Friday, March 18, 2011

Close, but no cigar?

I've often wondered why group plans, unlike individual medical, don't differentiate between smokers and non-smokers. It's long been known that tobacco-users have higher frequency of claims, miss more work, and generally drive up the cost of healthcare (and thus, insurance).

Until recently, though, this has not been reflected in group medical plan rates. When requesting group quotes, we typically include sex and age, family status and at least some medical underwriting information, but not tobacco use.

That may be changing, however:

"Some Maricopa County employees are fuming over a new health-plan requirement forcing them to submit saliva for nicotine analysis ... those testing negative for tobacco use are spared a premium that is $480 higher per year."

Covered employees who decline to submit to the testing are automatically assumed to use tobacco, and get hit with that $40 per month surcharge. On the other hand, employees are concerned that the information garnered from these tests may not be limited to tobacco use, but for more invasive purposes.

And then there are those who, on principle alone, refuse to participate, even though they're not tobacco users:

"I'm going to be penalized this year, but I'm still not taking it," he said. "This is a forced penalty and I've never seen anything like this. It's a disgrace."

I have little sympathy for this particular fellow: as a government employee, the taxpayers foot the bulk of his health insurance costs, and have a right to demand value for their taxes. The gentleman (and his cohorts) are free to opt out of the county-provided plan and find their own coverage in the open market, at their own (increased) expense.

The fly in this particular ointment, though, comes from a spokescritter who admits that they "do not keep data on how much tobacco users cost to insure compared with non-tobacco users." It's not enough that they "believe" that tobacco users cost more in claims; facts, not faith, are required here. It doesn't seem to me unreasonable that such data would be easy enough to get from their insurer(s).

The bottom line, of course, is the bottom line:

"I don't like my fluids on record in some file ... I would prefer not doing it, but we have to, to get the $480. That's about what it comes to."

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