posted on: 6/20/2006
revised: 3/9/2010
About a decade ago I expanded my personal service
to assist people who have trouble finding health insurance -
especially those who need to find a guaranteed issue individual
health insurance plan. Since the implementation of a federal
law known as HIPAA, each of the 50 states and the District of
Columbia have worked out a plan to make a "last resort" health
insurance available to people who do not qualify for other more
common types of coverage. About 20 states use an assigned risk
pool, the rest use some other uniquely designed system. In
many states, information is still very difficult to find. From
a consumer's viewpoint the early implementation stage of HIPAA is a
disaster.
Apparently an increasing number of
people have the financial ability to enroll in expensive guaranteed
issue health insurance, but are unable to find the plans or navigate
the enrollment process. It is difficult to know how many are
affected, but I guess that the number could be 50,000 people
nationwide.
Theoretically, other people could
provide this assistance. But over time I found that health insurance
agents, insurance company employees and state employees were
woefully lacking in the practical know-how to actually get someone
enrolled in a guaranteed issue health plan.
In theory my personal service was always
available but I did not encourage it. OnlineAdviser has been
available to anyone on an hourly basis, even for a single hour, to
help with all types of financial problems, including health
insurance. I have helped a number of people, especially
diabetics, with their overall financial planning, including health
insurance. But usually I shied away from helping people find
health insurance because I felt that I was taking advantage of our
ridiculously messed-up health insurance system. This was
capitalizing on a disaster, so to speak, that left an uncomfortable
feeling. After all, anyone can find health insurance with a
bit of research, phone calls and persistence.
After handing a number of requests, I
realized that I really can add value to this process. Only a very
few advisers are also licensed as health insurance agents in all 50
states. Probably none have the experience or desire to work in the
individual health insurance field. Most advisers avoid taking on
client engagements where they would need to admit that they have no
idea of the outcome. (I only know that health insurance is somehow
available but I do not know from who, how, when, how much it will
cost nor the terms or details of coverage). Yet in this situation,
this is exactly what is needed.
In all cases, my approach is the same:
1) Say that anyone can find health
insurance on their own if they look hard enough.
2) Point out that the starting point is
the state insurance department Web site.
3) Clarify that this transaction likely
requires several telephone calls - this is not an online
transaction.
4) Warn that the price of insurance will
be higher and the benefits less desirable than anyone would wish.
5) Say that I will help if needed, but
only through the OnlineAdviser system. (This is a
semi-automated process that speeds up service and keeps costs down
by collecting case data through an online form, generating an
electronic invoice and handling online payment in advance of
service).
6) Remind that I can not act as agent on
these policies.
6) Emphasize that Murphy's Law will
prevail. There are as many exceptions to the normal enrollment
procedures as their are applicants in these health insurance plans.
For that reason, there are no guarantees.
It may not have been a smart business
decision to offer this service on a flat fee of $150 when it might
ultimately take half of a day to complete. But because of this
service, some small number of people now have health insurance.
And in the long run, my $150 fee is the least of the financial
concerns of those who do not qualify for other health insurance.
Editorial note: Since the original date of
publication it has become easier for Americans to find guaranteed
issue health insurance without personal help so this service is no
longer needed or offered. More information on each state's
implementation of HIPAA laws regarding guaranteed issue health
insurance is included on the health insurance exchange on the
Freedom Benefits
Association Web site.
keywords: health insurance,
HIPAA, guaranteed issue, diabetic, exchange
related topics:
Copyright 2010 by Tony Novak. Originally produced and published for the "AskTony" column syndication prior to 2007. Edited and independently republished by the author in March 2010. All rights reserved. |