Finance

Elizabeth Newberry asked:


Finding an affordable health insurance plan in the US can be a daunting task. There are many different kinds of health insurance plans. The health insurance plans that usually come to mind when people think about health insurance are employer-sponsored group health insurance plans, state-sponsored health insurance plans, and individual health insurance plans. If a person does not have the option of buying into an employer-sponsored group health insurance plan, he will usually look into purchasing an individual health insurance plan or state-sponsored health insurance plan.

Many people overlook the affordable, short term health insurance plans available in the US. Below are some of the most frequently asked questions regarding short term health insurance.

What is short term health insurance?

Short term health insurance is health insurance that lasts for six to 12 months, depending on your needs. Short term health insurance is an affordable way to obtain temporary insurance to cover your health care costs, and the health care costs of your family.

What kinds of health care are available with short term health insurance?

A short term health insurance plan usually provides the same kinds of health care available with any other health insurance plan. A short term health insurance plan may give you coverage for doctor visits, surgeries, inpatient and outpatient treatments and procedures, other hospitalization services, discounts on prescription medications, as well as dental care and vision care.

Who should consider short term health insurance?

An individual who finds himself unemployed or laid off should consider purchasing affordable, short term health insurance in the US. Just because an individual’s employment status changes does not mean his, and his families, health care needs change, too.

Why is short term health insurance affordable?

Some short term health insurance plans are actually designed with unemployed and laid off workers in mind. This means that short term health insurance plans are made to be affordable for people without steady income.

Jordan FeRoss asked:


Employers offer group health plans as a part of the benefits package for their employees. Other groups that may offer these plans as well, such as churches, professional associations and similar groups. If you’re in a group that has health care insurance in Texas, then more than likely you can be covered in a group plan that is sponsored by your employer or organization. For small businesses in the state of Texas, they have special stipulations. There are some benefits that are authorized by the state that small businesses don’t need, but larger employers have to include in their health benefits package.

It is not mandatory that employers and other groups have to offer health care insurance in Texas. They don’t have to put money aside to pay for premiums. However, there are some health care insurance companies that mandate some employers to pay at least half of the premiums for their employees.

Here are a few descriptions of some Texas health insurance group plans:

? Small Employer - These health plans are used for businesses that have 50 or less employees that are qualified to get health insurance in Texas. The employees that qualify have to be working full-time and work at least or more than 30 hours a week. No other classifications (part-time, seasonal) are qualified for this plan. Also, the employee must not have additional health insurance elsewhere. There is usually an annual rate increase which comes with a cap of fifteen percent. By law, any employer or group in Texas that cancels one plan is responsible for putting their employees in another health care plan.

? Large Employer - In the state of Texas, large employers usually use the HMO health plan. Because of that, state law says the HMO must include a POS (point-of-service) elective. With larger employers, they can offer health care insurance in Texas to executives and other employees. No employee should be denied a health care due to a pre-existing condition.

? Self-Funded - These health care plans are managed by ERISA (Employee Retirement Income Security Act). This is for employers that want to pay the costs of health insurance for employees. There would be no HMO coverage. The self-funded insurance plan can be used in several states and are not required to adhere to the insurance laws of the state. The U.S. Department of Labor is responsible for overseeing this kind of health care insurance in Texas.

The majority of health plans for larger employers are self-funded. The Federal government doesn’t have a lot of requirements for this particular plan. However, these plans may offer a wider range of coverage than what we used to. This particular health care insurance in Texas also provides health coverage all across the board.

Employers and groups that use self-funded health care insurance in Texas may use subcontractors as the administrator of their insurance plan. The subcontractors as also known as third-party administrators, or TPAs. In order to legally act as a TPA with health insurance in Texas, they must have a state license. So, depending on what size company you work for will determine what kind of health insurance coverage you will get.

