Tuesday, July 28, 2009

Stupid Carrier Rant: Pre-Screens

[Welcome Industry Radar readers!]

Sometimes, carriers seem like they're begging for ObamaCare. Case in point: pre-screening small group plans. When I'm asked to quote a small group, I ask for a "census:" a list of employees' names (usually only first or last), sex, age or date of birth, family status (single, married, etc) and any known medical conditions. I'm always careful not to link an given employee to any condition; generally, it's really only important that we know what the condition (and any treatment or med's) is.
The point of that last bit is that, without knowing what problems may exist in the group, the carrier's going to just provide me with "street rates," which are rather like MPG on cars: useful for comparative purposes, but not particularly realistic. If I provide medical info, the carrier has an opportunity to provide a rate that's likely to be pretty close to the actual premium if/when we write the case.
This levels the playing field somewhat: you can get a feel for how certain carriers treat, for example, asthmatics vs diabetics. Comparing a screened rate to a street rate gives the latter carrier an unfair (and unrealistic) advantage. So it's really in all carriers' interests to make that process as easy and useful as possible.
But of course, we can't let common sense stand in the way of insurers' stupidity.
For small group, I use the services of a General Agency (think: wholesaler) which means that I can send in one Request for Quote (RFQ) and get multiple proposals. Typically, these include Anthem, UHC, Aetna, Humana and Medical Mutual (although others are also available). For a little while now, Humana and Aetna wouldn't provide pre-screened rates for any case, and now UHC has gone a step further: unless I provide the employees' and dependents' full names, heights and weights, no pre-screen.
This is stupid.
It's unlikely that an employer would know all of his employees' - let alone any of their dependents' - heights and weights. To get that, you really need an application from everyone. But that's already at the enrollment stage, which you can't get to without first getting quotes and choosing a carrier. Talk about the cart drawing the horse!
Which means that, for all intents and purposes, these carriers have determined that they don't need to provide more accurate quotes. This means that I really can't show any pre-screened quotes, because there's no way to know what the other carriers will ultimately do. Yes, I can (and will) explain to prospects that these numbers are for comparative purposes only, and will likely bear no resemblance to final, actual rates. But if you're an employer, especially one who's seen another premium increase on the current plan, wouldn't you want to know if it's even worth the bother of having all your employees' complete an application for a plan that's potentially even more expensive?
blog comments powered by Disqus