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Comment by phonon | Hacker News Reader

Except when "being your broker" means "some random sales dude with no training nor experience is handling your company's health insurance."

It's not particularly hard to get licensed (usually around $100, a training course of 40-100 hours (which they are large enough, they could set up inhouse), and possibly fingerprinting). Is it a hassle to get licenses in multiple states? Yeah--though most states honor other state's licenses, and just require the fee then.

In any case, this is table stakes--and if they can't get this basic aspect right (after being warned for years!) how well do you think they manage the tricky stuff? And why aren't they hiring experienced health brokers in the first place?

(The stuff about illegal rebates because they give away their software is garbage though. I'm 100% on their side for that.)

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I don't disagree that it's super easy to get a license and should be done regardless – but, geez, why is that a requirement? What's so special about selling health insurance that you should go to jail for up to 10 years if you're not licensed in it?

I'm curious because there must be something obvious I'm missing.

Sell inappropriate product, customer isn't covered, death due to lack of (covered) treatment ensues?

Because this is people's health you're talking about.

Do you feel drivers should have to get a drivers licenses? I hope you don't think Uber should just hire people off the street and put them in cars without proper licenses.

A simple health example off the top of my head - you sell health insurance to someone without understanding the product because you're so keen to 'make the sale'. Meanwhile you promised the buyer it would cover that heart condition he has when in fact you have no idea that it doesn't. A couple years later he needs heart surgery and finds out the plan he's been paying into doesn't cover his condition and now he cannot work to provide for his family, nor can he get treatment to get better.

> Because this is people's health you're talking about.

That argument is about as valuable as "think of the children."

> Do you feel drivers should have to get a drivers licenses?

That's not the right analogy. The equivalent would be requiring special licenses for all car dealership employees, which is not required. Salespeople aren't themselves doing anything medical and there's no reason they should have additional requirements beyond normal salespeople. We already have laws covering both (a) fraud, (b) minimum requirements of healthcare plans.

> A simple health example off the top of my head

Existing consumer protection laws would cover this. You can't sell a product and claim it has a feature which it doesn't — that's fraud.

Nothing about health insurance should mean that salespeople should require licensing. It's pure rent-seeking. There are plenty of other dangerous things which are sold by salespeople without licenses.

Perhaps a specific Zenefits example of employee incompetence is of use here.

The lady in this example is clearly not competent, and should not be selling products that people depend on for their health.

Not sure why you feel having gone through the hoops to demonstrate competence, learn about the various products, and how to advise clients of their options is merely 'rent seeking'.

---

"I made like $15,000 in the time I was there, just on commissions. And I never got my license," said an insurance salesperson who left Zenefits this summer. She estimated she had more than 100 conversations with different customers about insurance. "I took my test three times in a row, and I failed. They still let me work."

Without her license, she had to improvise on calls with customers.

When faced with a tricky question, "I would just google it,” she said. She would tell the customer, "Hold on one second, let me email the expert, he's on the line, hold on one second, I'll get back to you.” But in reality, “I would pick one of the first three links and I would just go off of that."

http://www.buzzfeed.com/williamalden/zenefits-under-scrutiny...

I'm not disputing that she's incompetent.

I deal with incompetence on a daily basis. Everyone from banks to airlines have incompetent employees, and we're not demanding that all customer support agents undergo licensing requirements. We live in a free market and the best way to deal with incompetence is the market. (Ex. I switched my bank after getting frustrated with incompetent tellers.)

Once again: the worst that an insurance salesperson can do is sell you bad insurance. They're not actually involved in medical procedures, so any harm they can do is financial. And if that harm is due to fraud (misrepresenting a product to you), you have legal remedies. Bank customer support people have just as much potential to cause financial harm, but we don't require them to be licensed.

Even more to the point: I can personally sign up for insurance directly on the internet, without talking to any licensed salesperson. If licenses salespeople are so essential to insurance, why can I buy insurance without interacting with one?

As far as I'm concerned, the only professions which should require government licensing are those where tort is insufficient to correct wrongs. (ie. someone can die: doctors, civil engineers, etc.)

"Once again: the worst that an insurance salesperson can do is sell you bad insurance. They're not actually involved in medical procedures, so any harm they can do is financial."

Sorry, there are very clear knock-on health effects here you're sweeping under the rug. Eg, if you're expecting to be covered for an urgent emergency life-saving procedure. Maybe you personally have sufficient cash on hand to pay for any required emergency surgery, that doesn't mean it's just a 'financial' problem to everybody else.

Do you really think it's appropriate to have someone be denied a medical procedure, and hope they survive so they can go through a legal challenge afterwards for 'fraud', and hope they can successfully provide proof of fraud over incompetence based on some phone conversation several years ago?

