Health Agents: Why Prescreens Matter

When I first started selling health insurance in 1991, agents had to complete every application and then deliver the policy to the client after it was approved. Those days have changed. Now, many people complete their applications online. Our job as agents is to guide the client and make this process as easy as possible.

Personally, I like to send a prescreen form to an insurance company for applicants who may have complicated medical conditions or who are taking several prescriptions. Taking this extra step is beneficial to the client and myself, because it allows us to get the real “rated-up” number prior to completing the application. It also helps to avoid an application denial altogether.

If the client is declined after submitting a prescreen form, they do not have to submit an application. Because applications are usually accompanied by the first month’s premium check, this also means they won’t have to wait for a refund. Consumers dislike shopping for health insurance to begin with — but it much worse to take the time to fill out an application and send in a check, only to be declined and have to wait for their money to be returned.

Unfortunately, several insurance companies have stopped their prescreen process. Moreover, I find that every condition is not listed in their underwriting guidelines. This seems very strange to me. To save time and money, it makes sense that insurers would rather prescreen a complex preexisting condition then take the time to underwrite an application, deposit the premium check, deny the member insurance, send a letter of denial and then issue a refund of initial premium (usually all within 30 days).

Hopefully, those companies that do not prescreen applicants will change their process in the future. Having this additional option in place is better for the client, the agent and the insurer — and at a time when health care reform has brought many new challenges to the table, prescreens help make the application process easier on everyone.

An added note

Last week I submitted two applications that I had previously prescreened. One rated-up the client 50 percent for kidney stones and the other applicant rated-up 25 percent for AD&D. I included the rate-up in the proposal and, luckily for us, both were issued a standard rate.

Cindy Holtzman is the director of Medical Refund Service Inc. She can be reached at [email protected].