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BC/BS insurance rant

Old 01-12-2018, 07:55 AM
  #1  
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BC/BS of Michigan is the least competent organization I have dealt with in the last 40 years, all of which have been in the healthcare business, the yin to a health insurance company's yang. As a business the various bcbsm departments do not share computer systems which allow customers files to be merged into a master file. To get an answer to any question you have to call a department which then conference calls other departments within the organization. They cannot resolve issues without referring the issue up the chain for help.

Unfortunately, they are the "name" insurance company in Michigan, a vestige of the collective bargaining pattern starting with the Auto/UAW contracts then spreading through out the state. In some areas they are virtually the only available insurance for people who travel to other locations.

On the plus side the Dan Loepp the CEO, has been paid almost $11mm in 2016 and more than that in 2017. All of which was based on a pay for performance reward system. Unfortunately the system rewards organizational cost cutting not service to the customers. Profitability was ensured for this next year by a 40% rate hike and elimination of plans with the most benefits.

I believe I will stop laying the lottery and instead start a campaign to run an insurance company. The payout is assured and the work must be easy as nothing works.
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Old 01-12-2018, 08:45 AM
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Least competent? You have never delt with Cigna.

Where I work we are self insured. 4 years ago we had bc/bs as our manager. During that time claims were rarely denied and our fund balance was so fat we got a $400 check at the end of the year.

When our contract was up with BC/bs Cigna won the next round and was appointed the new manager. Within weeks claimed became a nightmare, they did not have an established physicians in the area...total chaos and a nightmare.

Fast forward 3 years...The fund has been depleted, we had a 27% increase last and are predicting a 10% this year!

I am not an actuary or an insurance guru. What I do know is our demographic have not changed and in 5 years the fund is empty and all we have to show for it is less coverage.
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Old 01-12-2018, 08:51 AM
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Originally Posted by txj33p View Post
BC/BS of Michigan is the least competent organization I have dealt with in the last 40 years, all of which have been in the healthcare business, the yin to a health insurance company's yang. As a business the various bcbsm departments do not share computer systems which allow customers files to be merged into a master file. To get an answer to any question you have to call a department which then conference calls other departments within the organization. They cannot resolve issues without referring the issue up the chain for help.

Unfortunately, they are the "name" insurance company in Michigan, a vestige of the collective bargaining pattern starting with the Auto/UAW contracts then spreading through out the state. In some areas they are virtually the only available insurance for people who travel to other locations.

On the plus side the Dan Loepp the CEO, has been paid almost $11mm in 2016 and more than that in 2017. All of which was based on a pay for performance reward system. Unfortunately the system rewards organizational cost cutting not service to the customers. Profitability was ensured for this next year by a 40% rate hike and elimination of plans with the most benefits.

I believe I will stop laying the lottery and instead start a campaign to run an insurance company. The payout is assured and the work must be easy as nothing works.
How big is your company? As in how many employees are on your plan?
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Old 01-12-2018, 09:51 AM
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Originally Posted by eseyoung View Post
Least competent? You have never delt with Cigna.

Where I work we are self insured. 4 years ago we had bc/bs as our manager. During that time claims were rarely denied and our fund balance was so fat we got a $400 check at the end of the year.

When our contract was up with BC/bs Cigna won the next round and was appointed the new manager. Within weeks claimed became a nightmare, they did not have an established physicians in the area...total chaos and a nightmare.

Fast forward 3 years...The fund has been depleted, we had a 27% increase last and are predicting a 10% this year!

I am not an actuary or an insurance guru. What I do know is our demographic have not changed and in 5 years the fund is empty and all we have to show for it is less coverage.
BC/BS is different in each state, although there are some multi state organizations. The one in Michigan sucks now. Didn’t in the previous century. The organizations in PA or TX make Michigan look like romper room.
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Old 01-12-2018, 10:31 AM
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BCBS insurance review board in 2016 denied my Dr's order for a CT Scan. I bought one myself and discovered a very dangerous subdural hematoma . The they denied another CT scan and ordered an MRI which would have killed me as I have implanted devices in my chest. They are indeed death boards.
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