Short answer
Because GSI policies are individual policies, not part of your hospital's benefits package. Most GMEs don't endorse or sponsor them, so you won't see one at open enrollment. You have to find out through an insurance professional who has access to it.
A short clip from his webinar for residents and fellows, with captions.
Watch the full webinar from 35:03Not part of your benefits
It's not something you can go to your GME and ask about. A lot of times the GME wants nothing to do with it, because GSI policies are individual policies. They're not tied to your benefits package at that hospital. Once in a great while a GME or institution will mention or sponsor one, but the overwhelming majority don't.
You're not going to check a box during open enrollment and get this. You have to reach out to an insurance professional and get it on your own.
Why it's hard to find out
Sometimes only one or two insurance professionals have access to the GSI at a given hospital. Some insurance professionals don't know a GSI exists. Others know about it but can't offer it, so they don't bring it up.
How to find out
I keep a list of the GSI policies I know about. There are well over 200 teaching hospitals with GSI policies available to residents and fellows. I can access some of them and not others. If it's one I can't access, I'll point you to an insurance professional who can. Email jay@pgy1.com with where you're training.
Where Jay covers this
Jump to each moment in his webinars.