Instead of the much simpler solution of requiring some minimum license for the insurance seller?

I'm not sure about your online purchase example. Are you 100% sure these are the same insurance products requiring licenses as mentioned in the article, that no human sanity checks the product during the purchase process, or that the online algorithm itself didn't go through a sufficient license-compliant certification process?

> if you're expecting to be covered for an urgent emergency life-saving procedure

You will never be refused emergency treatment just because your insurance doesn't cover it. That's the law in the United States.

You will get a huge bill afterwards and there will absolutely be financial consequences, but not medical ones.

It's illegal for a hospital ER to refuse you due to lack of sufficient insurance. The point is that you won't die, so you will be around to come back and sue the broker. (In fact, insurance lawsuits are super common.)

Not to mention that we're dealing with a hypothetical case where you do actually have insurance but it's somehow insufficient (which, by the way, is unlikely under Obamacare). In that case, you would absolutely get treated, but your insurer would refuse to cover the bill and would pass it on to you. You could then sue Zenefits for misrepresenting the product and seek damages to cover the bill.

> same insurance products requiring licenses as mentioned in the article

They're not the same in that I'm talking about individual insurance and the article is group insurance, but that's irrelevant to the point. If there are serious medical consequences to buying insurance without licensed supervision, I shouldn't be able to buy my own insurance online.

FYI I believe they meant emergencies as in, any kind of medical service or procedure that your life may depend on. Which does not automatically mean the "emergency room." I.e. a much-needed surgery, drug, testing, etc.

This happens all of the time, people cannot go see a doctor or receive a medication because of an insurance goof up. And then they have to wait. And wait. And legal remedies are not guaranteed to solve the problem, and such remedies should not be relied upon as a fallback for untrained insurance salespeople.

What exactly are you trying to convince us of? That insurance sales should be have no licensing requirements? And you're hinging your argument on the fact that it is "financial" and not "health" related (which like I said above is not true). In that case are you also in support of getting rid of licensing and other regulations in the banking and finance industry?

   You will never be refused emergency treatment just because your insurance 
   doesn't cover it. That's the law in the United States.
   You will get a huge bill afterwards and there will absolutely be financial 
   consequences, but not medical ones.

Even ignoring the financial consequences, you literally have no idea what you're talking about. Hospitals are required to patch you up this second, yes -- but they don't have to treat underlying conditions until you're going to die from them. Regardless of how much damage that does. You can certainly die of very treatable diseases. Need a ct/mri, blood scans, cancer tests? Well, unless you're going to die of it this second, a hospital is not (and often won't) required to perform them.

The law you're citing -- EMTALA -- merely requires hospitals to stabilize patients.

> The law you're citing -- EMTALA -- merely requires hospitals to stabilize patients.

Yes, and that's what's necessary in an "urgent emergency."

>Once again: the worst that an insurance salesperson can do is sell you bad insurance. They're not actually involved in medical procedures, so any harm they can do is financial.

That's it, huh? Just financial? Only, you might get stuck holding the bag for a bunch of medical bills that aren't covered by some insurance policy you bought, so you get to spend your sick days fighting a legal battle against a company you might never be able to recover a cent from.

>"Bank customer support people have just as much"

Completely ignorant.

> you might get stuck holding the bag for a bunch of medical bills

What part of that is not financial?

> Completely ignorant.

Is there a licensing requirement for bank CS representatives that I'm somehow not aware of?

Ad hominem attacks are not an acceptable form of argument on HN.

As someone in the industry but not in the US, I'd say this is a case where your ignorance (and you are clearly ignorant here) is more of a hindrance than a benefit.

Providing insurance advice is the same as financial planning, mortgages, investments and any of a number of professions that are all licenced by the state. The reason for these licences is because not having them creates a wealth of misinformation that can (and historically has) resulted in massive amount of fraud and theft from consumers, because - like you - they generally aren't knowledgeable enough to be able to discern a difference of professional opinion from someone selling snake oil.

A licence is a minimum requirement to show to everyone that you have grasped the basic concepts and rules surrounding the product you are advising others on. It does some other things as well, like ensure you have proper E&O insurance and stay up to date with changing legislation, but that isn't its primary purpose.

Licencing is a form of consumer protection. End of story. Arguing that it isn't necessary and/or consumers in these industries don't need protection to counter their ignorance (which is the entire reason they are buying advice in the first place) is naive almost to the point of being moronic.

Errr...maybe the insurance carriers only want knowledgeable people selling their stuff? Who do you think gets sued if there is a problem? Insurance has been sold for a long long time. Another aspect is that if you a professional insurance agent, losing your license is a serious issue...so you won't act in ways to jeopardize it.

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