I have often wished that health insurance policy details were easier to understand, and more standardized from one policy to another in terms of how benefits are explained. My ideal policy, if I could create one, would simply have a deductible, and then wording to the effect of “all medically necessary services are covered at 100% after the deductible is met”, followed by a list of specific exclusions that the policy would not cover (these specific exclusion lists are standard on pretty much all policies). I’d prefer to not have caps on any covered service once the deductible is met (for example, a lot of policies limit the number of physical therapy visits that will be covered by the insurance company, even after a person has met the deductible, and even if the doctor feels that more PT is needed). My own family’s policy is an HSA-qualified plan with 100% coverage after the deductible, but it’s still got a lot of complicated wording in the benefit booklet, and some internal benefit maximums.
I doubt that such a truly simplified plan design will ever become the norm, but House Bill 1166, introduced by Colorado Representative John Kefalas (D – Fort Collins) would at least make policy details easy to read and understand. His Plain Language In insurance bill passed out of the House last week, and is headed for the Senate this week. It would require that all auto, dental, long term care, and health insurance policies sold in Colorado be written at no more than a 10th grade reading level starting in 2010. It would also require that all the fine print be no finer than a 10 point font.
To help offset the cost to insurance companies of re-writing policy details, an amendment in the bill allows for electronic administration of policy paperwork. In addition, the expenses of rewriting the paperwork to make it more readable should be a one-time cost, while the benefits for consumers will be continuous. All in all, this is a solid bill, and I hope that the Colorado Senate agrees.