Health plans bring a rush of consumers

By SHARON SALYER

Herald Writer

Phone lines are expected to be jammed this week with consumers rushing to buy individual health insurance plans, a market that has been closed for more than a year in Washington state.

Hundreds of callers contacted Premera Blue Cross and Group Health Cooperative on Friday, the first day the two organizations began offering the plans.

"The phones have been ringing continually," Group Health spokeswoman Keely Barrett said on Friday. "They’re swamped."

By day’s end, about 800 people had called Premera, said spokesman Scott Forslund. "We’re getting about 100 calls an hour," he said.

Regence BlueShield will begin offering individual health care plans again on Monday. The organization had a waiting list of 3,500 people who asked to be contacted when the plans were again available, said spokesman Chris Bruzzo.

"The waiting list is a good indicator of pent-up demand," he said.

Eight Regence employees were in training on Friday to prepare for the anticipated avalanche of calls.

The plans are popular with those running in-home businesses, early retirees, and those who are between jobs.

For more than a year, it hasn’t been possible to buy private, individual health care plans in Washington. Insurance companies blamed the closure of this market on multimillion-dollar financial losses.

The only option was the state’s so-call high-risk insurance pool, where premiums were often substantially higher.

State legislation passed earlier this year established new ground rules for individual health insurance plans.

Among its provisions:

  • All comprehensive individual plans are required to provide maternity and prescription drug coverage.

  • A uniform health questionnaire was established, which will be used by all insurance companies offering individual plans.

  • The sickest 8 percent of applicants will be assigned to the state’s high-risk insurance pool.

    While the legislation allowed individual health insurance to again be offered, it has raised some concerns.

    Tanis Marsh, state health care director for the League of Women Voters, said the new health questionnaire is designed to assign people with a variety of conditions to the higher-cost, high-risk health insurance pool.

    These include congenital and congestive health failure, coronary artery disease, kidney failure or being on kidney dialysis, an HIV or AIDS diagnosis, being on an organ transplant waiting list, or being a transplant recipient.

    In addition, there are lists of other medical conditions that when considered collectively can put relatively healthy people in the costlier, high-risk insurance pool, she said.

    But with 5,000 people on Group Health and Regence waiting lists, there’s a demonstrated demand for the policies.

    Premera previously had 65,000 people enrolled in individual plans, more than any other health organization in the state. It didn’t have a waiting list, but did have a phone number people could call for updates.

    All three organizations are offering both catastrophic and more comprehensive plans.

    Rates vary depending on the amount of the deductible, an applicant’s age and whether they smoke.

    At Premera, for example, health coverage for a nonsmoking couple in their late 30s with two children ranges from $156 to $496 a month. There are no co-payments required for doctor visits.

    Group Health is offering 10 percent "healthy pays" discounts for those buying comprehensive insurance plans with a $500 deductible and who are in good health. Enrollees must apply separately for this discount, Barrett said.

    For parents in their 30s with two children and a $500 deductible, the charge would be $489 a month.

    For this same late-30s, nonsmoking couple with two children and a $500 deductible, Regence would charge $387, but there are added costs of doctor visits and hospital co-payments. Total annual out-of-pocket costs are limited to $6,000 per family.

    In the state’s high-risk insurance pool, the charge for a couple in their late 30s with no children could range from $488 to $596 a month, with a $500 deductible. The charge for each child under age 24 would be an additional $159 to $194 a month.

    Having individual plans again available in Washington marks a significant change in health insurance availability, said Regence spokesman Bruzzo.

    "It’s a big step because now … everybody will have an option," he said.

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