Health Insurance Options For Self-employed?? Posted: 08-25-04 20:05pm
I live in massachusetts and I have a
family business with about 6 employees and
i've looked into many different health
insurance options for myself. Most of my
employees get insurance from their spouses
so i've basically had a non-group plan for
me and my family for the last 10 years
through bluecross/blue shield. I pay
around $750 per month for my family (me,
wife and 3 young children) and I want to
know if anybody knows of any other options
I could consider. I'm tired of paying so
much money every month.
Any help would be greatly appreciated!
Thanks
adam
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Adamo
New User, Becoming EHEALTHy
Joined: 25 Aug 2004 Posts: 3
Posted: 08-27-04 21:04pm
Anybody? Is there hope?
Adam
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CynthiaD
New User, Becoming EHEALTHy
Joined: 01 Sep 2004 Posts: 1 Location: Florida
Posted: 09-01-04 21:27pm
I'm surprised no one has responded. I
just discovered this forum tonight. I
can tell you're younger than me, but i'm
looking for answers also. Tonight, I
posted the following over at insure.Com.
I'll let you know if I get a worthwhile
response:
i'm 57, female, and have been
self-employed since the mid-80's.
Typically I buy into a health insurance
plan (ppo) at a reasonable rate and after
6 months to a year, the rate starts
regulary going up. I'm always told by
the insurance company that the reason is
because health insurance costs have gone
up and the same increases are being
applied to all people in my area/group.
No doubt rates were going up, but then
when I would go shopping again for health
insurance I was able to get the cost down,
usually to around the same price I started
at a year or two year earlier. Strange.
It became clear to me that this was a
racquet. Get the customer in, take their
money, start raising their rates to the
point where they will want to leave -
basically keep them for 2-3 years, which
reduces the insurance company's risk.
I've had this racquet confirmed by a
knowledgeable insurance agent who actually
teaches in a college.
Out of all this, my greatest fear has
always been that I would have a health
problem and I could no longer change
unless my problem was excluded either
temporarily or permanently. All the
while, my health insurance costs escalate
every six months.
Well, i'm there. I have had a mildly
abnormal pap for the last year. But, no
insurance company is going to cover this
and all the while my rates are climbing.
My monthly payment has gone from $232 in
10/01 to $580 starting 9/04. If my
figures are correct, that's about 150%
increase. Does it seem reasonable that
health costs have increased 150% in 3
years?
I hear the politicians talking about
making health insurance more affordable
for employers, but I am the employer and
employee (i incorporated about 2 years
ago). If, and that's a big if, anything
gets changed by washington, could this
benefit me in any way?
At this rate of increase, i'll be paying
$1,000 per month in a couple of years.
I wouldn't qualify for medicaid because I
make too much money, but I don't make
enough to afford these increases for much
longer. I had to put the balance of my
car loan on my home equity line of credit
to decrease my car payments and offset
medical insurance increases.
Why is washington doing nothing about what
is to me an obvious rape of the consumer
by the insurance companies?
Is it possible I could get coverage at a
better rate thru something like nafe
(nat'l association of female executives)
or similar and still have my pre-existing
condition covered?
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somarco
New User, Becoming EHEALTHy
Joined: 02 Jun 2004 Posts: 26 Location: Atlanta
Cynthia & Adamo Posted: 09-19-04 06:38am
This forum does not get a lot of traffic
and is loosely monitored. Unfortunately,
most of the traffic is from people
pitching discount health plans that are
extremely overpriced.
I do check in from time to time and offer
what assistance I can.
My experience, based on 30 years in the
industry, is most people have no clue how
to buy health insurance. Either they are
constantly shopping, looking for the next
"deal" or they buy coverage they don't
really need.
I can't really comment on adamo regarding
your premiums. My guess is you have
overbought in the coverage area, thats why
your premiums are high.
I am 54 and cover my wife and college age
daughter for $220 per month. We live in
atlanta, a relatively high cost area but I
am still able to keep the premiums
reasonable. We have had the same carrier
for 2 years.
As for cynthia, if you think this industry
is a "racket" then you will only look for
ways to justify your opinion. Seems you
already have.
By jumping around you are constantly
subjecting yourself to new waiting periods
and pre-ex terms. This will eventually
trip you up (if it hasn't already).
As for the "knowledgeable agent", well
either he didn't do a good job of
explaining things or you didn't do a good
job of listening.
Rates go up for a number of reasons not
related to your particular situation.
Overall, a new entrant who has just gone
through the underwriting process gets a
better rate than one who has been in the
pool for 3 - 5 years. That stands to
reason.
Other explanations for your frequent
increases can best be attributed to
contractual changes due to age and your
proclivity for shopping for the lowest
rates. Carriers do manipulate their
market share by introducing below market
rates on new product lines and then adjust
accordingly. But if you pick a good
carrier from the start you will be subject
to fewer fluctuations in premium.
