Entrepreneur Scott Kucirek's Net Journal column on buying health insurance for a startup ("Doc, I've Got This Pain. It Started When I Went to Buy Health Coverage," Business Week frontier Online, Aug. 27, 1999) inspired many comments from entrepreneurs and health-insurance professionals. Here are some samples:

Scott:
No, you haven't heard the last of it. Wait until six months from now when Blue Cross boosts your premium by 20% (that is if you have no claims in that period of time). Then look for another 10% hike a year later. I speak from experience. That's what happened to us. The only thing I can think of that will help those of us in small businesses is if the government steps in and gets this under control. It's just beyond belief.

Georganna Ahlfors
worklit@sprynet.com
President, Worklit Associates

Dear Mr. Kucirek:
I am a professional group insurance broker/consultant and was really bothered by what you and your employees had to endure. Not that putting in a group plan is easy -- it usually isn't. Still, there are many excellent brokers out there who don't take two hours for the "dog-and-pony show." A three-hour enrollment meeting is totally unacceptable. Even with the most difficult employee groups, a meeting should rarely last more than an hour and should cover all plans provided -- medical, dental, life, disability, and retirement plans. I applaud, you as an employer, offering benefits, paid for at such a high level.

Regards,
Bridget Sirkegian
Corporate Benefits America
CBAmerInc@aol.com

Scott:
Your article gives me a better idea how a businessperson buys his group insurance for the first time. It is a complicated process, which takes a lot of experience and knowledge to do right -- and there are always questions and problems. I'm an insurance agent/broker who had a similar experience when I bought my first home. What a pain. The biggest purchase of my life and I didn't know who to go to, what to do, or whose advice to trust.

Thank you.

Greg Smith
Group Marketing Services Inc.
Lincoln, Ill.
gssmith@gmsil.com

Dear Scott:
You've outlined the "standard" process of buying small-group health insurance, and it is indeed a morass. At least you had the foresight to pick a single broker to obtain quotes. Think of trying to analyze two competing brokers' assessment of your options.

Here's another twist to the decision process that should affect how a broker presents your options. The market for small groups with 2 to 50 employees is the most heavily regulated segment of the market. But the federal HIPAA legislation (Health Insurance Portability & Accountability Act) doesn't limit what insurers can charge, or "rate up," for health conditions, though there are state limits. It's 67% for Texas, for example.

For that reason, we always get staff at small companies to fill out complete health history forms before we get the quotes from the carrier. Otherwise, we can't know if the quotes are valid. We don't want our clients to decide to go with a carrier based on their standard rates and later find out they're going to add 30%, 40%, or 67%.

Mark D. Head
Senior Consultant
Insurance Partners Southwest LLC
Dallas
mhead@ipsw.com

Scott:
Your article was clever and not so unusual, unfortunately. I believe your experience could have been avoided by making sufficient time to select a really competent broker who would have determined your objectives, and the needs and medical status of the employees, at the start of the process and taken that information to a wide range of insurers.

The broker should have prepared an objective comparison of all quotes with simple explanations. Any competent broker should provide written notice to the employer and employees not to discontinue any existing insurance until they get written confirmation they're covered from the new insurer.

Our business -- like yours -- depends on the broker's experience, ability, and integrity. My youngest daughter's recent bad experience with a real estate broker makes your insurance story pall by comparison. Can you imagine how her experience will color her future prospects for real estate purchases and dealing with realtors?

Same advice. Know the professionals and be certain of their credentials and reputation before making a commitment.

Danny M. O'Grady, CLU
O'Grady & Co.
Midland, Tex.
Shamrock@nwol.net

Letters are edited for length, clarity and style.