I am facing my own mortality and the fact that I did nothing with my life. What a great time to study because this job will actually pay me well and is one of the top 100 places to work. Score!
Producer Responsibilities in Individual Health Insurance
Everyone gapes at the ridiculously long title of this chapter. And the characters continue to sit there patiently like the good little characters that they are. Finn is also being written in a far more interesting story so he's a lot less impatient. And Adrianna was the subject of a very interesting discussion today so she's feeling better, though apprehensive because said discussion involved more than a little bit of physical pain on her part.
BAYMAX: This next section of the chapter is longer than the others and even less interesting. However, it is important.
GOGO: More like torture.
FINN: Not so bad, really.
GOGO: Oh stop, you're being written into 2 stories at once.
HONEY: Technically we all are being written into more than one, probably at the same time.
TADASHI: Pouts. I'm probably not. Being killed off and all.
HIRO: So inconvenient.
BAYMAX: The first part of this is about Marketing Requirements. Full and fair disclosure and honesty in advertising applies to any Health Insurance advertisement for presentation, distribution, or other means of advertising. An insurer (company) whose Health Insurance policies are advertised is held responsible for all content irrespective of who wrote the advertisement or brochure.
ASTRID: Okay so what you're saying is ads have to be honest and disclose everything and the company is responsible for anything written in the ad.
BAYMAX: Excellent summation. Have a Tootsie Pop.
BAYMAX: It is considered to be an Unfair Trade Practice to advertise that an insurer's policy is guaranteed or covered by the Life and Health Insurance Guaranty Association.
Everyone gasps dramatically.
TADASHI: The evil term Overlord Katie didn't know has returned.
HIRO: Kill it with fire!
TADASHI: Um hello, sitting right here!
ERICK: Wait, did my sister die in the modern AU?
OVERLORD KATIE: I don't know yet. Probably not.
ERICK: I'm only 50% offended by that then.
BAYMAX: Sales presentations must be honest, accurate, complete, and defined to be clear.
HIRO: Okay...
BAYMAX: An Outline of Coverage must be presented at the time of application or upon delivery of the policy to an insured (client). The intent of the Outline of Coverage Provision is to present an insured with an an honest, full, and fair disclosure of their policy.
WASABI: So the Outline of Coverage Provision basically gives the insured all the information they need to know about their coverage.
BAYMAX: Correct.
OVERLORD KATIE: I'm totally losing interest in this story because I'm tired of typing all this up but I need to book it before I run out of time.
ADDIE: Aw it's okay, just keep spending your random moments talking about how much agony I'll be in.
OVERLORD KATIE: Thank you, Addie. That means a lot.
HICCUP: Aren't I the only one who calls her that?
OVERLORD KATIE: That's Overlord Emily and my preferred nickname and we created her so...
HICCUP: Fine.
BAYMAX: Field Underwriting is the initial evaluation and screening process performed by agents (producers) in the insurance field. It is during this time that information is gathered on an applicant. The process is essential in screening unacceptable risks.
TADASHI: Wouldn't they do a Consumer Report?
BAYMAX: Excellent use of vocabulary words but I am not sure. It isn't mentioned in this section of the database.
HIRO: Thank goodness Overlord Katie won't actually have to know all of this for her job.
BAYMAX: Indeed. The basic purpose of Health Insurance underwriting is to lessen the probability of adverse selection. Adverse Selection refers to those most likely to submit fraudulent insurance claims.
TADASHI: I thought that was about people with higher risks.
BAYMAX: That too. But people with higher risks are more likely to submit fraudulent insurance claims.
WASABI: That contradicts my notes...
FRED: It's best not to question things like that in life. Just keep going and don't look back.
GOGO: That was surprisingly deep.
FRED: I do read a lot.
BAYMAX: A producer (agent) cannot disclose any personal information or privileged information about a potential insured (client) without written permission. Written authorization by an insured must be dated and signed within one previous year. In addition, the information must be provided to an insurance regulatory authority or law enforcement agency.
WASABI: Wait, okay so the agent can't release personal information without written permission from the insured. It must be dated and signed within the year and be provided to law enforcement and regulatory authority.
HIRO: Whatever that means.
BAYMAX: Correct. To affiliate for an audit, further disclose needs to be made.
TADASHI: So they have to talk to each other and get more permission.
BAYMAX: Put simply, yes. The information must be provided to a group policyholder for the purpose of reporting claims and the information must be reported to someone having a legal or beneficial interest in a policy of insurance.
WASABI: So it has to be reported to a bunch of legal people and policyholders.
BAYMAX: That is correct. An application is an applicant's written request to an insurance company to issue a contract. An application's process for insurance begins with an approved application (APP) form provided by an insurer and is completed by the producer.
HONEY: Okay...
BAYMAX: When questions are asked of the applicant, their answers are written on the application and are called representations.
TADASHI: Yeah, we went over that.
BAYMAX: Yes we did. When an application is approved, a policy is issued. An application, joined together with the policy into one entity, is an entire contract.
HICCUP: So an application plus the policy is an entire contract.
