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The Honolulu Advertiser
Posted on: Thursday, October 23, 2008

ARE YOU BUYING THIS?
Self-employed hope to get health coverage

By Robbie Dingeman
Advertiser Columnist

That new law designed to make it easier for sole proprietors to get health insurance is stirring interest and questions, but insurance companies haven't issued any policies yet.

Nate Ikehara runs Hawaii Special Events LLC, a company that rents tents to hotels for outdoor events. He read about the law last week and was pleased to see that state insurance commissioner J.P. Schmidt said the initiative requires group health insurers to offer small group plans to self-employed individuals.

Schmidt estimated the new law — which went into effect on Sept. 1 — will help reduce the number of uninsured people among some 12,000 sole proprietor businesses statewide. But he said some details are still being worked out.

He said the Insurance Division has notified all the insurers in writing that they must offer coverage to all small businesses that qualify.

"Some insurers have disputed the Insurance Division's interpretation of the statute, and we are in the process of working through their challenges," Schmidt said.

He said sole proprietors should request an application in writing or fill out an application for coverage.

At HMSA, government relations assistant vice president Jennifer Diesman said the insurers — her organization as well as Kaiser Permanente and others — have submitted proposed rates and are now awaiting word from the state insurance division.

Until then, people can do what Ikehara did and call the insurers and ask to get information when it becomes available.

Diesman said: "We're taking their information and we're putting them on a list. We'll call them back."

She said the law requires that people be issued policies without clauses on pre-existing conditions such as cancer or other disease. And that is broader than what was available before.

Ikehara said he's glad to hear about new law but concerned that — for now — "it's in limbo." As a self-employed person, Ikehara said, he thinks it may help him find a better or cheaper health insurance policy than the individual one he has now.

He'll wait to find out more. "It's kind of frustrating," he said. But he said he was pleased to hear that the new law requires insurers to accept those who apply.

"They cannot deny you for a pre-existing condition," Ikehara said. "That is a really good benefit."

And Schmidt said his office is prepared to enforce the new law.

"The fact that some insurers may not want to comply with the law does not exempt them from the law," Schmidt said. And the state will investigate any denial or avoidance in complying with the law.

However, the state must follow required administrative procedures in dealing with any disputes.

Schmidt said the state has been making strides on successfully reducing the number of people lacking health insurance despite the concerns of some that the number of uninsured small businesses is growing.

The state prepaid healthcare law results in broader coverage here than in most states. A mandatory pool is usually cheaper because it includes the healthiest people who use fewest services, which balances out the costs of those who use more medical services.

Gov. Linda Lingle signed the bill into law in May.

For more information on the new sole proprietor health insurance, reach the state Department of Commerce and Consumer Affairs Insurance Division's Health Branch at 586-2804.

Are You Buying This? is a weekly consumer column. Curious about consumer issues or have a tip to share? Reach Robbie Dingeman at 535-2429 or rdingeman@honoluluadvertiser.com.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.