The good news is that the hard part is done.  Once you have decided on a plan, you are now faced with the enrollment process.  Let's walk through the health insurance enrollment process step by step so that you know what to expect.

The California individual health insurance application

The major carriers in California now offer both a hard copy of the health application and an online version.  The online application typically processes more quickly and we recommend this approach as long as it seems to be moving smoothly for you.  The online apps are relatively new (last five years) so they can get stuck now and then.  There are considerable privacy requirements for insurance companies so we feel confident in their online systems to protect private health information. 
 

Sections of the individual health application

Each carrier's application is slightly different but we'll go through some of the key sections.  The online applications pretty much follow the same structure as the hard copy apps with some added clarifications on online signatures, etc.

1.  General information.  This is your basic information.  You will have an option for a residence address (needs to be in the State) and a billing address in case someone else is paying for the policy.

2.  Plan Selection.  The carriers have needed to have two companies to roll new plans so go by the plan name.  For example, Blue Cross of California's new plans are under their BC Life and Health banner.

3.  Prior insurance.  This is important to the carriers because it can affect waiting periods for pre-existing conditions.  If you have qualified coverage that did not lapse prior to the new plan, this can go towards your waiting period.  It also affect your potential options for HIPAA guaranteed issue coverage if you meet the requirements.

4.  Health history questionnaire.  This is the hard part of the application.  There is a number of questions you answer "yes" or "no" to regarding prior and current health conditions.  A separate section follows for more detail to "yes" question as well as prescription and last physician visits information.  Answer honestly and with as much detail as you can.  It's important that you list relevant information that the underwriters need in order to make a decision.  If information is left off or incorrect, the carrier can rescind coverage.

5.  Signatures and Authorizations.  You will need to sign the document (or e-sign) and complete a HIPAA authorization which allows them to request medical records if they wish to look deeper into a given health situation. 

6.  Billing Section.  Depending on the carrier, you will probably be able to request a billing (monthly, bi-monthly, or quarterly), monthly credit card deduction, or automatic checking account deduction. 

7.  California health Broker information.  This section is for us and it allows us to help with both the enrollment process and future membership issues. 

The California individual health insurance underwriting process

Once the application is submitted (by fax or online), it is now in underwriting.  Underwriting is where the company's "underwriter" looks at the application and makes a decision as to approval and if so, at what rate or "tier" based on company guidelines.  If the underwriter can make a decision based on the information in the application (especially the health history section), you will usually receive a decision in 5-7 business days depending on the carrier.
 

Medical records request

The one thing that can slow down the process is if they need to request medical records.  As the applicant, you do not need to do anything.  The carrier (or a third party company such as WFI) will contact the doctor or provider directly to copy the records.  This process varies significantly depending on how quickly the doctor's office responds.  It can run from 1 week (the fastest) to over a month.  As the patient, you can help speed things along by pushing the office.

In California, you have a "10 day free look period" from when you receive notification of their decision to decline the offer with no payment required.  The plan is called a "policy never effective".  You do not need to bind the policy outside of paying the premium.  The ID card and policy will typically arrive in 5-7 business days.

Other important concepts to help you understand your California health insurance quote are:

Individual health insurance underwriting
Access to the California online application
A quick introduction to California health insurance history
Understanding health insurance costs