Summerlin asks for premium decrease (!)

[Linkmeister]

This story was on the front page of the Advertiser this morning, so I thought I'd look the company up on the web. It's a privately-held subsidiary of i/mx Health.

Here's the website

Here's what they offer:

The product suite have been announced. They are called Summerlin Easy Hawaii and consists of an “All 20%” coinsurance plan, a “$15 Office” co-pay plan, and a “PPO” plan. These plans offer open and direct access to providers…freedom to go directly to any physician, hospital or health care professional for covered services. No referral is required! All three plans feature excellent coverage for routine preventive care, specialty care, hospitalization, surgery, diagnostic testing and emergency care. The new products include prescription drug coverage; only a small number of services require preauthorization or notification. Dental and vision riders are available as options.

From the Advertiser story:

After the 20 percent decrease, Summerlin's rates for its Comprehensive Medical Plan with a $15 co-payment would average $240 per month for a single person, $490 for two and $720 for a family plan.

Hmm. That would be $50/month less than what I pay to Kaiser right now. This needs further investigation.

[pzarquon]

Re: Summerlin asks for premium decrease (!)

I'd completely forgotten about this company until this article. Talk about good PR. Apart from McDonald's, anyone know any other local companies signed on? Any actual customers?

[Miulang]

Re: Summerlin asks for premium decrease (!)

One thing you want to watch out for are companies with no real track record. In the late 1980's, there were a bunch of new players in the insurance market in Seattle. They all came in promising cheaper rates, etc. Very often, you get what you pay for, and now most of the newer players in our local market have folded their tents and moved on.

When evaluating health insurance, make sure you are not just looking at what the cheapest rates are. One major consideration is getting a list of docs who have signed up for Summerlin. If your doc hasn't joined the group, then you would have to switch doctors, which can be a hassle if you've established a good relationship with your current doc. Are the offices and office hours of the docs enrolled in Summerlin convenient for you? Which hospitals would they send you to if you needed to be hospitalized?

Again, you're talking about your health and your life, so don't just go for the cheapest plan unless you're young, single, and healthy.

Miulang

P.S. I find Summerlin's claim that you can choose ANY physician, hospital or health care professional for covered services a bit of a stretch. The catch is "covered services".

[Miulang]

Re: Summerlin asks for premium decrease (!)

More info about Summerlin from last Fall, when they were supposed to open shop. They will be "cherry picking" and going after the individual and small business groups, where HMSA and Kaiser have difficulty competing on a price basis.

Miulang

[zztype]

Re: Summerlin asks for premium decrease (!)

They will be "cherry picking" and going after the individual and small business groups, where HMSA and Kaiser have difficulty competing on a price basis.

I gotta say that having been a sole proprietor trying to buy health insurance, HMSA and Kaiser displayed a near-contempt for my kind. The rates for someone who is not a member of a large group were so high above what a regular employee is accustomed to, and the services offered for that money so pared down from the regular employee customer, that I opted to "go without" for a long time.

When I did quit my business to go back to regular employment, a major consideration was that I would finally get health insurance at a reasonable price.

Conditions may have improved since then, but I imagine not by much. It was as if the "big boys" were saying that my business wasn't wanted, as I was too small.

If Summerlin is going to "cherry pick" this market, then good luck to them. They will have plenty of takers, if my experience is typical.

[Linkmeister]

Re: Summerlin asks for premium decrease (!)

I gotta say that having been a sole proprietor trying to buy health insurance, HMSA and Kaiser displayed a near-contempt for my kind.

If Summerlin is going to "cherry pick" this market, then good luck to them. They will have plenty of takers, if my experience is typical.

Yep. HMSA has virtually zip for sole proprietors (or did when I was looking five or six years ago). Kaiser has two plans, neither of which are very good (50% co-pays for lab, x-ray, etc. That's not horrid for out-of-pocket, I suppose, but what if you need an MRI? I saw a bill for one of those two weeks ago: $3,950!!)