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

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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.