Bernie Cohen
Insurance Solutions

TWO KINDS OF HEALTH INSURANCE - GOOD AND BAD
Self-employed & Individuals at Risk
               By Bernie Cohen,
Specialist in Benefit Packages

ARLINGTON-Have health insurance?  Think you're covered? If you'reself-employed, maybe not. Let's say the worst happens. If you're in a group plan you are probably okay.   If you have an individual plan there could be real problems.  Insurance companies like to take in premiums, not pay out on  claims. If you are part of a group - and the larger the group the better-you are likely to have protection because of the power of numbers. The insurance company is less inclined to bully you, lest hey get booted out at contract renewal time.  But, if you have an individual plan, as most self-employed people are apt to have, the insurance company is under no such constraint. What is unfortunate, and what most self-employed's do not realize, is that there are probably more loopholes in health insurance than in any other kind of insurance.  Most often, loopholes exist in how something is stated in the insurance plan-legalese. But, sometimes a loophole is created by what is not said, or by a company's policies and procedures. Obviously, these latter cases are the more insidious; it requires knowledge that is not easy for the layman to come by.  Language that one should be wary of concern exclusions, termination clauses, and the ubiquitous "usual, customary and reasonable."

   An example of what is not written, is a policy offered as part of a "trust," which is far different than the asset protector that we usually associate that term with.  Probably the only way one can learn about the policies and procedures of a company is from the experiences of others. A particularly odious practice is "post-claims underwriting." Underwriting is the process of determining the insurability of an applicant. An insurer which utilizes this loophole will re-investigate a policy holder's medical background after a substantial claim is made, and can use seemingly outrageous reason to deny that claim.   Litigation is often the only way to collect and that is never a sure thing. At the very least, the policy holder has to spend precious time fighting with insurance company employees trained to run the customer in circles. What is that time worth to a small business owner? What is the self-employed to do in order to find real protection?

    For an individual, there are only a few choices. One is to join a HMO and be subject to a mandate of how cheaply can a patient be treated. Another is to seek out a affiliation that offers "true group protection." There are many affiliations, but very few that offer this type of protection.  Bernie Cohen is an independent consultant who specializes in small business benefit packages. He can offer "endorsed" health insurance plans for self-employed individuals at affordable rates.  Contact Bernie Cohen at 703/933-91111, FAX 703-933-2040, or E-mail:  bigbern@cox.net
 

Affordable health insurance for the self-employed with the protection of a true group. A national non-profit organization. NASE protects the rights of self-employed individuals.