Tom Clyde: Blue cross blues
January 17, 2015
One of the less appealing parts of being self-employed is that you are the whole operation. When the computer crashes, there is no nerdy IT guy down the hall whose Star Wars figures can fix things. And you get to buy your own health insurance because the HR department is you. Buying health insurance is about as pleasant as a compound fracture, and nearly as expensive.
The process used to involve "medical underwriting," where somebody who has never seen you will perform some mystical assessment of your health over the phone and pronounce you acceptable, or high risk. The conversation used to include things like, "I see you were treated for an ingrown toenail in 1987. So we are excluding coverage for anything below the waist, or that might be connected to a bone." A sinus infection 15 years ago used to put you in the same rating class as somebody who was coughing up blood while filling out the application. Being alive was a pre-existing condition that resulted in disqualification or long delays for coverage to take effect.
All of that theoretically changed with Obamacare. Buying health insurance now is supposed to be as simple as buying a can of beans. You can get bronze beans, silver, gold or platinum beans. They can’t deny coverage because of a case of food poisoning during the Nixon administration. But the insurance companies have still managed to mess it up.
The idea of "open enrollment" was their way of making everybody buy their insurance at the same time. That prevented the guy who got hit by a bus from buying insurance on his iPhone from the ambulance on the way to the hospital. You had to buy it in advance. It also helped with their rate-setting because the risk pool was assembled at the same time. But like the DMV learned years ago, when we all had to renew our license plates in January, it’s a stupid system. Open enrollment could just as easily be three months prior to your birthday, and spread the sales traffic out all year.
But no, everybody did it at the same time. Everybody had to renew in December, and all of their plans have changed, so it wasn’t as simple as just doing what you did last year. I started calling to renew my plan with Blue Cross at the end of November. After holding for a long time, I’d get the message that, "to better serve you, all of our sales staff are in training today. Please call back another time." That happened several times, suggesting that their sales staff would be extremely well-trained, if and when they answered the phone.
I finally got through to sales, only the well-trained company system was overloaded and bumped me to an outside insurance agent. It only took about an hour and a half to complete the application (remembering that the only basis for denying coverage now is being dead). He kept saying, "OK, you should be good to go." I said, "Should be" is not what I’m after. Either I’m insured or I’m not insured. I wanted a higher degree of certainty than "should." But he assured me that I "should be good to go."
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Over a month passed, and I never received a new policy or a bill. I got a couple of emails from somebody called Cambia Health, saying I had urgent messages in a secret mailbox, if I would just log in to their site. Since I’ve never heard of them, I assumed it was the Nigerian Prince of insurance companies. I called Customer Service and was told that I was in their system (no surprise — I’ve been a customer for 35 years). Cambia is apparently an alias for Regence, who is embarrassed to conduct business under their own name. On the next call, a woman just back from maternity leave, who had missed all the training, said I just needed a "plan change" which she would do right on the spot. But still no policy or bill.
So the other day, a moving van pulled up to the mailbox and left me with a mountain of paper from Blue Cross/Cambia. It appears that I now have no less than three health insurance policies, each with a huge deductible and providing the same crappy coverage. But there still isn’t a bill, and customer service is still in training and unavailable.
So if I break my leg skiing, and get hauled out to the poshpital, I’ll just tell them that I should be good to go, and they will happily treat me, knowing that they should be paid, and it all should work out in the end. Or they throw me out in the snow because I have no proof of insurance.
Tom Clyde practiced law in Park City for many years. He lives on a working ranch in Woodland and has been writing this column since 1986.
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