CLIFF: Like a math problem.
ERICK: You're still here?
CLIFF: Yep. Apparently SOMEONE forgot to give me lines last chapter.
OVERLORD KATIE: I'm sorry, Cliff, can you ever forgive me?
CLIFF: Oh Overlord Katie, how could I hate you? You've given me the least amount of angst of your main characters.
OVERLORD KATIE: Yeah, about that. You're a secondary character.
CLIFF: Say it isn't so!
OVERLORD KATIE: Sorry but the Haddocks plus Erick are the main ones.
FINN: Why not Brandyn or Inga?
OVERLORD KATIE: Give it time.
ERICK: Brandyn doesn't need more time. You know all the fans want us to make out.
FINN: Gag.
ADDIE: What the fans want and what will happen are two separate things.
CLIFF: Word. No one's even speculated about my soulmate yet and she's already been written into the series several times.
ADDIE: She hasn't even spoken to you yet.
CLIFF: The only females who have spoken to me as of yet are you and my mom!
ADDIE: Maybe we're soulmates.
CLIFF: I'm flattered but you're madly in love with my bruh.
ADDIE: Time will tell.
HICCUP: Everyone wants Addie and Erick. I even want think it's cute. And no one's good enough for my little girl.
BAYMAX: Speaking of relationships, are you and Stephanie going steady?
HIRO: What? Uh I guess? I haven't been updated.
OVERLORD KATIE: You can blame these jokers here for that.
HIRO: Or you could just write the stupid story.
OVERLORD KATIE: Have you ever had writer's block? It's horrific. Plus I embarrass you in every chapter of that story!
HIRO: True...
HONEY: Wait so are Tadashi and I a couple?
TADASHI: I don't know. I like both you and Gogo because a certain overlord is a multishipper.
HONEY: Yeah, I've got some feelings for F- uhh someone else in this room.
FINN: It's me.
HONEY: No offense, dear, but no it's not.
GOGO: Burned.
FINN: Yeah well maybe you and I can go out after this is over.
GOGO: Are you hitting on me?
FINN: Is it working?
GOGO: No.
FINN: Then no I'm not.
ERICK: Someone likes girls with dark hair.
FINN: Shut it, Larson.
CLIFF: Finny and Inga sitting in a tree-
FINN: Don't make me kick you.
BAYMAX: Maybe we should continue the lesson on insurance.
WASABI: That sounds wise.
BAYMAX: It is also required that a "Notice to the Applicant" be issued to all applications (insured, client) for Health Insurance to inform them that a Credit Report will be ordered concerning an applicant's past history and any other health insurance for which the applicant has applied in the past.
HONEY: Okay then.
BAYMAX: I will paraphrase the next part. Applications should be filled out in ink and using whiteout is not allowed, nor are pencil erasures. It's best to start with a fresh application if a mistake is made and if a mistake is made, you can cross it out and initial the correct answer.
TADASHI: Simple enough.
BAYMAX: If an applicant pays the first premium with their application (under the terms of the insurability conditional receipt), the insurance coverage goes into effect as of the date of the receipt of the premium, provided the application is approved by underwriting.
HIRO: So as soon as the premium is paid, the coverage goes into effect.
BAYMAX: Correct. The policy must be delivered personally or mailed. It is recommended that the producer physically deliver the policy, whenever possible, so that the client's original needs and the policy are reviewed. If the premium was not paid at the time an application was submitted, the producer (agent) must collect the premium and obtain a signed statement of an insured's good health.
WASABI: So it's best to deliver a policy so you can go over it and collect the premium if it hasn't been paid?
BAYMAX: Exactly. Finally, errors and omissions are misunderstandings or misrepresentations. The most common time they may occur are during times of the sales process or the policy's delivery. They could lead to legal action being taken by an insured against an agent and his or her company.
ASTRID: Not good.
BAYMAX: Insurers are encouraged to document all correspondence with an insured in the event errors and omissions should occur.
HICCUP: And that's all there is?
BAYMAX: That concludes the section. There is one section left before we move on to chapter 5. That will contain Medical Plans.
OVERLORD KATIE: I tried to read the first page. It was complicated.
BAYMAX: Do not worry. We will go over it together. You and your closest imaginary friends are here for you.
OVERLORD KATIE: Thank you. You're the best characters in the world.
CLIFF: You're so welcome. And thanks again for the significantly decreased number of horrific events in my life compared to others.
OVERLORD KATIE: Don't mention it.
ADDIE: Rub it in, why don't you.
HIRO: Hey, it could be worse. You could be me.
TADASHI: I'm alive, aren't I?
HIRO: For now, Tadashi. For now.
Took my nap. It was lovely. Bedtime for me now and chapter 2 section G next! Also we have a ton to write for Growing Pains so don't expect a chapter right away but we are wrapping it up. Hiccups discussions are getting interesting. We changed a plan we had in place for over a year and we already like it more. There are going to be a LOT of deleted scenes!
~KateMarie999
P.S. Reviews don't bother me, gust. I love any and all that I get except off topic or excessively negative ones, both of which are quite rare.