Interesting trend developing over the last two weeks related to underwriting for individual health insurance plans. Having been in the Texas health insurance business since 1993 I feel I have more than an addaquate grasp of market conditions and the personalities of  each Texas health insurance company, however after the last two weeks I am starting to question my own ability. Now, I am not questioning my personal knack for properly finding the most affordable health insurance in Texas, my second guessing comes in the form of underwriting. I have spent years developing relationships with the different Texas health insurance companies, gathering the contact phone numbers of underwriters and company executives in order to ensure every client I represent gets the utmost attention. Also this process has allowed me to understand and know what each and every Texas insurance company looks for when deciding what underwriting decision to administer to every new client.

Now, why am I mentioning all this? Simple, over the last two weeks it appears that most of the health insurance companies have done an about face on underwriting. Prospective consumers of individual health insurance in Texas are getting negitave underwriting decision at an alarming rate. Clients that 6 months ago would be approved prefered or standard are now being denied coverage. Also, private health insurance consumers are having medical records and paramedical exams requested at the same alarming rate.

Aetna health insurance in Texas has so disappointed me over the last 2 weeks that I am almost to the point of backing away for quoting them unless the consumer and their family are so squeaky clean from a medical standpoint that our creator looks at them as role models. This is ridiculous. Aetna has always been one of the more liberal outfits when it comes to underwriting. According to an inside source a meeting was conducted in mid January with company staffers to inform them that the underwriting “nut” would be tightened down. This source went on to express that changes had to happen because of the low profit margin Aetna has built into their policies and there was growing concern that President Obama would authorize administrative policies that adversely affected their ability to remain profitable. Of course this information would never be confirmed by Aetna corporate, but like I said my knowledge is from an inside source.

I have also noticed another very large health insurance company in Texas ordering not only medical records but wanted the applicant to consent to a paramedical exam. A paramedical exam is a short physical exam usually preformed at the insurance companies expense and preformed at the Texas health insurance consumers home or place of business. Another Texas individual health insurance company ordered a massive full blown physical exam and expected the client to pay for it. Of course I advised against it as I felt this was nothing more than the insurance company attempting to get the client to cancel the underwriting process.

Almost every individual health insurance company in Texas has a process called pre screening available to Texas health insurance brokers but for the last 10 years I have never had to use it as I almost always knew with unbelievable accuracy what decision the health insurance company would render. I now find myself spending hours each days pushing emails back and forth to underwriting pre screen departments so I can get a little better handle on their view regarding different health conditions.

Health insurance companies in Texas will say nothing has changed but I say, hogwash. I know something has changed and my daily conversations with fellow agents and brokers confirms this. They are having the same difficult problems. Now, my theory on why. I think this wrecked economy has insurance companies feeling the same pinch that banks are. Since insurance companies invest a large percentage of their money in real estate and other vehicles that have taken a massive hit they could be tapped out and only lucky to survive to the next day. Another factor that could be coming into play is the threat by President Obama to snatch the health insurance companies up by the hair on their head and shake some common sense into them with health care reform. Whatever the true reason, the one being penalized is the individual health insurance in Texas consumer.

What should the shopper for affordable health insurance in Texas do? One, and this is a biggie, deal with an established veteran broker or agent. We are the only ones that have the experience to navigate through the changes and upheaval. One thought, with these changes, i will become even more conservative in my underwriting approach and would rather error on the side of caution. This is not the time to take risks, still shop your Texas health insurance, but be careful.