Repost: Health Insurance? - Posted by TAT

import · July 11, 2002, 1:49pm

Posted by JT-IN on July 13, 2002 at 24:11:28:

Hi Frank:

It was a pleasure to put a face with a frequently seen and well respected name such as yours, at the recent convention… as well.

On to insurance… you happen to live in a state which is notorious for wreaking havoc on insurance companies with some of the laws affecting them quite severely. Many companies refuse to even attempt to compete in NY due to some of these dictatorial and restrictive laws.

However, some of these laws or requiremnts are actually good for the consumer, but tend to go too far, which ultimately hurts the consumer. Obviously, the laws are not meant to hurt anyone, but many times that is the end result of far reaching legislation.

I have some very definite ideas and thoughts about the area of health insurance, that I feel would work toward reform of the entire industry. Lord knows it is needed at this time. Congress must get involved setting a level playing field, but let the companies resolve the problem, not making the problem a gov’t solution. Otherwise, we will all be at the mercy of a system that is far worse than medicaid and medicare combined.

Come next convention, we must sit down and discuss some ideas concerning this subject. I will share some indepth ideas as to what I feel the solution to the crisis is… and it involves getting everyone in the game. The largest problem among us is, the million sof un-insureds, who choose to be so purposely, taking the chance based on being reasonably healthy at the moment. These consumers must be made to do the right thing… which is to be protected; like it or not. If they choose not to play/pay, and they become ill, we all pay for this… big time. Just like auto insurance… if you are going to drive, gotta have insurance.

Can yo imagine how bad the auto insurance industry would be (worse off than present), if we did not force folks to be responsible here…? We woudl each be paying lot smore for auto insurance as a result of more uninusreds… Health insurance is no different.

I have the method to want to make them play, on the health insurance playing field… Of course I am not quite analytical adn indepth enough to comletely know whether this would work… as maybe someone much smarter tahn I could calculate the accuarial side of the impact, and say whether my ideas hold water…

Anyway, until next convention… or until they appoint me health insurance czar of the US… I guess we will never know for sure… LOL, LOL

Just the way that I view things…

JT-IN

import · July 11, 2002, 1:49pm

Repost: Health Insurance? - Posted by TAT

Posted by TAT on July 11, 2002 at 13:49:01:

Does anyone have any ideas or suggestions for health insurance for self employed individuals. What are the full timers doing for insurance?

Thanks,

TAT

import · July 14, 2002, 9:38pm

Re: Repost: Health Insurance? - Posted by Fred

Posted by Fred on July 14, 2002 at 21:38:24:

TAT,
The purpose of health insurance should be to protect you and your family in case of a catastrophic illness or accident. Call an independent insurance agent who represents many carriers and tell him that you want a policy with a $5,000 deductible, at least 80/20 coverage after the deductible is met, and a cap on out of pocket expenses. Then set up a medical reimbursement account in your business (ask your CPA about this) so that minor doctor bills become an expense to the business. Using this strategy I am now paying less than $200 per month as opposed to over $900 previously. The difference is put into my medical reimbursement plan; if the money is never used it becomes part of my retirement account. Pretty neat. Good luck.

import · July 13, 2002, 1:46am

Re: Repost: Health Insurance? - Posted by Joe Clifford

Posted by Joe Clifford on July 13, 2002 at 01:46:34:

Check with your local Chamber of Commerce – several of the Chambers here in the Denver area have banded together and negotiated better rates for their small business members… any time you go to an insurer as part of a larger group (where the law of averages works in the insurers/underwriters favor) you’ll come out ahead and probably save some $$$.

import · July 11, 2002, 9:58pm

Health Insurance for Self-Employed - Posted by JT-IN

Posted by JT-IN on July 11, 2002 at 21:58:18:

TAT:

The thread that Frank Chin is referring to can be found here:

http://www.creonline.com/wwwboard/messages/arc_2001/arc_44/44478.html

Frank is referring mostly to the deductibility and financial aspects of insurance. While these are important features and concerns, what is at the core element of the insurance debate is affordable, quality major medical coverage. Ugh… that is really a mouth full if one is to digest this completely.

