What do James Presley, Bob Barnes and William Rusteberg have in common? The year was 1984, Corpus Christi, Texas.
Coastal Bend Health plan, an HMO, had notified Nueces county officials of their intent to offer benefits to county employees which they were allowed to do under the Health Maintenance Organization Act of 1973. Under the Act employers with 25 or more employees were required to offer federally certified HMO options if the employer offered traditional healthcare options. The Coastal Bend Heath Plan made their move.
Blue Cross was the incumbent carrier but required 75% participation in order to continue coverage. Coastal Bend Heath Plan ended up enrolling about 1,600 employees leaving 300 employees on the Blue Cross plan.
Blue Cross terminated coverage citing participation requirements putting the county in a bind. In search of alternatives the county went to bid for a PPO plan option but there were no takers.
The Coastal Bend Heath Plan representative, a friend from a former life, called and asked if I could help the county find a PPO plan option. “I don’t know if I can. Can you introduce me to the County Judge?” I responded.
I was introduced to Judge Barnes and liked him immediately. He was a quiet kind of guy, a good listener, not prone to idle talk and hard to read. “Can you help us?” he asked.
I reviewed all the claim information Blue Cross had provided the county and cross checked the data against the county’s employee roster. I was able to determine the risk factor of the 300 employees who were left without coverage.
I submitted my findings to Transamerica Occidental Life Insurance Company and requested a proposal.
“Bill, we no bid this account with multiple agents when they went to bid. Home office won’t take this group!”
“Why not! There is a rate for any given risk and I’ve got the data your underwriter needs for proper rate setting” I explained. “This is a good risk, the HMO has the dogs!”
We ended up writing the case with Transamerica Occidental Life Insurance Company.
Enter James Presley, a local Corpus Christi Transamerica Occidental Life Insurance Company general agent specializing in life insurance sales. He hand delivered a letter to Judge Barnes demanding an Agent of Record letter by justifying he was the local Transamerica agent.
I didn’t know any of this was going on until I met with Judge Barnes to sign documents. “Bill, I want you to read this letter” he said. It was Presley’s letter, on a Transamerica Life Insurance letterhead demanding an Agent of Record designation.
“What are you going to do Judge? I asked.
“Nothing” he said.
