Analysis from HealthPocket shows the health insurance industry
averages an application rejection rate of 22 percent of submitted
individual and family applications nationally.
And some states are much worse: Montana has the highest percentage of
area insurer rejections with 45 percent, followed by Alabama (40
percent), District of Columbia (37 percent), Arkansas (35 percent) and
Alaska (34 percent). Plus, some insurers have declination rates greater
than 70 percent, analysts found.
“Clearly there is great variability across states and within states
in terms of how frequently an insurer rejects a health insurance
application, but nationally it seems to be occurring more frequently
than industry analysts had assumed,” says Kev Coleman, head of research
and data at HealthPocket.
For example, Kaiser Permanente plans in Georgia have a declination
rate of 34 percent, but in Hawaii the same company has a much lower rate
of 22 percent, analysts said.
HealthPocket, a free website that compares and ranks all health
plans, analyzed publicly available insurance records of 9,450 plans for
individuals and families under the age of 65 to determine the average
declination rate of health insurance applications, and compared this
average to the declination rate of individual insurers.
Beginning Jan. 1, 2014, under the Patient Protection and Affordable
Care Act, insurers are prohibited from discriminating against or
charging higher rates for any individuals based on gender or
pre-existing medical conditions.
“What is unclear is whether some insurers have increased their
declination rate in order to improve risk pool health and profitability
prior to 2014, when [the pre-existing provision goes into effect],”
The research called out the plans with the highest declination rates.
They are: South Dakota’s John Alden Life Insurance Company (73
percent), Utah’s Assurant Health (71 percent), North Dakota’s Assurant
Health (58 percent), Kentucky’s Time Insurance Company (56 percent), and
Idaho’s Assurant Health (56 percent).
Additionally, some non-profit insurance companies have higher
declination rates than for-profit insurers, analysts found. Kaiser
Permanente in Georgia, for example, has a declination rate of 34 percent
while Humana, a large for-profit insurer in Georgia, has a declination
rate of 23 percent.
But East Coasters fare the best with their chances of getting health
insurance. Maine, Massachusetts, New Jersey, New York and Vermont all
have zero declination rates.
NOTE- Thats because these states have community rating, guaranteed issue… Reeve