One of the challenges I face most often these days, in our pre-2014, marketplace is helping give the small business owner some peace of mind when facing finding insurance when they have a family member with a pre-existing medical condition. For the purposes of this commentary, let’s define a pre-existing condition as something causing a decline in the Individual/Family market.

I often get referred to hopeless people faced with “nobody will insure me”. Well, as a skilled broker, committed to helping insure and provide peace of mind to as many clients as possible, most cases are not hopeless. Many times, the husband and wife business can get Small Group Health on a Guaranteed Issue basis. What does that mean? They cannot decline you for medical issues, or namely pre-existing conditions. All we have to do is prove we are a viable business here in California per the guidelines of AB 1672, which is the statute that defines small businesses in California.

So, when faced with a client who has been declined for health Insurance in the IFP market, I first ask if he or she is married. As long as they are married, we can get them GI Group Insurance in California. Period. If they have a Corporation, we need a current Statement of Information listing both husband and wife as Officers (not Directors) of the company. If they are not Incorporated, we can place them with two carriers who have liberal interpretations of AB1672. All they need to do is get a Business License that lists both the husband and wife as owners of the business entity of choice, and we can get them coverage.

One client was recently referred to me with a daughter, a little less than two years old, experiencing some medical issues that she would grow out of, but declinable conditions in the Individual/Family Plan Market at this time. They came to me with three weeks of Cobra to go…almost in a panic. They followed my instructions to the “t”, and promptly got the coverage they wanted for less than they were paying on Cobra and most importantly eliminated that panic from our first call.

Another client had he and his son on an IFP plan and his wife on a state HIPPA plan. We were able to consolidate all of them onto one plan, significantly improve the benefits to all, and save him some money each month.

In another case, I was working with a woman and her husband in the IFP market, and one of them was declined. She was feeling hopeless…I was able to get the carrier to re-visit their situation, provide a letter of explanation, and they were ultimately offered coverage by that carrier, saving them significant dollars in their monthly budget, while significantly improving benefits. Working with an experienced broker, with a reputation with the carrier can often pay dividends even though it costs you nothing!

Bottom line, I keep saying that here at the David Lindsey Agency, we are Insurance Specialists charged with creating peace of mind for our clients in this challenging and changing Health benefits climate we have now. We work hard to help our clients sleep at night so we can too!