Cynthia Perfeni asked:


It has become alarming that a growing number of fit and healthy people today actually think that they have nothing to do with health insurance. They exercise regularly, do not smoke or take alcohol, eat nothing but nutritious diet, and lead a healthy stress-free lifestyle. Some even convert to vegetarianism, practice yoga meditation, reiki, chi gong and other Eastern practices thought to prevent diseases and increase longevity. So who needs health insurance anyway?

Sadly though, a number of these health buffs, some in the prime of their lives, suddenly get sick and die. You’ve probably heard of this athlete who, while jogging, just suddenly keeled over and fell dead in his running shoes. This just disproves that being healthy means being invincible to all diseases and sickness. There will always be a “chink in your armor” that infections and dread diseases can penetrate.

Is health insurance only for the old and the sick?

If health is wealth, then it cannot be emphasized enough that having a health insurance is definitely one of the best investment you can ever have. The famous pro-gun slogan “It is better to have it and not need it than to need it and not have it” can very well hold true for health insurance.

Health insurance has become one of the hot issues that often spark debates and controversies. Each individual has his or her own opinion as to who should get medical insurance. As was stated above, the healthy and the strong believe they don’t need health insurance anymore. The sober truth is nobody is born with a crystal ball to gaze into their future. Nobody can foretell the time and circumstance when they will get sick and require medical attention.

Another problem is that uninsured healthy people have the tendency to miss health checkups and regular physicals that provide advance detection of dread diseases, abnormalities and malignancies that could be silently spreading in their system. This can lead to disastrous consequences.

What are the benefits of health insurance?

This popular type of insurance safeguards you and your family from sudden medical emergencies that could lead to financial crisis. A well-chosen health insurance plan can provide some financial security and save you from a lot of worries if and when urgent medical care should arise.

This insurance makes cash available to pay for the various medical expenses and health care requirements covered by the policy. It also covers disability expenses and long-time health care requirements like in-house nurses and caregivers. This means you get immediate and complete health care as compared to uninsured individuals.

How does health insurance maintain your health?

One misconception about this type of insurance is that it is ONLY a way of settling medical bills in case you became sick or got injured. While this is true, it is only a part of the many benefits of health insurance and not the whole. This type of insurance not only insures your health; it ensures it.

Keeping you in perfect health not only helps keep the cost of health care at a minimum. It can make health insurance premiums low and within reach of everyone. Health insurance providers like Blue Cross Blue Shield know the value of keeping you healthy. They are also aware that keeping you in good shape eventually saves them a lot of money.

Health insurance companies have various ways to make you aware of the benefits of staying healthy. One of them is through educating the public by means of available online materials and information. They make the public the public aware that smoking kills, that obesity leads to heart complications, that wearing protective gear lessens the damage of accidents or that stressful living leads to a shorter life span.

Wiley Long asked:


o much for coverage and not having enough coverage may be a familiar scenario for many of the residents in America. Not many health insurance companies offer policies with coverage that will give you dental, eye and alternative care. Americans are spending over $30 billion annually just for dental services and most of it is out of their own pocket. The prices for dental care can be very horrid, ranging between $850 to $1,000 for crowns, $150 for check-ups and cleaning and thousands of dollars for oral surgery.

Most of the dental plans available are expensive - the reason being that the insurance companies know that the individuals who purchase dental coverage already have dental problems and will definitely be using the coverage. This is also known as “adverse selection”.

Another option is available today with the HSA, or Health Savings Account. This is an account that you can use to accumulate tax-free dollars for medical bills that aren’t covered under your High Deductible Health Plan, or HDHP. It is required that you are enrolled in a High Deductible Health Insurance Policy to qualify for an Health Savings Account. These plans have high annual deductibles, but you receive low monthly premiums in exchange. Since the money in the HSA is tax-free, the account holder can funnel their dental expenses through the HSA for a tax write-off.

If you decide to get a health plan with dental coverage, the deductible cannot be paid for with the HSA, but the expenses rendered from services can. Since you’ll be funding your account with pre-tax money, you can easily save $600 or more off the costs of your family’s yearly dental expenses by paying for the charges from your Health Savings Account.