Health insurance is one of the most misunderstood commodities that is bought by such a large segment of our society. We have so little true understanding of this product, until it usually too late. The education that we receive about health insurance is usually when we get the bad news about lack of insurability, rated premiums, or restricted coverage or the fact that our carrier has left the marketplace, resulting in cancellation. Never is any of this good news to hear, but only then do most people really care to understand the nuances of this industry.

With all that “hot air” expended, I am nearing the point of which I will be personally shopping for Health Insurance benefits. We are about to enter the COBRA world, as my wife has recently left her employment voluntarily.

Insurability is key, as their are some conditions by some family members that will somewhat restrict standard coverage, so the shopping detail may be rather extensive.

I just heard of a company that had some intruging claims advertised on the radio, but failed to write down the number. It is being advertised locally by a large radio station, and I am certain that I will hear of it again, and will check it out.

Stay in touch on this issue. Feel free to use me as a sounding board resource, for assistance in evaluating any plan that you learn about. I can surely give the “down and dirty” as to the risk factors, with a quick evaluation of the benefits and their underwriting and rating systems.

The short answer is that there are not really any good alternatives for a self emplyed person, in this area of coverage. It is simply a matter of selecting the plan with the fewest liabilites for you and your needs, whether they be financial needs (lack of ability to pay a high premium) or due to special health needs.

So, now that I haven’t really answered your question, maybe I can be of help to both you and I, as we do the search for some respectable health insurance coverage in the marketplace.

JT-IN

import · July 11, 2002, 7:00pm

Re: Repost: Health Insurance? - Posted by Frank Chin

Posted by Frank Chin on July 11, 2002 at 19:00:57:

Hi Tat:

I am a full timer, and had a “C Corp” set up to facilite the FULL deduction of Health Insurance. The C Corp is set up to perform property management.

The issues involved are:

1- Corporate plans (thru a C Corp) are less expensive than individual plans.

2- Corporate plans for two or more employees are less expensive, and more plentiful than for a single employee.

I’m currently enrolled in a HMO type plan as PPO plans became too expensive.

If you check the archives using the key “health insurance”, there’s a thread discussing the issue that I initiated a while back.

Frank Chin

import · July 11, 2002, 6:01pm

Re: Repost: Health Insurance? - Posted by jeff

Posted by jeff on July 11, 2002 at 18:01:15:

I WISH TO GOD I COULD ANSWER THIS QUESTION WITH SOME EXPERIENCE!!!

id give away my neighbors kids to be self employed.

if insurance was the biggest of my problems, id be the happiest person to ever log into this site again.

was i complaining again? my bad, i have no answer for this, it just always gets me tore up to hear about self employed people having troubles. i only wish i could have those troubles myself. if i was self employed, my biggest troubles would be to steal bread from a store or “borrow” some from the mouse traps of homes i visit.

ill sit back and remorse in the glow of your answer while i try to stop the crying. I NEED A HUG!!! LOL

import · July 12, 2002, 9:47am

Re: Health Insurance for Self-Employed - Posted by Ron (MD)

Posted by Ron (MD) on July 12, 2002 at 09:47:36:

JT,

I’m in a similar situation where I don’t want health insurance that requires medical underwriting.

The best option I’ve found is a group plan through the state association of realtors. I’m a licensed agent, so I’m eligible for this. It still costs me roughly $10k per year for family medical and dental…and the coverage isn’t nearly as good as my old corporate plan (when I had a real job).

Regards,

Ron Guy

import · July 12, 2002, 8:36am

Health Insurance - A few more thoughts - Posted by Frank Chin

Posted by Frank Chin on July 12, 2002 at 08:36:07:

Hi JT:

Just to add the rates I mentioned in the post below is a family plan. Individual rates run about 1/3 of a family plan, and a couple at 2/3’s.

One feature often made in “small print” is the “lifetime maximum”. Many of the PPO plans have a maximum of “one million” dollars, which sound like a lot, but can be quickly depleted in the case of a serious accident.

As far as I can recall, the HIP HMO plan I’m currently on does not have such a maximum.

