work?

Posted: October 5, 2010 in GuideStone, Insurance

When I was growing up I remember hearing my Daddy tell someone one time that he was “Inshorance Poe”. :)  What he meant was that he had so much money going to various policies to protect him in an untimely death that he could not afford to live.  Well, that certainly seems to be the case in today’s insurance market and it certainly does not look as if it is going to get better any time in the near future.  One other thing I learned from my Daddy growing up was that you do not accept anyone’s word for anything when purchasing insurance because if it the policy does not say it then it is not going to be covered.  Which brings me to my latest adventure with GuideStone.

During this past year Gail and I noticed that we had a few extra insurance dollars as Gail is now employed full-time.  With these extra dollars we decided investigate to short-term disability insurance as I am already insured with long-term disability.  Long-term disability insurance covers one for 12 months and longer but does not cover the first 90 days after the accident,  while short-term disability only provides coverage for 30, 60, or 90 days.  Thus, while I am covered with Long-term Disability the first ninety days leaves me vulnerable to a huge out-flow of funds already in savings.  I decided to contact GuideStone to inquire of the steps needed in order to secure the needed disability insurance.  When I contacted GuideStone I was told that I needed to go through underwriting in order to be considered.  I admit there was a small level of concern raised with that information but I did not consider it big issue for me as I already have medical coverage and long-term disability through GuideStone.  I awaited the paperwork in order to apply for the short-term disability and much to my surprise I received an entire application for all of the products.  I was confused and really did not quite understand what it was all about.

As I opened the packet I noticed it was a 15 page application, this in itself was quite overwhelming.  As I perused the pages I noticed there was some very in depth information.  I noticed that it asked for some personal information.  No problem as they need that information to qualify that I am who I say I am.  I then noticed they desired employer information.  Again, no problem as this is information that is needed.  However, after this information there is much more information that seems to be required.  I stopped and went back to the instructions to inquire of the information that is needed.  It is here that I took another look at what the application was asking.  Why?  In the instructions one is instructed; “To avoid delay in processing of your application, answer all questions“. (Emphasis mine)   I contacted GuideStone and ended up speaking to two people to express my concern.  Understand I was treated very respectfully and in a professional manner by both people.  I understand they were doing their jobs and were trained very well in order to handle the situation such as mine.  I explained that according to the application I was supposed to give answers to all of the questions, thus placing myself in a position of being subject to underwriting for another medical policy.  The Customer Service Representative along with her immediate Supervisor were very cordial but firm about what I was supposed to do.  I was eventually told by the Supervisor that I only had to complete the information for the insurance vehicle that I wanted to apply.  However, I also had to complete pages 7-12 (which is complete medical information on myself and my dependents, though they are not applying for coverage) and then sign page 13 along with page 14 and 15 (which is Certification of Dependent Eligibility).  On page 13 I am told there is no reason to complete page 14 or 15 unless my dependents are applying.

However, it is page 13 which causes me a huge quandary.  It is on this page that the following paragraph is found.

Caution: If your answers on this application are incorrect or untrue, Unum and its duly authorized representatives, Case Professional Resources, LLC, or GuideStone may deny benefits or rescind your insurance or other coverage, limited to the contestability period.  Any person who, knowingly or with intent to defraud or deceive GuideStone or any insurance company, submits an application for insurance or other coverages containing any materially false, incomplete or misleading information may be subject to civil or criminal penalties, depending upon state law. (Underline emphasis mine)

Please understand that I am not going to try and mislead anyone.  However, if I give “incomplete” information then I am subject to civil and criminal penalties.  Thus, my dilemma in completing only the part of the insurance that I am applying.  I was assured by the supervisor that all I needed to complete was the part of the disability for which I was applying.  But, that is not what the applicant is informed of in the instructions for completing the application.

One other issue that causes serious heartburn for me is the fact that I am being subject to underwriting for short-term disability when I am already insured with long-term disability.  I expressed this concern but it has fallen on the ears of a deaf policy.  Let me say that if I had not already gone through underwriting I would understand completely the need for this information.  However, with my being a customer with the medical coverage and long-term disability, the short-term disability should really be a given. Why?  GuideStone has been my insurance provider through Blue Cross Blue Shield ever since I have been a pastor.  They have all of my claims requested by my medical provider.  Thus, they know all of my medical procedures and know there is nothing to hide.