There are some other options for dental coverage available. With prepaid dental plans you will be charged low monthly fees, which are usually around $7/month for individuals and $16/month for families. The plans give you significant discounts on check-ups, fillings, extractions and other dental services provided by a network dentist. Some plans help with the expenses for eyeglasses and contact lenses. Since these plans aren’t insurance, it can be paid for with the HSA. When calculating what medical expenses will be reimbursed from your HSA, include dental fees and premiums from the prepaid dental plan.

More About Health Savings Accounts

Any health expenses that aren’t covered under you HDHP can be paid for with your HSA, such as deductibles, eyewear and dental care. As long as the bill you are trying to cover was needed for a health problem, it can be paid for. So if you decided to get a massage while at the spa - this wouldn’t be covered, but if your doctor recommended that you go to a masseuse after a painful accident; this would be covered. Having a Health Savings Account is the way health insurance should be - you get to choose what medical help you receive for your health conditions.

This means if you decide to get alternative medicine instead of going to an allopathic physician (conventional doctors that use prescriptions drugs and other treatments for quick-fixes instead of delving to the root of the problem), you can do so and have the expenses paid with your Health Savings Account.

What is Considered an “HSA Qualified Expense”?

The definition of qualified medical expenses is only partially given in IRS Publication 502 and through different federal court rulings. There are few restrictions - as long as the expenses are for medical treatments or prevention for a health problem. For instance, yoga wouldn’t be identified as a medical expense unless your doctor recommended it as a treatment for medical reasons, such as for physical therapy after an injury, then it is qualified as a medical expense.

Many may question why the government would give a tax deduction for someone using some crazy vibration machine to cure their cancer. Again, the HSA is how health insurance should be. You should get to choose what treatments would best benefit your health condition. This gives account holders that power to manage their health as they see fit. Health Savings Accounts are encouraging individuals to take personal responsibility of their health care while loosening the monopoly traditional health care has had over the past couple of decades.

Timothy Simmons asked:


Health insurance is a critical part of our health care system. For those that are lucky enough to have health insurance, they know that it shouldn’t be taken for granted. For a large number of the unfortunate who don’t have health insurance for their families, do so at great risks.

Health insurance has long been a popular political subject for our country. There are many that fill health insurance should be socialized. There are just as many feel it should be kept private. While both parties may have sound arguments, we have to accept what is available to us. So, unless you’re a government employee, or one of the dwindling corporate employees still receiving health insurance, you need to go out there and get it on your own.

There are a number of health insurance choices that should suit your specific needs. A Health Maintenance Organization, or more commonly called HMO, is one popular health insurance choice. HMOs are one of the most common forms of health insurance provided by employers. They allow you to visit a pre-selected hospital, doctors, or clinics, without restriction. This may or may not be totally covered by your employer, but usually comes at a fixed monthly cost.

The Preferred Provider Organization, or the PPO, is similar to the HMO concept. With the PPO, you are not forced to get a little dig their doctor or hospital. When you do, however, you receive a discount for doing so. This system works on the reimbursement, philosophy. Essentially, you are reimbursed by your insurance company after services are rendered. Sometimes, they will bill your insurer at the time of service.

Indemnity health insurance plans are eight other top and plan that has become quite popular these days. One reason is, you are able to choose any position or hospital you choose. The drawback to this of course is that it comes at a premium. In addition to higher costs ease typically require a larger deductible. For the hypochondriac this may not be the best choice. Those that like to make lots of visits to hospitals might find other plans more suitable. But for those that have to be on their deathbed to see a doctor, this may be an appropriate plan.

The Health Savings Account, HSA, has some similarities to the indemnity health insurance plans. As the Health Savings Account is probably most suitable to the individual that doesn’t require a lot health care, or checkups. These individuals, which most commonly are men, may find the Health Savings Account to be a good choice for them.

