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Smoking Control Policies in Private Health Insurance in California: Results of a Statewide Survey
Journal article   Open access   Peer reviewed

Smoking Control Policies in Private Health Insurance in California: Results of a Statewide Survey

Helen Halpin Schauffler and Daniel Gentry
Tobacco control, Vol.3(2), pp.124-129
07/01/1994
DOI: 10.1136/tc.3.2.124
url
https://doi.org/10.1136/tc.3.2.124View
Published (Version of record) Open Access

Abstract

Objective: To estimate the extent to which private health insurance companies in California promote smoking control among their policy holders through premium differentials based on smoking status and through benefits that cover smoking cessation treatment. Design: A mail questionnaire sent to a random sample of private insurance companies licensed by the California Department of Insurance to sell health insurance (54% response rate). For those respondents that sold health insurance in California in 1991 (n = 48), and had adopted a smoking control policy (n = 26), a telephone interview was conducted to obtain additional detail on specific policy designs (81% response rate). Participants: Private health insurance companies that sold health insurance policies in California in 1991. Respondents to both the mail questionnaire and the telephone interview were key informants from the underwriting departments of the insurance companies sampled. Results: Approximately 27% of the private health insurance companies surveyed reported that they risk-rate health insurance premiums using smoking status, with average premium differentials of 16% for individual policies and 10% for small-group policies. Only one (2%) of the health insurers surveyed used smoking differentials for large-group policies, and only in a small pilot programme. The primary reasons private health insurers use smoking status to risk-rate health insurance premiums is to market their products to non-smoking individuals and small groups, and to discourage smokers from purchasing their products. Only one (2%) of the health insurance companies surveyed sells any policies that cover smoking cessation treatment. Conclusions: In 1991 only about 25% of private health insurers in California were using premium differentials based on smoking status in individual or small-group policies. Fewer that 5% of private health insurers were selling policies that cover smoking cessation services, despite a state mandate to offer smoking cessation treatment benefits, and recent public policy pronouncements at the Federal level encouraging their coverage.
 Employer provided health insurance Group health insurance Health insurance Insurance benefits Insurance companies Insurance coverage Insurance policies Insurance premiums Insurance providers Smoking cessation

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