Frank Chin

import · July 12, 2002, 7:58am

Health Insurance - An Update - Posted by Frank Chin

Posted by Frank Chin on July 12, 2002 at 07:58:44:

Hi JT:

You provided some good insights in that thread, and I was glad to be able to finally meet you at the convention.

Since I posted that thread, my Cobra ended and I went to a POS plan, and finally a HMO plan. The problem was the expense and scarcity of good coverage and plans.

I few words about the change of plans later on.

The Cobra I had was a PPO plan costing $595.00/month through United Health care. I paid $120.00/month while I was employed. The HR department advised me that when Cobra ends, the same coverage would cost me $1,100/month (as an individual), under last year’s rates.

Health care insurance jumped 25% to 30% in the past year (year 2001 to year 2002) here in NYC. HMO corporate plans costing over $600.00/month is now costing over $800/month. PPO/POS corporate plans costing over $800/month last year now costs over $1,100/month.

Might I stress that these are Corporate one employee plans, which are harder to get, than the those plans for two employees and up. Individual plans costs way more.

Just out of curiosity, I called about individual Health Plans, and Empire Blue Cross quoted me $1,900/month for a POS plan, and slightly less for a HMO plan. Similar plans at Oxford cost over $1,600/month. Empire Blue Cross is supposedly a non-profit plan. The quotes matched the maximum rates approved that I found in a NYS WEB site.

So the “C Corp” I set up made perfect sense as I’m saving anywhere for $600 to over $800 month, representing the diffference between individual and corporate rates.

New York State has a plan for people with no coverage that costs $600.00/month. You can go on this plan if you’re rejected everywhere else, or if Cobra ended. Unfortuantely, there are income requirements, and I am over and above it (by about 10 times). In addition, you have to prove elegibility annually that your income is below a certain amount. Coverage is bare bones, and not as good as the commercial plans I looked at.

I also understand there is something called a Pension Portability Act which insures that I cannot be rejected by any plan as long as I don’t have a 63 day gap in coverage. If one has a gap exceeding 63 day, the new insurer can deny coverage or coverage of existing conditions.

I mentioned earlier that I changed from a POS plan which I went on as of Feb 1, to a HMO plan as of May 1 this year. The broker contacted me in early April and requested I switch over immediately as they learned that the Health Plan I was on, called Atlantis, is in the process of going to receivership by the New York State insurance Department, as they have not been paying the bills. The brokers knows of a doctor submitting bills to Atlantis, and received no payment since last September!!

Unfortuantely, I had a bout of pneumonia the day I came back from the convention, and my doctor sent me to the hospital. Apparently, the bills weren’t paid, and I’m now getting bills from the hospital which says “Bill submitted to your insurer, but payment is YOUR RESPONSIBILITY”.

So my project today is call the hospital, and then the insurer to see what’s going on. One thing about United Healthcare is they send me a computerized letter immediately upon receiving a bill to advise me if they’re paying, or I’m suppose to pay because its below the annual deductible.

Currently, I am under an HMO plan via HIP, a plan that boast about having over a million members, and they deal with doctors and hospitals direct. And because they are so large, all the doctors I use, except the pediatrician, is already with HIP, so I don’t have to switch doctors. My wife got a good recommendation from one of our tenants for a pediatrician under the HIP plan, and she liked the HIP pediatrician.

Any insights you can provide would be greatly appreciated.

Frank Chin

import · July 12, 2002, 10:58pm

Re: Health Insurance for Self-Employed - Posted by JT-IN

Posted by JT-IN on July 12, 2002 at 22:58:41:

Ron:

But you must admit that having a high premium and mediocre coverage is way better than getting a Corp job, even if it comes with great medical insurance.
Good for us guys with poor coverage and an entrepenuerial lifestyle…(smile).

JT-IN

PS. I think that I had typed in the phone number correctly, but compare it anyway… 303-838-5488
In case this is not it, I have recently seen Dwan posting on the board in the past couple of days… maybe you or I could snag her email addy, and send a note. If I have any luck I will get back to you… and vice-versa; OK…