Health Savings Accounts are a way to both have a way to save and pay for medical expenses. Any contributions that are made to the Health Savings Account that go unused for medical purposes are retained in a savings account. This savings account can hold many popular investments, such as mutual funds. So, getting back to the individual that avoids medical care, this individual gifts for both best of both worlds. They get the protection of the much-needed health insurance. This provides protection against large medical or accident issues. But, if these funds go unused, they get the benefit of putting the money away for retirement. Any after-tax dollars that are contributed to the Health Savings Account can be detected, up to $2900 for 2008.

Choosing a health insurance plan may seem like a very confusing process. There is no open and shut method of choosing the best health insurance. Each individual is different, with different health needs. The most important step here is to get some form of health insurance. Go in without adequate health insurance puts you and your family at tremendous risks. And those risks just aren’t worth the possible consequences.

Dennis Alexander asked:


Do Not Read This Unless You are Making a lot of Money!:

If you would like to know how you can save up to 47% on your current Health Insurance Coverage read on… this is going to be one of the most informative messages you will ever read. After reading this message you will never going to have words; expensive and health insurance in the same sentence.

As you already know health insurance costs are at highest they have ever been and there is no sign of them slowing down. More and more Americans are forced to cancel their coverage simply just because they cannot afford it.

Who are the uninsured?

• Approximately 46 million Americans, or 15.7 percent of the population, were without health insurance in 2004 (the latest government data available).

• The number of uninsured rose 800,000 between 2003 and 2004 and has increased by 6 million since 2000.

• The increase in the number of uninsured in 2004 was focused among working age adults. The percentage of working adults (18 to 64) who had no health coverage climbed from 18.6 percent in 2003 to 19.0 percent in 2004. An increase of over 750,000 in 2004.

• Nearly 82 million people - about one-third of the population below the age of 65 spent a portion of either 2002 or 2003 without health coverage.

• The number of uninsured children in 2004 was 8.3 million - or 11.2 percent of all children in the U.S. (1).

You might say that I have great coverage that I am happy with… that’s totally fine.

For past sever years average rate increase for health insurance was 16.2% and what if it keeps on going? If you are right now paying $500 per month for your health insurance in three years from now you would expect to pay over $780 for the same plan. Wait… we all know that insurance companies consistently decrease their benefits and increase co-pays and deductible. Therefore you will pay more for less coverage. By the way if you keep same plan for over five years you will pay over $1000 a month just for your medical coverage. What if you use your Health Insurance?… Chances are if it is not for a regular doctor visits or a check ups it would be considered pre-existing condition. That means your chances of changing to a more affordable coverage in the future will be nearly impossible. That is one of the main reasons people cancel their health insurance because they were diagnosed with something or taking a prescription medication and the insurance company kept raising their rate until they could not qualify for any other coverage and could not afford the one they had.

Now you are saying I do not need coverage my spouse works for a company and I have group coverage… Great.

What would happen if your spouse left that job or the company stopped providing benefits? Probably the most obvious things that you can see how much that group coverage is really costing you. Next time check how much is deducted out of the paycheck for health coverage, especially for dependents. Group plans do cost more money because by law they are what are called “guaranteed issue”. That means you can have serious medical conditions and still get coverage. Insurance companies have to follow the law and they know they have to accept everyone who works for a large company, therefore they do charge more money for coverage. The biggest problem is not the cost of group health insurance it is what happens if some one, while on the group plan, is diagnosed with a condition or starts to take prescriptions medications. We get back to same issues as mentioned before, unable to qualify for health insurance in the future. There are people that want to leave their job but they cannot because they are going through treatment and cannot to pay for it on their own.

There is another solution… Some might save, so what is the point of even having health insurance. Once you diagnosed with something and insurance company is going to keep raising rates to the point where I am going to have to cancel it anyway. Especially if something does happen and I have to use my coverage I might not be working and I might not have income. Is my insurance company is still going to keep raising my rates? YES.

Before you think about cancelling your coverage consider this. Here are some statistics

• A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses. Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.

• Illness and medical bills caused half of the 1,458,000 personal bankruptcies in 2001, according to a study published by the journal Health Affairs.

