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Wednesday, February 7, 2001

Last night I went to bed thinking about insurance. If you believe that's the key to a restful night, then please let me know what desert island you're on, because I'd like to join you.

Here's my thumbnail concept of what insurance is all about. It's where a big company spends half its time coming up with new and clever ways to take your money, and the other half figuring out how to keep from paying it back. I know that's probably slightly oversimplified. There must be more to it than that, but at the level I deal with, that's how it appears.

My company's health insurance is carried by one of the big names. Because one of our employees lives in an area where there is no HMO agreement with any doctor's group, we have to apply for a change in the policy to allow him to use a doctor who's not part of a group. This means that our whole company has to be reevaluated. We started the process almost a year ago, and we've completed all the forms and answered the questionnaire and given the insurance company all our payroll tax records.

Now I have a note from the agent that the insurer wants to know why we're not covering two employees who "appear to be full time," even though I made a note on the application that they were part-time workers. In other words, they won't take my word for it the first time. They want me to tell them again that these guys are not eligible. I wonder why they'd believe me this time.

This is what I went to bed thinking about. Not that I have any great difficulty with the question itself. But it's been asked and answered. If I said they were part-time employees, that's what they are. You don't have to delay the whole process by doubting my word, or whatever it is you're doing.

We're a construction company. These two men work when we have jobs for them to do, and when we don't they stay home. Some weeks they might work forty hours, other weeks ten. In another month, they'll probably be gone to greener pastures anyway. Why does their status, which I've clearly indicated, have anything to do with our coverage?

Sure, the insurance company wants to cover as many people as they can get into the system. They want our premium to be as high as possible, at the same time that they're sending out monthly notices about conditions that are no longer covered. And now that they're renegotiating all the HMO agreements, there's another rate increase in the works.

With these kinds of questions running through my head, I shouldn't have even put my head on the pillow. I know I fell asleep some time during the night, because I woke up freezing this morning. I'm going to wait for the insurance agent to call me again before I worry about this stuff any more. I have so much work on my desk right now that one lost night's sleep is all I'm willing to spend on this. Well, that and one journal entry.

Isn't it ironic that I get so worked up over health care, when the best way to stay healthy is to keep this kind of stress out of my life. Isn't it?

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