With this frustration of Insurance through GuideStone one can only imagine the frustration one will experience with ObamaCare.  I finished the phone conversation frustrated and knowing that my concerns would end up on the deaf ears of a company policy.  (Do not get me wrong I believe that those to whom I spoke will pass the information along, but I am not too encouraged that it will make it past a policy that is already in place.)  While I have the advantage to forget about this and just move on, with ObamaCare no one will have a choice.  One will have to purchase whatever is decided and there will be no recourse such as the one I am choosing–FORGET IT AND LET IT GO.  So the next time you get into a disagreement with a insurance provider have heart ObamaCare will-change it before long and-MAKE IT WORSE.

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Comments
  1. Tim, I tried to call you about this but couldn’t get an answer at the church so I’ll give you the Readers Digest Version.

    What you did mention tells me that Guidestone has a subsidiary that is a licensed Insurance Agency .. Case Professional Resources. Most likely. Could be that the many states don’t allow LLC’s to have an agents’ license unless the principals are licensed, so they went that route.

    You also reveal that UNUM is the insurance company that will be insuring the Short-Term coverage. Unless they also provide the Long Term, they would necessarily need all new information. Neither Guidestone nor Case Prof. Res. would have any control over that. UNUM wouldn’t know you from Adam’s tomcat, except for what’s on paper.

    Even if UNUM is the present ST provider, your health may have seriously changed since that was purchased, so they’d likely need updated info.

    As to asking for all the details in such a case, ask yourself this. Consider your car insurance. Would you want to be lumped into a single dollar pool for the collection of premium and the payment of claims, with all reckless teens and drunks? Probably not .. so the underwriting process is all about fitting you into a “risk grouping” .. which comes out as a rate group .. with basically similar people … with similar exposure.

    You could also draw a similar conclusion about grouping your home or renter’s insurance with slum dwellings for purposes of rate making.

    As to all the dire things that might happen if one were to willingly withhold information, you have to remember that some folks play really fast and loose with what they put down on applications, and it behooves the company to warn in advance the possible legal ramifications of doing so.

    That’s the “why”. It’s as much for your protection as anybody’s, because, in the end, you’re the one who’s sending them the money to pay claims, and you don’t want to send more than you have to, or invest in some insurance that goes bust because they took in a lot less than they had to pay out.

    Blessings, brother.

  2. Tim Rogers says:

    Brother Bob,

    As for the article I hope you do not read it as a slam against GuideStone as that was not the intention.

    Now, with me knowing that you are retired from the Insurance profession, and because you are my friend you know I do not mean anything personal. However, I am very suspicious of insurance companies because of the way they are set up to do business. Insurance companies are set up to make as much money as they can for their investors. Thus, they take the risk of insuring people, animals, actors chests, actresses derrieres, you name it and an insurance company will insure it. The Insurance company has a mind set we will pay only the claims that we say we will pay and not a penny more. That should be their mindset and they should pay what they say they will pay. Here is the biggest gripe that I have. When one files a claim the wording has to match what is in the insurance policy. For example, lets say that my calf muscle was insured. I have an accident and it affects my calf muscle and my medical provider charts that he treated the “back side of my lower leg”. When that if filed, my insurance provider would probably reject the claim. It would have to be refiled using the term that is in the policy. Granted, the insurance company does not know me from Adam’s house cat. And granted, the back side of the lower leg can be argued that more is involved than the calf. The fact remains that it was the calf that was treated and it was the calf that I have been paying insurance on to protect.

    Now, if there is a different company insuring the “short-term” disability than is insuring the “long-term” disability there is no problem. GuideStone is certainly following that and I believe fighting for the best rates for us. However, my frustration and concern lies in the paperwork that I am asked to submit. As I say in the Op there is nothing in the directions that instructs one to only fill out the information for the insurance that one is applying. Therefore, one is required to re-apply for all insurance any time the underwriting process is entered into for only one insurance.

    Now, on other thing that you said I believe is the misunderstanding of the public because of the Insurance companies PR campaigns.

    You said;

    Would you want to be lumped into a single dollar pool for the collection of premium and the payment of claims, with all reckless teens and drunks? Probably not

    Brother, we already are lumped into a single dollar pool in the medical insurance. When an insurance company figures funds they factor in an amount that is fraud. They know that they are going to pay fraudulent claims and factor that amount into the premiums they are going to charge me, even though I am listed in a preferred health group category.

    Blessings,
    Tim

  3. You ought to see what happens when insurance becomes mandatory and everyone must be insured. I’ve seen it happen more times than I can count.

    As for profits, most insurers make 1 to 8% (last I heard) profit, which is nothing stellar as an investment, from the stockholder point of view. You can check that against internet/tech companies here: http://larrycheng.com/2010/03/08/just-how-profitable-are-healthcare-insurers/

    Few of them showed less profit than the best insurer shown, which happened to be UNUM.