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Re: [IP] What I found out when I called GHP CareMark insurance about my Humal...
In a message dated 9/15/01 11:16:12 PM US Eastern Standard Time,
email @ redacted writes:
<< I did call the insurance company - and apparently each company that has
insurance has their own policy. No two are the same. >>
I guess it always surprises me that people don't know this. The insurance
company sells a product. That product is made up of many pieces that each
have a cost. Your employer chooses the pieces that it needs at a price it can
You could compare it to buying car insurance. (Something everybody is
familiar with.) State Farm does not have a standard policy for everybody.
Nationwide does not have a standard policy for everybody. Etc. You don't buy
State Farm if you want "this" in your policy and Nationwide if you want
"that" in your policy. You choose what you have to have, what you need and
what you want, shuffle around with deductibles, etc., and you shop around to
get the best price from among the reputable companies. My husband and I, for
example, use the same insurance agency and agent, but our policies are not
the same because our cars are not the same age. Neither of us are
accident-prone, but if one of us were that would make a difference in what we
So it's the same with health insurance. If you were buying health insurance
in the private sector (if you could with diabetes :-\ ), you would decide
what kind of coverage you need, how much of a deductible you can handle,
whether you need prescription medication coverage, maternity coverage, etc.
Then you would probably take that list and shop around the different
insurance companies that provide coverage in your area to get what you want
at the lowest cost. That's what your employer does, too.
However, your employer is doing it for the entire workforce. Just like you,
your employer only has so much money to spend on insurance. So they get the
best deal they can at the best price they can. What they get for the benefit
of the whole, however, may not benefit *you* in particular. Them's the
breaks. :-\ So if you're dissatisfied with your insurance coverage, the place
you need to "lobby" is your employer.
For example, the place that covers me (through my husband) did not cover
diabetes education. So I called staff benefits and explained the importance
of being educated about diabetes. (The fact that my coverage is through a
university -- which *sells* education, and I pointed that out -- didn't hurt.
LOL) It then began covering diabetes education. (This was before state law
was passed mandating diabetes education.)
Now. To make things even more interesting, the insurance companies cannot
charge whatever they want. Remember that they are in competition with the
other insurance companies that do business in their area. If they price
themselves too high, the competition gets the business. They're working with
mandates, they're working with escalating prescription drug prices, they're
working with expensive new technology and probably, for the most part, doing
the best that they can, and cutting back on what they *believe* is less
important. What's important depends, of course, on your perspective.
Anyway, I hope you get the general picture. And, no, I don't work for the
insurance industry. I was a business writer for a long time.
Jan and Elvis
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