The secret to the insurance game is, to belong to a non-profit pool. Health insurance companies operate as 'for-profit' and believe me, two of the top 10 highest paid executives in Orange county are Insurance executives. The profit margin is there.
The question exists whether the profit margin itself is fair. Traditional insurance carriers return approx 65% of premium dollar in the form of benefits paid. approx 20% is considered administrative. This pays all salaries as well as commissions and administrative costs. The rest is pure profit. However, surprisingly insurance companies don't make their money off of this profit margin. It's when they INVEST it that the $$$$ really starts rolling in.
There is an alternative, however not available to very many. It is considered a non-profit trust. This eliminates the 15-20% profit margin, while still paying out benefits and administrative costs at approx 80% of the dollar.
You might check with your DOI (Department of Insurance) for the state you live in, and ask about MEWA (Multiple Employer Welfare Associations) and whether they are licensed and certified for your state. Each MEWA exists for the sole purpose of serving its constituents. Namely, if there is a MEWA for Commercial Fisheries in your state, and you are a Commercial Fisherman, you can join them. However check their financials and make sure they are in good shape.
This is one solution. There are many others, such as Healthy Families here in California that was paid for by the Tobacco Tax Initiative.
I don't feel sorry for anyone who can't get up off their patookis and work for these things. I am at work sick today. If I can do it so can others.
I had to deal with an irate broker a couple of years ago who sold an employer a policy in the small group market (2-50) that he believed had coverage for infertility, which it did not. The coverage was for diagnosis and treatment of the underlying cause. I explained in Small Group the risk pool is not large enough to pay for 'elective' procedures because the carrier (Insurance Company) runs the risk of being adversely selected against.
I recommended she go to work for Save Mart or Microsoft or some employer that has thousands of employees across which to spread the risk of 1 or 2 elective procedures. He was pissed.
Basic fall back health care is already provided in this country in the form of MediCal etc. If you want more, go get a job.
Lisa
Licensed Class