Comments for blog.limedaley.com/post/health-insurance-issues-for-the-self-employed

Comment #1689

2014-08-29T23:08:13Z

I'm in the same boat in North Carolina, but still waiting for the NC DOI to make a determination.

http://www.nerdwallet.com/finance/question/health-insurance-wrong-information-when-signing-up-recourse-9738

Apparently Arizona has sided with the customer on the issue.

http://www.consumeraffairs.com/insurance/health_net.html (search for squeaky)

Comment #1688

2010-10-27T14:39:49Z

Some friends mentioned on facebook that they've been getting letters from their employers about their health care costs going up due to the provisions of the health care bill that recently went into affect (namely, dollar limits being removed for annual and lifetime benefits for prescriptions and "essential" benefits).

Since I haven't heard anything, I went to my insurance's website - they list the new provisions, but no mention of increased costs, though I would assume the prices have to rise to cover the additional costs.

But, I did note that they've finally changed the way the deductibles are listed, so now they are more clear about the higher family limit, though I guess it still isn't perfect, now that I re-read this post, and how I interpreted the deductibles originally, and not how I interpret now that I understand what they really mean.

Comment #1687

2009-06-12T20:27:14Z

Heather had gotten her new individual policy card a while ago, but they never sent a bill, so I was suspicious about whether it was actually going to work (seems like someone would figure out that their rates are completely strange, and would "fix" them before we got to sign up...)

But, I talked to someone today, and they always bill on the 10th of each month, so the bill should be coming any day now.

Can anyone explain the math?

Our old policy was a $7000 family deductible (deductible is the same whether the kids are on the policy or not - the kids added $100/month for premium), max out of pocket $10000 (including the deductible). The premium for that was $183/month.

The new policy has individual deductibles of $1200 and max of out pocket $2200 for each person and the combined premium is ~$200/month.

Perhaps doesn't sound too crazy until you consider the difference between individual deductibles and family deductibles, that the "normal" case where one person has a large bill in a year, and the other has basically none, would result in us paying a maximum of $10000 with the old plan, and a maximum of $2200 with the new plan.

Comment #1686

2009-01-28T23:28:23Z

Being a self employed graphic designer I know all too well what it's like to try and deal with an insurance company head on. I myself had issues with getting clear answers from agents and from companies doing the vague fine print shenanigans. Being in transition in life right now I'm back on the hunt again for insurance, but have been digging up great resources online for the self employed to help so that I don't get into the same situation that you're going through. Great post though, and I hope that your Representative is able to do something in the way of putting pressure on the commission and Highmark to be more honest with its customers.

Comment #1685

2009-01-20T20:14:24Z

I did end up emailing Daryl Metcalf, our representative, and his office got back to me today, and asked some additional questions in order to research it further. Sounds pretty promising.

Comment #1684

2009-01-19T03:19:35Z

No, they have not done anything, and they insist that it is perfectly clear. They don't seem to understand the problem, where their application doesn't even have a $7000 deductible check box at all, and if it were there, I wouldn't have checked it. The online application at the main Blue Cross Blue Shield site shows very clearly a $3,500 deductible plan, and it isn't until you sign that document, and start using the plan when they tell you (in fine print in a 100 page manual) that the $3,500 deductible doesn't apply, though of course they don't really say it in plain terms like that.

As I said, the PA Insurance Commission agreed that their marketing, application and online documents are misleading consumers, and they are looking into forcing Highmark to change them, so in the future, they will be forced to tell the customers prior to applying what deductible they are signing up for.

The only bad thing is for all the customers who already signed up and were tricked into getting a deductible twice as high as the application said they would get.

Also, I think I might have forgotten to mention: when our health care provider looks up our plan on Highmark's website, it tells them we have a $3,500 deductible. Highmark's answer to that is that the vendors shouldn't trust the information Highmark has in the vendor website that Highmark created (I forget the name for it - an acronym of some sort). I think vendors would be quite surprised to hear Highmark say that the information is not reliable, since the vendors use that site to figure out if their patient is insured or not, and what their deductible, and 80/20, 90/10%, etc. plan is.

I think everyone except Highmark thinks this is a clear case of fraud. Maybe it'll end up being a class action lawsuit, and I'll get $0.20 of my money back or something.

Comment #1683

2009-01-19T01:40:55Z

I got dizzy with the deductibles of the health plan. But have Highmark done anything to resolve the problem? I mean, they should have explained everything from the beginning and the papers should have not lied.