Take care,
bob vineyard, clu
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Adamo
New User, Becoming EHEALTHy
Joined: 25 Aug 2004 Posts: 3
Posted: 09-19-04 09:46am
Bob, thanks for your response. It's been
awhile since I posted. I'm a little
unclear by what you mean when you say I
may have 'overbought'. I've looked into
the local health insurance market and
there seem to be very few 'non-group'
providers. I've been with the same
company 'blue cross/blue shield' for the
last 12 years, I have a plan they call
'hmo blue' and I have no prescription
coverage and I pay, as mentioned above,
over $750/month. How on earth do you
have a premium of $220/ month for your
family? Is it 'non-group'? Do you have a
deductible? Is it just that insurance is
cheaper in atlanta than boston?
Thanks
adam
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sandyallen
Extremely EHEALTHy
Joined: 02 Feb 2004 Posts: 4580
Somarco Posted: 09-19-04 13:22pm
Hi bob! My name is sandy, I am curious
too! With this insurance being through
employment does the employer pay for some
of your family's medical insurance and you
pay the $220.00 per month? What type of
deductibles and out of pocket do you pay
and your co-pays, what about your
medications. I better quit while I am
ahead, I may have already asked too many
questions, like I said before, I am just
curious and you did say this was through
an employer.
I was with b/c & b/s of or and I had
to pay $482.00 per month because I am
classified as high risk with my medical
situations but they would be going to
approximately $550.00 per month after the
first of the year. I now have medical
insurance thru my employer but I still
have to pay a lot of out-of-pocket
expenses. But so far it has been cheaper
than the $482.00 per month(knock on
wood).
Sincerely,
sandy
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somarco
New User, Becoming EHEALTHy
Joined: 02 Jun 2004 Posts: 26 Location: Atlanta
Posted: 09-20-04 07:07am
Adamo -
by overbuying I mean you have (probably)
bought coverage you dont need. That
happens often, especially with those who
left the corporate world of very low (or
no) deductibles when they pick coverage on
their own.
Many of the plans offered (at least in ga)
have doc & rx copays to help through
the everyday items. The major expenses
are then subject to a deductible and
coinsurance. Most people dont need a $500
deductible and would be quite safe with a
$2000 deductible or even higher. The
savings can be 30% or more.
In my case I have a $10,000 deductible
with 100% coverage above that threshold.
We rarely go to the doctor and are not on
any maintenance meds. The out of pocket
to us is minimal but I have protection in
case of a major claim.
Sure $10,000 would set us back but not as
much as paying $600+ per month for
coverage I will rarely use.
Bob vineyard, clu
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somarco
New User, Becoming EHEALTHy
Joined: 02 Jun 2004 Posts: 26 Location: Atlanta
Posted: 10-01-04 04:40am
Lisa, why would you suggest a discount
plan as a replacement for health
insurance?
Bob vineyard, clu
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somarco
New User, Becoming EHEALTHy
Joined: 02 Jun 2004 Posts: 26 Location: Atlanta
Posted: 10-01-04 11:47am
Let me make one thing clear, I would never
encourage someone to substitute a discount
plan for an insured plan . . . But I
was curious about your post and wondering
what kind of response I would get.
Anyone who replaces an insured plan with a
discount plan needs to have some serious
asset protection planning. When a major
claim occurs their only escape will be
personal bankruptcy.
Discount plans, especially dental plans
have some benefit to those in metro areas
where the patient does not have an
existing relationship with a provider.
Dental networks typically have less than
20% penetration into the provider market
and most providers that do agree to
discount their services are either new
formed practices or those who have had
difficulty establishing a client base.
Most providers in a dental network are
inexperienced.
Given the pricing structure of ameriplan
for their current limited benefit plan I
will be curious to see how the medical
plan fares. Frankly, I am surprised the
roll out hasnt occurred before now. Their
alliance with phcs was announced quite
some time ago.
Bob vineyard, clu
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sandyallen
Extremely EHEALTHy
Joined: 02 Feb 2004 Posts: 4580
Posted: 10-02-04 01:03am
What really gets my goat is that
some(caps) of these people on welfare and
some(caps) of these people that are so
called "disabled"(unable to work, hah!),
that are in better shape than some of us
working people get 100% coverage for
medical, dental, vision, hospitalization,
food stamps, hud, breaks on utilities,
phone and everything else, making more
money than some of us working people, some
are working under the table, living tax
free and we have to pay for them and
ourselves, and most of these people don't
have to pay a dime. I realize that this
is the system and politics but something
needs to be done!
Look at all the money we have given to all
the other countries, and iraq, our own
country, it is going to h*e*c*k!
I realize that this is kind of off the
topic but thanks for letting me vent
anyway!
I realize that this is called "the land of
the free," but it is only free for some!
Sincerely,
sandy
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nicoluzakis
New User, Becoming EHEALTHy
Joined: 16 Dec 2004 Posts: 5 Location: Phoenix, Arizona
Hsa Posted: 12-17-04 20:29pm
Admo,
i would recommend a health savings
account. These are increasingly populare
and can be very beneficial to your
situation. As bob mentioned, you can get
a high deductible plan with 100%
coinsurance. So, your premiums are lower
and of course being self employed you can
get the write off. Also, you can place
100% of your deductible (maximum of $5,000
I think) into a seperate savings account
gaining interes tax deferred. You can
also spend the money out of this account
(liberaly) on anything to do with your
health tax free! This should help you
out on both ends. Please see your local
broker for more information.