• Average day in the hospital is $7500 per day.

How can you save up to 47% on your health insurance? Simple… You probably already heard of Health Saving Accounts. They are becoming more and more popular everyday. With the way health insurance prices are moving today Health Saving Accounts are the only way to keep your coverage, save hundreds per month on your health insurance and still have a peace of mind.

To this day I was not able to hear a good definition that everyone can understand. I will do everything I can to make it simple to understand. The easiest way to understand Health Saving Accounts is to think of them as Roth IRA or your Company’s 401k plan. Instead of giving your money away to insurance company you get to keep it more of it for yourself. The way HSA plans work is there health insurance combined with savings account which works in a similar way to your retirement account. There tremendous benefits to have HSA qualified health plan. First all the money that you put in to your HSA account is 100% tax deductible and it is your money that rolls over year after year. At the age of 65 and up if you have not used up all of your HSA money you can roll it over in to your retirement account. Second your health insurance costs are going to be cut almost in half. For example if you had Health Insurance plan with $2500 deductible now and it is costing you $300 per month the same plans with HSA qualified plan, now will cost you only about $160 per month. The reason you save so much money with HSA qualified health plan is because HSA qualified plans do not cover anything until the deductible is met. There are exceptions depending on the Health Insurance Company. Some insurance companies will pay for your once a year physical before you meet your deductible.

Let take an example of how HSA qualified plan could benefit you. Let take some actual numbers from actual health insurance company. In this example I am going to use HSA plans from company called Assurant Health. Assurant Health is leader in Health Saving Accounts and they one of the first companies to implement them. The main reason is that Assurant Health is part of the world’s largest financial company that sets up retirement accounts. In this example I am going to use a family of four, husband 46, wife 42, kids are 12 and 16. On a regular family plan with $2500 deductible, maximum out of pocket of $5500, co-insurance of 80% and doctor visits covered with $35 co-pay, they are going to pay $676.40. Something to keep in mind that all of the regular PPO plans that are available on the market today have family deductible which is double of individual deductible. That means that if you have a plan with $2500 deductible and $5500 maximum out of pocket that means that your family deductible is $5000 and your family maximum out of pocket is $11,000. When we are comparing HSA qualified health plans there is only one deductible, once you meet it you are covered at 100% on the most plans. There are some companies and plans that you still might be responsible for the percent age of the bill until you reach your maximum out of pocket. Most HSA plans do not have maximum out of pocket that meant once you met your deductible you are covered at 100%, it’s that simple. The same plan with $5700 deductible for the entire family with HSA qualified health plans will only be $491.64 per month. For the total monthly savings of 184.76 per month. Also your maximum out of pocket will decrease from $11,000 on a regular plan to $5700 with HSA health plan. That’s yearly savings of $2,217.12 and additional savings of $5300 on the maximum out of pocket. (that’s if you have had to use the plan for emergencies) The main reason for starting HSA health insurance is for Saving Account and being able to put money in to account, at your discretion, tax free. You can put money in to HSA qualified account up to your deductible and you do not have to put any money in to that account if you do not want to. Health Saving Accounts are as flexible as you would want them to be. TO get more information on HSA accounts and get quotes for HSA qualified health coverage see my bio.

Jordan FeRoss asked:


Fro purposes of definition of health insurance in Texas, there is a difference between small employers and large employers according to state and federal mandates. For a small employer to be called just that, they will have to have no more than 50 employees that work full-time (actually 2 to 50 full-time employees). These employees that are defined as full-time must work at least 30 hours or more each week in order to qualify. That does not include temporary workers or seasonal workers.

With small employers, they are protected by some legal statutes. Some of them include coverage levels and increases in insurance rates. The thing with small employers is that with the health insurance law in Texas, they have to have the right amount of employees that are eligible for health insurance. It is not based on the number of total employees per say. With health insurance for small employers, it is mandatory that those eligible are offered health insurance coverage for themselves and their immediate families.

