Monthly Archives: June 2010

Joining the 50 million

Our health insurance was canceled last month. We have joined the ranks of the uninsured. Collateral damage in health care reform and the race to parse the regulations, drive trucks of cash through the loopholes and squeeze every dollar out of every soul still breathing.

Payments were current. We had not made a claim that exceeded our deductible in a couple of years. Nothing had changed. And we weren’t even told until three weeks after it had happened. There’s no appeal. No reason required. No COBRA. It is just gone. And it was done on purpose.

Our business had used  Business Advantage, a PEO (Professional Employer Organization), to act as our “virtual employer” to provide Blue Cross group health care insurance. Technically, we worked for an LLC owned by Business Advantage for this purpose. According to Wayne Surman, National Sales Manager of Business Advantage*, “We decided to close that company because rates had gone up.” Business Advantage voluntarily shut down Near Northside, LLC because they didn’t think they were making enough money, which immediately canceled our policy and whomever else was in the plan. While failing to apologize for not telling us that we were going to be totally screwed, he did say we were welcome to “apply” for new coverage – coverage, subject to acceptance, with a new LLC and at new rates.

Responsible: Left to Right: Stanley R. Joseph, Wayne Surman and Jason C. Joseph of Business Advantage.

Were we just chumps? Hard to know so far. It seems pretty straight up for a business to fold a company and ruin the lives of anonymous customers when, in the owners’ judgment, it makes good business sense. The people behind Business Advantage, Stan and Jason Joseph, are well connected, and as far as I can tell, well thought of. Perhaps, they didn’t realize they were making a life and death decision in the lives of others? Perhaps, they needed the money more than we need health insurance? Perhaps, it had gotten to be too much trouble. All understandable these days. And it makes me hope there is a hell.

The CBO expects this to happen to 3 million others while waiting for health care reform to be fully implemented in 2014. Robert Woods Johnson research puts that number much higher. People who are employed. People who want coverage. People who won’t have it. People, like me.

While we will apply, no company is expected to take us on an individual policy because of preexisting conditions. Blue Cross has offered us a take or leave it conversion policy – take it and our rates will go up by $2,586.26 a month, plus, of course, a required payment for the month we had just lost and will never be able to use, a higher deductible and the expectation that rates will rise even higher.

A certificate of insurance was included with our cancellation notice. A certificate of insurance offers some federally required exceptions to preexisting condition exclusions if a policyholder is not without insurance for 62 days and is able to get back in an employee sponsored plan. It does not, however, give you squat protection for individual coverage. The 62-day clock on insurability had already ticked down to 42 days when we found out we needed it. We will apply, but acceptance and affordability is a serious concern. As is trust that it won’t happen again in a few months. Or next year. Or the year after.

By now, you must be asking yourself, “what about the health care reform bill, I remember reading on LikeTheDew.com that within 90-days of its passage, uninsured individuals who have a preexisting condition will have access to a state or federal high risk insurance pool?

There will be no Georgia pool. Georgia goobernatorial candidate and Insurance Commissioner John Oxendine has written US Health and Human Services Secretary Kathleen Sebellus saying of the fully funded federal program, “I cannot commit the state of Georgia to … a scheme which I believe the Supreme Court will hold to be unconstitutional, leads to the further expansion of the federal government, undermines the financial security of our nation, and potentially commits the state of Georgia to future financial obligations.” (Source: AJC) Georgia joined 17 other states refusing to participate (including almost all Southern states).

The federal high risk pool will be funded beginning July 1st. Details of the process and eligibility are still being developed, but the law requires that individuals be uninsured for six months – perhaps, this will save us next fall. The cost benefit is extraordinary: it is capped at $11,900 a year including all out of pocket costs. Easily $25,000 less than a private plan.

We could take the chance and bet we’d be healthy for six months to wait for the federal program, but what if we were wrong? Or, we could bet that we could pay the huge price increase even if we had nothing left to use it — which is what they want: pay as much as you can possibly afford and be too broke to ever use it.

In complete candor, the medical history questions on the forms make me apoplectic – the fear of the costs rob my sleep –  the fear of an insurance need limited by a preexisting condition is cruel, but in America, hardly unusual.

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* Feel free to contact Wayne Surman, Business Advantage Program Employee Leasing, 11175 Cicero Drive, Suite 100, Alpharetta, GA 30022, Office: 678.242.5277,  Fax: 678.242.5241, Cell: 678.480.5200, email: wsurma[email protected] or [email protected] – Linkedin: http://www.linkedin.com/pub/wayne-surman/13/478/a14 or Stanley R. Joseph, President & CEO of Business Advantage, Inc. – Linkedin: http://www.linkedin.com/pub/stan-joseph/5/73b/954, Jason C. Joseph – Linkedin: http://www.linkedin.com/pub/jason-joseph/0/915/100, Co-Founder and Executive Vice President. The Josephs are also involved in  X1 Capital Partners, LLC, Hibernian Pacific Holdings, LLC and Fog City Blue Entertainment, LLC who do business at the same address as Business Advantage, Inc., but, of course, those businesses could close at any time without warning.