P.S.
You do not lose the money at the end of
the year. As I said, it gains interest
and at 70 years old or when you withdrawl
social security, you must withdrawl as
income like an ira. If you withdrawl
early for a non-medical purpose, you will
face a 10% irs penalty.
Jason
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jonpdrew
New User, Becoming EHEALTHy
Joined: 22 Feb 2005 Posts: 1 Location: wisconsin
Archer Msa Info? Posted: 02-22-05 21:48pm
I am currently checking out health
insurance for my small biz that is
growing. I also have a regular day job
so I am a pretty busy person all around.
Finding good health coverage is really the
last hurdle to me jumping into my biz full
time. Where I currently work which is
about a 500 person facility the insurance
is top notch and I pay nothing.
Unfortunately if I stay there i'll being
saying "i wish I had tried to get out on
my own when I could". I guess I would
rather try and fail than not try at all.
So anyway, I ran across this thing called
an archer msa but I can only find sporadic
info on it. Does anyone use this and are
there different types. Also my business
is computer illustration so the odds of me
getting hurt on the job may only amount to
me getting a spranged thumb on my
trackball. Is there any insurance
tailored to computer jocks like me or are
all self employed people lumped together.
If I get placed in the same catagory as
the bearing strait crab fishermen
(apparently the most dangerous job in the
world) i'm thinking that's not quite fair.
Any info from you folks out there would
be greatly appreciated.
Jon
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somarco
New User, Becoming EHEALTHy
Joined: 02 Jun 2004 Posts: 26 Location: Atlanta
Archer Msa Posted: 03-04-05 21:05pm
The law making msa's possible was allowed
to sunset 12/31/2003. The replacement is
much broader. Talk to a qualified agent
about hsa's.
As to your question on otj injury, that is
a wc question. Depending on where you
live, wc may not be an option (or
required). In ga you are not required to
have wc until you have 3 employees.
Most health insurance plans will
include/offer 24 hour coverage if you dont
have wc.
Bob vineyard, clu
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ProcardAbra
New User, Becoming EHEALTHy
Joined: 31 May 2005 Posts: 2
Posted: 05-31-05 19:12pm
Hello
Last edited by ProcardAbra on 06-02-05 10:48am; edited 1 time in total
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somarco
New User, Becoming EHEALTHy
Joined: 02 Jun 2004 Posts: 26 Location: Atlanta
Posted: 06-02-05 06:08am
Procardabra -
your discount plan is not insurance.
Apparently no one has explained to you the
kind of trouble you can get into promoting
it as such. When you pay some hefty fines
and are sued by those who bought the card
because of your misrepresentation, maybe
you will learn.
I note you have been chastised on other
forums for soliciting. Guess the message
has not registered yet.
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keg06525
New User, Becoming EHEALTHy
Joined: 09 Jun 2005 Posts: 17
Not Able to Get Coverage Posted: 06-10-05 11:22am
Cynthia: I fully understand your
frustration. I had a policy with mutual
of omaha for twenty years (major med) and
never made a claim. In dec. -03 they
termianted all individual major med
policies and I have been a nervous wreck
ever since. I have parkinson's disease
so I am unable to find a company that will
insure me. I am 61 years old and hope
and pray that I can avoid a major
hospitalization. I am actually anxious
to reach 65. Dee
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dgmunger
New User, Becoming EHEALTHy
Joined: 13 Jun 2005 Posts: 1 Location: Denton, TX
Supplemental Insurance Posted: 06-13-05 19:31pm
Those who are having problems with high
deductibles should consider supplemental
insurance. It has relatively low
premiums, pays cash to the policyholders
based on fixed amounts for specific
services, and is guaranteed
non-cancellable with some suppliers.
It is not designed to be all things to all
people - just a little help. There are
hospitalization policies, accident,
cancer, heart attack/stroke, etc. There
are some qualifying questions on some of
the policies, but it is worth a little
research.
I hope this idea helps someone.
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keg06525
New User, Becoming EHEALTHy
Joined: 09 Jun 2005 Posts: 17
High Deductible Posted: 06-13-05 20:47pm
I am looking for a high ($25,000)
deductible policy. Any suggestions?
Ty.
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donaldmolbert
New User, Becoming EHEALTHy
Joined: 21 Jun 2005 Posts: 6 Location: Nashville, TN
Posted: 06-21-05 18:14pm
Whatever you do, do not purchase any
health insurance from an organization
called "national association for the
self-employed", and also do not purchase
anything from mega life insurance company
and midwest life insurance company.
Ask around. You'll find out why.
Go to the big names, such as fortis,
golden rule, world, etc. Real insurance.
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keg06525
New User, Becoming EHEALTHy
Joined: 09 Jun 2005 Posts: 17
Individual Major Med Posted: 06-22-05 05:56am
I was rejected by fortis because of an
existing condition. I have given up on
getting any kind of coverage.