A health insurance carrier can mandate that at least three fourths of eligible employees from a small employer seek to get health coverage. With certain carriers, this can be part of how they will get their health care plan. Depending on the number of eligible employees, the law can mandate that not everyone has to participate. This can apply to health insurance in Texas.

Or if the number of employees is low, require them to have total participation of 100%, no exceptions. If the small employer includes spouses and maybe a few others, then the spouses must each get separate health insurance coverage. There would be no dependent sharing for either spouse. This applies to health insurance in Texas as well.

With the small employer, the ones that qualify for health care coverage are bound by the exact terms and conditions. No one can have anything different in their health insurance policy. If it were a larger employer, then the policies would be different. They could be more flexible because they have more people that would need or want coverage. The health insurance in Texas can dictate that.

However, whether it’s a small employer or a large one, it is against the law to force a new employee to get health insurance in Texas in order to stay employed there. It is also against the law to single out any employee that can get health care coverage due to how old they are, medical history status or pre-existing conditions that they may have.

It is important that small employers follow the rules about health insurance in Texas. The small employer needs to know what is allowed and what is not allowed for their employees. To make sure that things are in order, they should consult their health insurance handbook or contact their health insurance representative. Having that in place will make things much smoother when it’s time for employees to use their health insurance. They need to make sure that they are providing the right kind of health insurance to their employees.

Jordan FeRoss asked:


If you live in the state of Texas and for whatever reason you lose your group health insurance coverage (via your employer), you will still be able to have health coverage. However, you will be paying more because your employer will not be paying into it. Health insurance in Texas is mandated by health coverage called COBRA. COBRA stands for Consolidated Omnibus Budget Reconciliation Act. This alternative health coverage is mandated by the federal government and is to be used in the event you are no longer employed.

The way it works is you would pay more than you would if you were still an employee of a company. You would continue coverage for you and your family. This kind of health insurance in Texas can help you keep health benefits for you and your family. With COBRA, you are allowed coverage for 18 months and for your spouse and dependents, they are allowed health insurance coverage for twice as long. This alternate health plan is basically used when an employee is not longer employed.

COBRA is used where companies have more than 20 employees. If an employee is disabled or uses Medicare, the rest of their family is allowed to use COBRA. There is a window of 60 days to give you time enough to decide whether or not you want to use the alternative health care coverage. If you decide to get this health insurance in Texas, payment of the full premium is required along with a fee.

In the state of Texas, if you wish to continue your HMO health insurance, through COBRA, you can do so. However, since it only covers certain areas, you would have to stay in the designated area in order to get the benefits. Otherwise, you will only get coverage for emergency services. Having COBRA as health insurance in Texas may be more costly, but it’s better than not having any health insurance at all.

In the state of Texas, there is a law that discusses a continuation period. This period lasts for about half a year. This continuation period starts when your COBRA coverage stops. If you can get the continuation, but prefer COBRA instead, then you will have two years to get health care insurance.

State law mandates that health insurance carriers are to make available a group continuation privilege for those who no longer have the alternate insurance. The person should have been covered under the group contract. With this kind of health insurance in Texas, the group insurance coverage won’t stop until after there is evidence that no payment has been made.

There is another alternative health insurance in Texas. The state uses what is called the Health Pool. For those who can’t get health insurance coverage because of a pre-existing condition or related chronic illness, they can use this health coverage. They have coverage for major medical procedure. The amount you pay depends on several factors: age, gender and where you live. Depending on these factors, the insurance carrier will tell you how much you would be paying. So whatever your situation in regard to getting alternative health insurance is, you should be able to find something that can get.

Tom Tessin asked:


Generally, people have the philosophy that student health insurance is just an unfruitful investment of money. The reason behind such philosophy is that colleges and universities always provide health care services and facilities to all their students.

However, it is not good to depend only on the college health insurance, because, a college health insurance may not provide you with a broad coverage for some health issues. Hence, it is better to go for this type of health insurance, if you have you have a child who goes to college.

