NAIC ikufuna kusocheretsa malonda a inshuwaransi yazaumoyo – InsuranceNewsNet

Ogwiritsa ntchito amawomberedwa ndi zotsatsa zabodza za Medicare Advantage ndi mapulani ena azaumoyo. Oyang’anira inshuwaransi amachitapo kanthu kuti azindikire ndi kuthana ndi kutsatsa kosayenera kwa mapulani azaumoyowa.

Oyang’anira inshuwaransi awiri aboma adapereka chidule cha zoyesayesa zolimbana ndi zotsatsa zabodza pa Lachitatu Lachitatu la 2022 National Insurance Commissioners Summit.

Zotsatsa pawailesi yakanema zokhala ndi othandizira otchuka akulimbikitsa owonera kuti ayimbire nambala yaulere kuti alembetse mapulani a Medicare Advantage, komanso zotsatsa zogulitsa mapulani akanthawi kochepa kapena “owonda”, osagwirizana ndi Affordable Care Act, ndi zitsanzo ziwiri zodziwika bwino za kutsatsa kwadongosolo kosayenera, thanzi, okamba adatero.

Franklin T. anati:

NAIC inakhazikitsa Health Insurance Improper Marketing Working Group (D) mu 2021. Ndalama zake zikuphatikizapo:

  • Gwirizanani ndi olamulira aboma ndi aboma kuti apereke thandizo ndi chitsogozo chowunikira kutsatsa kosayenera kwa mapulani azaumoyo, ndikugwirizanitsa zochita zoyenera.
  • Onaninso zitsanzo ndi malangizo omwe alipo a NAIC omwe amayang’anira kugwiritsa ntchito majenereta otsogolera pakugulitsa zinthu za inshuwaransi yazaumoyo, ndikuzindikira zitsanzo ndi malangizo omwe akufunika kusinthidwa kapena kukonzedwa kuti athetse zomwe zikuchitika pamsika.
  • Kupanga chilankhulo mkati mwachitsanzo chomwe chilipo kale kapena kupanga choyimira chatsopano kumapatsa mayiko kuthekera kochitapo kanthu motsutsana ndi majenereta otsogolera.

Martin Swanson, wachiwiri kwa director ndi phungu wamkulu wa dipatimenti ya inshuwaransi ya Nebraska, adati gulu logwira ntchito likuwunikanso lamulo la Unfair Trade Practices Act, makamaka ponena za tanthauzo la lamulo la “jenereta ya inshuwaransi yoyamba.”

Pansi pa Gawo 2 la Lamuloli, “Primary Insurance Originator” amatanthauza chilichonse chokhudzana ndi malonda kapena bungwe lomwe limalengeza kupezeka kwa inshuwaransi, kapena limaganiziridwa kuti ndi inshuwaransi kapena ntchito.

Zomwe gulu likuyesera kuchita, Swanson adati, ndikuzindikira “jenereta wamkulu.”

Ndime 3 ya Lamuloli ikunena kuti sichilungamo kuti kampani iliyonse ya inshuwaransi ifalitse, kufalitsa, kufalitsa, kufalitsa kapena kuwonetsa zotsatsa, zotsatsa kapena mawu omwe ali ndi anthu pazofalitsa, kulumikizana pa intaneti, imelo, wailesi kapena wailesi yakanema. Zonena zabodza, zachinyengo kapena zosocheretsa, zoyimira kapena zonena za inshuwaransi kapena bizinesi ya kampani ya inshuwaransi.

Swanson adati gulu logwira ntchito likufuna kusintha chilankhulo cha Gawo 3 kuti liphatikizepo jenereta yotsogolera ya inshuwaransi ndi kampani ya inshuwaransi. “Monga pano, tili ndi mphamvu pazogulitsa koma osati jenereta yayikulu,” adawonjezera.

“Ndi chilankhulo chotakata koma chiyenera kutero chifukwa machitidwe amisalawa akusintha nthawi zonse,” adatero. “Agogo aakazi pa Facebook amayang’ana zithunzi za zidzukulu zawo pamene ayamba kumudzaza ndi malonda a Medicare Advantage.”

Swanson adati bungwe lake lamva kuchokera kwa opindula angapo a Medicare omwe anena kuti adalandira mafoni kuchokera kwa munthu wina yemwe akunena zabodza kuti amagwira ntchito ndi dipatimenti yokalamba ya boma ndikuti akuyenera kusintha mapulani awo a Medicare. “Ndi chinyengo,” adatero.

Makampani ambiri a inshuwaransi omwe amapereka mapulani anthawi yayitali, kapena otchedwa “mapulani ang’onoang’ono”, asamukira kumsika wa Medicare Advantage ndipo akupereka okalamba zomwe Pyle amachitcha “mapulani opanda pake.”

“Iwo akuganiza kuti n’kosavuta kupusitsa munthu wamkulu yemwe akuganiza kuti akupeza mapindu ambiri posintha ndondomeko ina,” adatero. “Sindikufuna kuwona akuluakulu athu akunamizidwa ndikunena za mapulani awo oti achite nawo ndondomeko yosafuna.”

Unduna wokhudzidwa ndi zaumoyo

NAIC ikuyang’ananso mautumiki ogawana zaumoyo, omwe safunikira kutsatira ACA.

Pyle adati NAIC ilibe ulamuliro pa maunduna okhudzana ndi zaumoyo, koma adawonjezera kuti “izi zitha kusintha” chifukwa mapulani ena ayamba kutsatira ACA.

Adalozera ku Virginia Bureau of Inshuwalansi, yomwe yatulutsa mndandanda wa mafunso omwe amafunsidwa pafupipafupi kwa othandizira omwe amapereka mapulaniwa. Mndandandawu udawonetsa kuti maunduna okhudzana ndi zaumoyo samatsimikizira kuti alipiridwa, zomwe zitha kusiya ogula kuti alipire ndalama zazikulu zachipatala. Othandizira omwe akufuna kupereka mapulaniwa ayenera kuwonetsetsa kuti akumvetsetsa zomwe angakwanitse ndipo ayenera kufotokozera zoperewerazi kwa ogula kuti asawasokere. Ma Agents akuyeneranso kupatsa ogula chodzikanira chovomerezeka mwalamulo.

“Zolinga zabwino zimafuna kuchotsa zisudzo zoipa. Tikufuna kuchotsa ochita zoipa. Izi ndi zabwino kwa aliyense, makamaka ogula.”

Susan Robb ndi mkonzi wamkulu wa InsuranceNewsNet. M’mbuyomu, adagwira ntchito ngati director of communication wa Association of Insurance Agents ndipo anali mtolankhani wopambana mphoto komanso mkonzi. Muyimbireni iye [email protected]. Tsatirani iye pa Twitter @INNsusan.

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