Why are my open enrollment forms asking about preexisting conditions?

My preexisting conditions are none of your damned business.

That was the tone (if not a direct quote) from someone going through the open enrollment questions on their new plan. 

They had a point.

This person had had a physical disability since birth. Something visible that limited activities of daily living.

They'd spent their whole career overcoming discrimination in the workplace. 

They'd spent their whole life navigating the healthcare system and advocating for their rights.

There are rules against changing people’s access to care or cost structure based on preexisting conditions.

There are rules about what health info employers can ask for and track. 

But different rules apply to life and disability insurance than apply to medical insurance.

Disability doesn’t have to cover you for conditions that started before the policy began. Since many disabilities start slowly, insurance companies put eligibility and waiting periods in place to prevent people from buying a policy only when they realize that they need it. 

It sucks for the unlucky person with unfortunate timing, but it’s the only way to keep disability policies affordable for everyone else.

Life insurance has a similar issue. 

They need to be reasonably sure that you’ll be alive for a while to pay the premiums. 

If you have a “dreaded disease” (a real term) or are just an “actuarial risk,” they may increase your premiums, reduce your coverage, or deny any coverage at all. 

Since employer group plans need to offer the same coverage to everyone, employer-sponsored plans are sometimes the only way that people with serious or chronic health conditions can get any disability or life insurance at all. 

This is a good thing.

But unlike medical insurance, group life and disability insurance can limit your coverage if you have a preexisting condition.

That’s why the benefits administration system was asking this poor employee about their preexisting conditions. Disability and life enrollments were part of the same process as the health insurance enrollment. 

It was allowed, but it was a bad look.

The employee wanted to skip the questions, but they were required fields. The system wouldn’t let them complete their enrollment without responding.

And they were pissed. Justifiably so.

After we apologized for the optics and explained the reasoning behind the questions, they decided to lie. 

It wasn’t a perfect solution. Lying on insurance applications is technically considered fraud, but how can it be fraud if “none of your business” isn’t one of the options?

If this person filed a claim, they would still be covered for the minimum amount so long as they met the other criteria. But they would probably have some ‘splaining to do. 

And that sucks. But I would be by their side to advocate and argue that it was the stupid application's fault.

Make those fields optional. For heaven's sake.

You can collect that information if anyone ever actually files a claim. You don't need it at enrollment.

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👋 I’m Claire. I understand insurance regulations to make the employee experience a little less shitty.

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