In a nutshell, folks with network-driven plans, who see par providers for non-covered expenses, don’t get the insurance companies’ discounts for those services. Nowhere in the sales literature or training, nor in the policies themselves, is this made clear.
So, an agent who is not aware of this situation has no obligation to inform his client – or potential clients – of this salient fact.
But what about those of us who do?
I’ve already mentioned how I felt compelled to explain this to a potential client. Today, I had an even more worrisome experience: One of my clients is a locksmith, who has a (very) small business. About 5 years or so ago, I sold him (or he bought from me, you pick) an MSA (subsequently converted to an HSA). He came by today, because we needed some locks re-keyed. I hadn’t spoken with him in a while, so we spent some time catching up on “mom and them,” and (naturally) the conversation turned to his insurance. He positively gushed about how happy he’s been with the HSA; in fact, he has almost $10,000 socked away in the loss fund, money that (in his words) would have been in the insurance company’s pockets, not his. So why am I ticked?
Because I had to decide whether or not to ask him about his experiences (if any) with non-covered expenses. I literally argued with myself for several minutes about this. In the end, he excused himself to go about his work, so I was (at least for the nonce) relieved from engaging him in this subject. But I know that I will – I must – bring it up with him at some point, most likely sooner than later.
Ah, ignorance is bliss. (Or would be, I suppose)
