So last week arrived with bad news. For the last year and a half I have bought my health insurance from Blue Shield of California via a group called PacAdvantage. PacAdvantage is an employer-buying coalition that had its origins back in the mid-1990s as the Cal HIPC—a forerunner of the never-were regional health alliances. Still if you are an employee of a company between 2 and 50 employees you can buy from a choice of somewhat overpriced health insurance plans from PacAdvantage. The cost is about double what it would be buying in the individual market if you are “healthy”, but about half what it would be if you’re medically underwritten against….all for the same high-deductible plan of course.
How can I as a solo operator buy into this? Well I’m a member of an association called the SF Media Alliance which as one of its side benefits allows you to buy in. Well those of you who’ve been following at home know where this is going. All the people who buy in are of course those who can’t get it in the individual market at the “healthy” rate, so the Media Alliance as a whole is likely to be a bad “client” for PacAdvantage. So PacAdvantage is kicking Media Alliance out (I suspect there’s a lot of legal jumbo I don’t know about going on behind the scenes). But the basic reason is that there’s bound to be a lot of sicker than average people buying from Media Alliance even though I have filed zero claims in the past 18 months, nada.
So I started looking around to see what I could replace it with. One option is to pay into my domestic partner’s plan (and I may well end up doing that) but I’d rather just buy a cheaper high deductible plan like the one I have, as I don’t intend to use much care in the next year and will have a stack of cash in my HSA ready to cover any expenses if I do need it. (This is not an endorsement of a certain THCB commentators ideas, it’s just me responding to the atrocious incentives in the system).
So over the coming weeks I’ll document my experience here, remembering that yesterday AHIP was boasting about how wonderfully its members were making the whole process for the blighted consumer
I start with my first visit to the eHealthinsurance site. You may note that they seem to have bought out all my Google Adwords (at least they own the whole box at time of writing). They of course are a broker not an insurer themselves, but as they are the leader in the online insurance broking space I assume that they’ve spent a little time talking with the insurers for which they act as a channel about how to “delight the customer”. (Snicker, snicker)
I’ve had insurance via them before, but most of my info seems to
have got trashed when I logged back on, so I first tried to figure out
if it was worth getting regular insurance — given my knee story had
made me a pre-existing condition the last time I signed up and sent my
quote for a $2000 deductible plan with Blue Shield from $70 to $400 a
month, after I was underwritten. I IM’ed with the eHealthInsurance rep
who told me to call them instead to talk to a real insurance agent.
First person to answer the phone was the guy who’d just IMed me telling
me to call. He put me onto someone else (presumably a licensed agent)
who said that the insurers look back an unlimited period of time
because they want to underwrite you, and there’s no specific cut off.
(Not many favorable hints there! I was hoing for him to tell me that
Blue Shield looked back 2 years, but Blue Cross only one, or something
to give me the impression he was on my side. Silly me!)
OK, I thought. I can buy a 12 month short-term policy like I had
previously, after all I know they just exclude really sick people not
those of us who’ve had presumably one-time surgery. Life has changed a
little since the wild days of 2003. For a start the same coverage that
was $70 a month then is closer to $120 now. That’s a
little lot more
than a 10% annual increase! And after I went through spending 10
minutes filing out the form, it told me my policy was to start the next
day. Whoops, I need to change that but I couldn’t figure out how. So I
IMed with the customer service rep again. Here’s the conversation:
Rep: Welcome to eHealthInsurance’s live chat service. How can I help you today?
Matthew Holt: OK, I’m filling in the short term insurance form for
Blue Shield. it wants this to start today. I want it to start in one
month. Where do I tell it that?
Rep: Are you sure that it is a short term application?
Matthew Holt: yes.
Rep: Ok if the effective date is wrong on the short term then you
need to start a new application when you first put in your gender and
date of birth. There was an option under that to change the effective
date That is where you need to go back to and them the application will
be for the right day Then you would need to answer yes and just go on
with the application
Matthew Holt: you mean I have to start the whole thing again?
Rep: Yes if the effective date is wrong, because you cannot make
changes to the application like that on a short term application. Sorry
Matthew Holt: is that your fault or Blue Shield’s?
Rep: Blue Shield’s. It is their application
Matthew Holt: but the damn thing hasn’t left your site yet?
Rep: I know but that is just how it is done I am sorry
Matthew Holt: What happens if I just leave it and complete it the
day before I need coverage which will be after the effective date?
Rep: If there is an older effective date, the approved date will be day after submission date.
Matthew Holt: OK so rather than starting again, I should just finish and submit the day before I want it then
Rep: technically yes
Matthew Holt: It’s quite amazing to know that Blue Shield is quite
that incompetent. Are you SURE that it’s them and not you…before I
Rep: It is their application…. I don’t know who’s exact fault it
would be to starting a new application if the effective date is wrong.
But it is their app we just help you apply and get the application to
Can anyone spot the obvious customer service problem here? Answers
on a postcard please. Meanwhile, I’m not much closer to figuring out
what I should do, but I know that the easiest thing for me with
eHealthinsurance is to leave it to the last minute.
Check in next time in the ongoing saga of whether Matthew will ever
get his health insurance, and the strange tale of which drugs may make