A recent article in USA Today reminded me that I hadn’t been to healthcare.gov in quite some time, and I went back to see how it had improved since I tried it out a year ago. The option to look at individual/family health insurance plans now includes nearly all of the plans that we offer through our brokerage (with the exception of Assurant/TIME, which for some reason wasn’t showing up for me on the healthcare.gov site). In addition to basic quotes, the healthcare.gov site now shows data for each quoted plan with regards to the percentage of applicants for whom underwriting results in an increased initial premium and also the percentage of applicants who are declined.
This is definitely interesting data to scroll through, but as the USA Today article mentioned, it can also be a bit misleading. Some carriers offer applicants an alternate plan rather than offering them the plan for which they applied. Although the applicant might very well accept the alternate offer and therefore be insured, she would technically be considered part of the “declined” group for the purposes of the comparison site.
When I got individual quotes for my family on healthcare.gov, I saw options from Anthem Blue Cross Blue Shield, Cigna, Celtic, Humana, Rocky Mountain Health Plans, and UnitedHealthOne. All of them use underwriting that can result in an initial rate increase or a decline, and the percentages for both possibilities varied considerably from one company to another and even from one product to another (from the same carrier). Although the data was interesting, it seemed like it might make the application process even more confusing for an applicant who is not being guided by an independent broker. Your policy will cost the same amount regardless of whether you use a broker, but an experienced broker will be able to help you make sense of the plan comparison information, including the underwriting statistics. A policy or carrier’s statistical likelihood of declining or rating up any one application isn’t really relevant to each specific client… what is relevant however, is each carrier’s underwriting guidelines for the particular pre-existing condition the applicant has.
Rather than just choosing a carrier that seems to have the best price and a low-ish percentage of declined/rated-up applications, it makes more sense to ask a broker – who is familiar with the underwriting guidelines of each carrier – which carrier is most likely to provide the best option for your specific situation. Most reputable carriers no longer have application fees, but there’s still the time and energy it takes to apply for a policy, and that might as well be spent applying for the policy that is most likely to work out. Sometimes there really are no options at all in the individual market, and an applicant will have to fall back on CoverColorado or GettingUSCovered. But if there is an option to get coverage in the private market, an experienced broker will usually be able to direct applicants towards the carriers that are most likely to work, without applicants having to apply randomly and hope for the best.
