Health plans for individuals returning soon

By SHARON SALYER

Herald Writer

For the past year, Washington residents who needed to buy individual health insurance were out of luck.

But their luck is about to change.

Action Thursday by a state board means that consumers will again be able to buy coverage in early December.

"It’s good news for the people who have been waiting to buy health insurance," said Jim Stevenson, spokesman for the state insurance commissioner’s office.

"It most seriously impacts early retirees, those who are pre-Medicare," he said. "In a lot of cases they’ve quit their jobs to become self-employed."

In September 1999, Regence and Group Health, the two remaining organizations that offered individual plans, announced they wouldn’t sell them any more, blaming the move on mounting financial losses.

So, for the past year, "many have not found satisfactory insurance," Stevenson said.

But Premera, Group Health and Regence all announced Thursday they will again offer individual health insurance plans. The insurance is expected to take effect Jan. 1.

All three organizations said it will be several weeks before pricing information is available.

Demand for individual health plans was so high that in mid-September, 2,400 people in Western Washington had requested that they be put on waiting lists established by Regence and Group Health, even though no one was sure when the plans would be available.

Premera, which will resume selling individual coverage by Dec. 4., said it will offer three plans. The organization stopped selling the plans in 1998, but it still has 70,000 people enrolled in them.

Group Health expects to resume selling the individual plans the first week in December, spokesman Don Glickstein said.

"We will offer several different kinds of plans to give folks options," he said, adding it has 18,000 members with individual plans.

Regence has 50,000 people enrolled through its individual plans. It, too, plans to begin selling the plans again in early December, spokesman Chris Bruzzo said.

Announcements by the health care organizations on re-entering the individual health care market followed action by the Washington State Health Insurance Pool board.

On Thursday, the board approved a questionnaire that anyone who wants to buy individual health insurance in Washington state must fill out. It is designed to screen out the sickest 8 percent of applicants, Stevenson said. They will be insured through the state’s high-risk pool, where coverage will be available, but more expensive.

"The screening tool is based on a point system, with values placed on different diagnoses," said Edward Denning, the board’s executive director.

Health care plans will have 15 business days to consider an application for individual health insurance.

Conditions that may cause an application to be rejected and sent to the state pool include: congenital and congestive heart failure, coronary artery disease, kidney failure or being on kidney dialysis, an HIV or AIDS diagnosis, and being on an organ transplant waiting list or being a transplant recipient, Denning said.