The advent of the online application has changed health insurance enrollment on the individual market significantly in California.  The major carriers have all brought out their versions of the online application starting with Anthem Blue Cross and most recently by Pacificare of California.  Over a decade ago, health insurance applications were processed much the same way they had been handled thirty years ago.  A hard copy of the application would be completed and forwarded to the health insurance agent.   This application would then be mailed to underwriting.  Already, we would be five to seven days into the process before review could even begin.  Issues with mail and missing paperwork can severely delay processing.  A big improvement would happen when the carriers (again, led by Anthem Blue Cross) allowed us to fax the completed application into underwriting and mail the original.  The carrier could start on the faxed copy.  What are the advantages of the online application and how does it work?

The benefits of the online individual application

The first significant advantage to completing an online application for insurance enrollment is both speed of correctly completing the application and its subsequent processing.  The health insurance application is never easy to complete.  In fact, it's one of the main reason people procrastinate about enrolling for health insurance.  The online application helps in this area because it guides you through the process.  It knows if additional information is needed (or not) and prompts you to complete needed sections.  This insures that the information on the application is complete and accurate.

Once the completed application is submitted, the processing typically occurs in 50% of the time that a paper application needs.  In fact, the new trend is towards auto-adjudication...a fancy word that says the computer can automatically approve or decline some applications based on the information listed in it.  In this case, we sometimes have a decision back automatically or in a few days.  This was unheard of before the advent of online applications. 

The Tonik application processing

A new direction started by Tonik health insurance is the simplified online application.  With standard plans, the underwriter can request medical records if he/she wants to look further into a situation.  This process of requesting medical records can significantly slow down the underwriting process. Tonik health insurance, which is offered by Anthem Blue Cross does not request medical records.  They will make a decision (to approve or decline) solely form the information on the application.  On one hand, this "simplified issue" speeds the processing up for Tonik enrollment but on the other hand, some people might qualify for coverage if they could get more information from a doctor.  If an applicant is declined coverage for Tonik health insurance, we recommend that they apply for a standard plan such as those offered by Anthem Blue Cross to see if they can qualify.  Tonik only allows online applications.  They do not have paper applications for enrollment.  Health Net of California also accepts online applications only for it's NetSaver plan.  As the carriers look to reduce premiums going forward, they will likely embrace such cost-savings processes more so.

Completing the Online Application

The online application actually follows pretty closely to the paper app in terms of sections and needed information.  There are a few distinct differences.  As part of the online universe, an ID# and password is needed to start and continue the application.  This ID and password can time-out if not active for a period of time.  You can also save your completed work and finish at a later date.  This is an improvement to the first online apps where you had to start over.  The online application require an e-signature and this has been an issue in the past.  It's pretty functional now and does not pose a problem.  The carriers have also made progress in terms of ease of use when completing the online app.  As your health insurance broker, we can help if you run into any snags online. 

Online applications links:

      Health Net
      Anthem Blue Cross
      Blue Shield of California
       Tonik

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