Dan Nielsen: Insurance comes in many shapes

Nov. 6--It's open enrollment season -- that special time of year when we put on our gambling hats and take a guess at how sick we'll be during the next 12 months. Few decisions are less enjoyable to contemplate than possible illness for ourselves and our loved ones.

Will I suffer a horrible accident? Will my spouse spend time in a hospital? Will one of our children contract a disease? Or will we all cruise through flu season and beyond with smiles on our faces?

The unknowable answers to those questions determine which health insurance plan we should purchase.

Each of us must confront choices in coverage, cost and deductible. We each make a guess, educated or not, and set the wheel of health spinning for the year. Then round and round it goes; where it stops nobody knows.

Insurance is intended to provide peace of mind that if the wheel stops in a bad place -- it we are injured or get sick -- we don't descend into economic ruin. But making the annual insurance decision can take an emotional toll.

If we spring for an expensive health insurance plan and then stay healthy, we may regret spending so much. If we buy a more affordable plan and get sick, the resulting bills can bury our budget for years.

High-deductible health insurance plans grew in popularity over the last decade because the monthly premiums are smaller for both employee and employer. But competition for workers in today's tight labor pool has led some corporations to begin offering more low-deductible plans, which cost more per month but reduce the possibility of catastrophic financial damage.

For the third year in a row, the National Business Group on Health recently reported, the percentage of companies that offer high-deductible plans as their employees' only options will decline in 2020.

Not all companies are reversing course. And the insurance industry has come up with its own alternative solution to the dangers inherent in high-deductible health insurance plans. Some companies now offer supplemental health insurance plans -- extra insurance that covers things not covered by primary insurance.

We can buy insurance to cover what our insurance won't cover. Yes, that sounds unnecessarily complicated to me, too.

I yearn for the days when I was young and invincible, and insurance was simple and easily understood.

When I was into backpacking, I worried about what I could eat if I got stranded in the wilderness. My insurance policy was buried at the bottom of my pack in the form of a can of tuna that I vowed not to open unless my situation became dire. That can of tuna always made it back home untouched. And the cost was never lost, because once back home I eventually recycled the protein into a sandwich.

When exploring the Nevada back country in my old Jeep, I was well aware that the gas gauge was broken. My insurance was a full 5-gallon gas can lashed to the back bumper. If the main tank ran dry, I could just pour in some more. I used that insurance countless times.

When traveling closer to civilization, I used to worry about ending up cashless. My insurance was a money belt with a few $20 bills inside. I tapped that a few times, too.

The nature of insurance changes as we age. When you're young, insurance might be a packet of breath mints in your pocket, just in case. When you're elderly, it might a spare pair of underwear, just in case.

Today's world of insurance is infinitely more complex. Health insurance is big business.

Total private health insurance direct premiums totaled $867.5 billion in 2017, the Insurance Information Institute says.

Nearly 6,000 insurance companies were in business in the U.S. and its territories in 2017, according to the National Association of Insurance Commissioners.

And they all seem to offer a whole lot of options.

Open enrollment season makes me feel like I'm driving toward a cloverleaf of a dozen interconnected highways and it's impossible to know what problems lurk ahead in each lane. Should I turn left at high deductible, go straight at percentages, veer right at prices, speed up at dental, take the exit at optical? Do I feel lucky?

Open enrollment season is a necessity. Personally, I find beach season much more relaxing.

Contact Business Editor Dan Nielsen at 231-933-1467 or [email protected].

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