Need of such an Insurance Policy

Student health insurance is necessary for students, who wish to study abroad and for foreign students, who wish to study further in the United States of America. If your child is not insured under your health insurance policy, might apply for such health insurance.

A students’ life is full of excitement and adventure and this leads to an exposure of unorganized and unhealthy way of living. Late night parties, Fast foods, and dorm style of living provides refuge to various types of microorganisms, health disorders and finally diseases. To get well, students need to spend thousands of dollars for their medical bills.

Since, students may not earn thousands of dollars all by themselves, all the expenditure of medical bills and other costs comes on their shoulders. Hence, to avoid spending a fortune, it is better to go for health insurance policy designed for students.

Advantages:

If your child is planning to pursue his/her studies abroad, the family health insurance policy may not provide coverage to that extent. With a student health insurance policy, you need not worry at all, because it covers all the health related issues even in a foreign country. There are other advantages of such an insurance policy.

One of the advantages of this insurance policy is that students may go to their choice of doctor rather than depending on the university or college health facilities. With the help of these policies, student does not have to take an appointment before consulting the doctor and need not have to wait in queues to consult a doctor.

Where to Find?

If you are looking for a student health insurance, make a small research of the insurance market. Various insurance companies have different policies to provide. For instance, some insurance company may provide discounts on vision care, prescription drugs, dental care and other such services.

Hence, you need to study the various terms and conditions about these policies before opting for one. Such research and study may take up most of your time and money. To avoid these, you may also make a search online and purchase this type of health insurance policy without having to spend your precious time and money.

Overview:

In the end, the choice lies with you whether you need to purchase a student health insurance or not. This health insurance may prove to be a lifesaver for your child in college. It also helps in saving thousands of dollars on medical issues. These health insurance policies help your child in case of medical emergencies.

Dennis Jarvis asked:


Many employers in California do not realize that paying for employee’s individual health insurance policies presents many problems. There can be liability for the employer in doing so. Let’s look at the implications and understand why providing Small Group health insurance to your California employees is important.

First, we need to understand the differences between Small Group health or employer sponsored health insurance and individual/family or private insurance. Small Group is quite different in a few key ways. First, it is governed by California law AB 1672. Among many provisions set forth in AB 1672, Small Group coverage is guaranteed issue to qualified small companies with 2-50 employees. This means that a person with a legitimate employer-employee relationship (can be full or part-time depending on group preference) cannot be declined due to health.

Individual/Family health insurance is quite different in this respect. Individuals must qualify based on health in a process called medical underwriting. They can be declined coverage have rates increased based on their health history or status. This difference in medical qualification is a big issue for small groups that pay for individual health insurance plans for their employees if the group is eligible or capable of providing group health. If an employee is declined coverage and/or suffers a major medical bill, he/she can go after the employer saying that the employer should have sponsored a qualified (guaranteed issue) group health plan. This assumes that the employer met the requirements under AB 1672 to offer such a plan. As an employer, you also do not want to know too much about an employee’s health status. If you need to let the employee go, there can be issues in knowing that they were declined individual health insurance. Keep a good separation from this knowledge to avoid issues in hiring/firing.

Employers usually offer individual plans based on cost but the difference hardly justifies this exposure to liability. In California, the employer can pay as little as 50% of the employees health insurance premium and with options such as Employee Elect through Anthem Blue Cross, an employer can now offer a full range of plans to each employee with a fixed contribution (dollar amount or a percentage of a given plan).

The other main issue deals with the tax treatment of employers paying for employee’s individual health plans. Officially, only a qualified group plan premium for employees can be deducted as a business expense. Paying for individual health plans generally cannot be deducted. Make sure to run your company’s situation by a tax professional but this is a major drawback for paying for individual health plans.

In summary, with all the options, both from a plan and cost perspective, on the market, small group health insurance makes the most sense. Run your instant quote and please let us know how we can help investigate your Small Group health insurance options. It is important to avoid the liability of employees not qualifying for individual health plans due to health history and to make sure you take advantage of the tax benefits associated with paying for qualify Group health plans.