Exploring the Wild West of health insurance

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

November 8, 2013 at 10:22 AM

Washington state has gotten plenty of props for a health-insurance website that works better than most. At last count, 55,000 residents had enrolled in Medicaid or individual insurance through the state exchange.

Yet Washington Healthplanfinder has its limitations. Some of the search functions, for example, still don't quite seem to work reliably, including the option to 'customize my search.' And by design, the site is built only to let you search for plans inside the insurance exchange, but not outside (plans outside are not eligible for federal tax subsidies).

So what's a health-insurance consumer to do in the new world of the Affordable Care Act? One option is to ditch the official sites and explore the sometimes deceptive but potentially informative world of the private sector. That's right folks, you can go rogue.

The best site for comparative shopping that we at HealthCare Checkup have found bills itself as the ' Washington Health Insurance Exchange,' but make no mistake, this is a private site run by an insurance broker named Vernon Bonfield. In small print on his home page, Bonfield explains that the site is NOT a government site, but someone stumbling on the page could easily be confused. State Insurance Commissioner Mike Kreidler and Gov. Jay Inslee have both criticized the site as being misleadingly similar to the state page.

That said, Bonfield's site makes it easy to call up health-insurance plans inside and outside of the exchange for side-by-side comparisons. His site also includes a calculator for entering your income level and estimating your potential tax break to defray premium costs. You don't need to share your name or otherwise register to use the site.

Brokers like Bonfield are licensed to represent specific insurance companies, and are paid commissions from those companies for selling their products. Their job is to advise consumers on which plan they should buy based on their health care needs and financial constraints.

By comparison, the 'in-person assisters' and 'navigators' who are trained to help people maneuver the state's exchange site are not allowed to suggest which plan would be best to purchase. Healthplanfinder can help you locate brokers and navigators near you, and the state has a database to doublecheck that your broker is legit and to find out which insurance companies they can represent.

Other sites offer similar services for comparing and shopping for health plans, including the national company eHealth, though their site only gives insurance options for 'featured' companies, unless you look for the fine print and ask it to display all of the plans available.

A government-provided option for comparing plans inside and outside of the exchange is available on the Office of the Insurance Commissioner's webpage, but you have to click on links for each insurance company and there doesn't appear to be an easy way to do side-by-side comparisons of premiums, deductibles, co-pays and all that good stuff.

For folks trying to navigate the new world of individual insurance plans, it can feel like the Wild West out there. There's still uncertainty about what the rules mean and how they're being interpreted by insurance companies. The government has shifted deadlines and there's pressure for them to make more changes. It can be tough to track who the players are and the names of new programs.

If you've discovered other sites or resources to help sort out your insurance options, please let us know, and be sure to stay tuned for updates and explanations as the health-care overhaul continues to unfold.