Individual & Family Health Insurance, and HEART

The end of 2010 and now early in to 2011 I have seen a surge in a queries for individual health plans, as well as family health plans - sometimes the dependents of a worker, i.e. spouse and children. In addition the amount of folks on COBRA and coming to an end has been astonishing. I really do not trust the 9.5+% unemployment rate by the way...I feel it is much closer to 20% when you look at real life and the folks who are working minimum wage jobs to make ends meet as opposed to their normal vocation....I could go on and on, but back to my point.

Many, many employers are passing on the cost of health insurance other than that for the employees, to the EMPLOYEES. It has been a massive change in the last couple of years as the U.S. and global economies have abolutely melted down. I see many more folks coming to our organization in search of alternative than in some instances paying 1k +/mos in insurance premiums that their employers are burdening them with as we have now fallen off the cost cliff at least here in the U.S.

So, what do you do? Well, depending on some states like CA and KY for instance this can be super news as child-only policies are still offered and in addition pre-x is gone for children under 19, so they can't be assessed those...having said that I have still seen insurance companies rate them up quite a it, as well as burying the costs in parents if they are attached to a family plan. Now the bad news, other than those 2 states, we at least can't sell child-only policies.

More "so-so" news is just the underwriting process for attaining family plans instead of taking in the chops from your employer - let me explain:

I work for X company, and used to pay 30% of the full premium for my family - for example 1600/mos in total premium charged to my company by the health insurance company, and $480 getting taken pre-tax from my paycheck bimonthly for example ($240/paycheck)...that was how it used to be....Now my company is saying, we will pay 100% of you (the rate charged to the health insurance company for me is let's say $500, and the $1100 is now being passed on to me to cover my family. So I went from $240/paycheck for all of us, now shooting up to $550/paycheck...like a 220% increase)....

We are seeing this ALL OVER THE PLACE! So then we get the phone calls and it is good news if you are healthy - and what I mean by that is no diabetes, no heart ailments, or major chronic illnesses in the family etc...if you fall in to this category you can taken the controls back fast and purchase private health insurance for a much better premium. Now let's say your loved one (the fomer dependent on the employer plan) has diabetes, and you have an autistic child. YOU MUST STAY PUT!! You will not be able to secure health insurance outside of CA or KY for just your child, and then anywhere else in the U.S. basically (other than NJ and NY for example) your spouse will be declined b/c of the Diabetes, and then the children can't get a private plan b/c there are no child-only policies...get it? The insurance companies screwing us again.

And by the way, let's talk high-deductible health plans, a la consumer-directed health plans. I do feel they are our savior, but health insurance carriers are still gouging us price-wise...Oxford Health Plans in NYC for example...they are an awesome company, but for the plan designs they offer, they have cornered us in to buying what they want to sell us ($800/single employee) POS and PPO plans that have astronomical pricetags, and make them record profits. When we compare those plans to their high-deductible health plan offerings with managable deductibles (let's say $1500/year for a single person) it is easy for a broker, consultant or the insurance company/and consumer for that matter to talk themselves out of buying the savior (high-deductible health plans) b/c we can transfixed on that $1500 deductible as opposed to the rich PPO with 0 deductible in-network anyway. So here is what maddens me, the $1500 plan is still $425 + per single employee monthly. That is not priced well, period. In my company we joke about TARP (troubled-asset recovering program) that the Fed Govt established to basically stabalize our country and bail out some banks. If what should happen to health insurance companies did (i.e. that $425 plan, sank to $250 where I think it belongs) we would then need HEART (HealthInsuranceCompany Eroded-Asset Reconfigured Trust) or something of that nature as they would have their claims reserves set up with a premium 50% lower let's say, and would all tank in a quarter. It is funny to say it so matter-of-factly, but I believe it in my bones. But some would say it SHOULD HAPPEN! Well, one thing is for sure, I do not what the government involved in health insurance, and believe for starters Medicare should be run privately...we have given the government plenty of time to bankrupt that system....so make that private, keep health insurance private, but do please blow up the profit machine, the current metrics, all of the waste with too many employees and too much paper (everything automated to some degree)...coming from a distrbution perspective (which I am) big deal, slam my commission (which is how I pay my mortgage, and not much more these days) and allow me to continue to help individuals and small companies as I love to do, and let's make it a day. We have already had our revenue hammered by more than 55%, which frankly has been fine with me. I am in business to help and in order to make the revenue work, it just means I need to help 55% more people every day than I used to for the same static money. Again, fine with me, as that means in the end I actually help MORE PEOPLE.

Sounds all great right? Well I am one of the honest guys in this business, but I am surrounded by dirtbacks and agregious big companies who want their executives to keep fat paychecks. So blow em up, keep the smaller/boutique businesses humming (the engine of the U.S.) as they should be and always should be. The big corporate interests and the government are the problem.

I could write 20,000 more words without a break, but these are my thoughts for the day, and I think a good brain dump.