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Re: Insurance, etc. - Information Sources » judy1

Posted by fachad on July 15, 2002, at 21:23:38

In reply to Re: Insurance, etc. - Some Small Comforts » fachad, posted by judy1 on July 15, 2002, at 12:53:45

I came to know about this stuff from negative experiences in both personal and professional areas.

On the level of personal experience, my wife has had a lot of medical problems, and we found out about the whole "utilization" thing when her company plan became so expensive that we tried to get self-paid insurance.

That's when they told us to that due to her medical history, she was "uninsurable" as a private person and we need to pursue an employer group plan.

She works for a family business with her parents, so she was given the task of finding affordable health insurance for their company. That's when we found out about the "profiling", and how the insurance companies keep stats on employer groups to identify high utilization and increase premiums for those groups.

I don't think they are supposed to release such detailed information, but the insurance agent actually told her which people were to blame for the rate increases.

Also, I started a business that year, and wanted to get health insurance benefits for my employees. That's when I had to gather medical history questionnaires from each employee to turn in to these prospective insurance companies so they could give us quotes. It felt so weird to look at everyone’s medical history, and knowing what meds they were on, like I shouldn’t be seeing this stuff, but insurance companies want that info before they will give small groups quotes for benefit packages.

With both our small businesses, it is a big stress every year about how much the premiums are going to go up, and if the company will still be able to afford to provide health benefits, or if it will just cost too much. It is a very serious business issue - the costs are really high even with employees paying part, it puts a huge strain on a small company. Many companies cannot afford to provided health benefits and remain in business.

And knowing that every time I see a doctor for anything, and every time I fill a script, it is being monitored and used as a basis to increase our premiums...it is very upsetting, but that's just how it works in the real world.

It really is an awful situation.

> It was a comfort- thank you so much. You're so knowledgeable about all of this, is that because of all the negative experiences or is this your field? Take care, judy


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