Health Insurance Cost Question

[annasmom]

I know this has been discussed before, but my questions are pretty specific. Can anyone share with me the cost of buying your own family health insurance plan??

My dh is thinking about starting his own business and we were discussing the potential cost of health insurance last night. I think we pay a small fortune for our existing health insurance that we get through his company - $1500 a month. I cannot imagine that buying our own plan could be much more expensive, but it must be, right?

FWIW, I am pretty sure that he and his potential future business partner could form a group, and buy a group plan at a discounted rate. Does anyone know about this??

[dules]

We have insurance that we pay 100% though it is through DH's employer's "group". His employer does not contribute so we pay it all.

It's $1300/month for so-so family coverage. The advantage to it coming through his employer is that they deduct the premiums pre-tax, instead of us having to claim it at the end of the year.

It's slightly less than I paid for COBRA when I left my former employer (that was better coverage).


Mary

[jenmcadams]

They could definitely form a group and buy a group plan (although it's a small group plan, so don't get benefits of huge purchasing power people normally assume for a group). We've been doing COBRA for our family since my husband became self-employed 17 months ago (so one more month) and we're just getting ready to buy a group plan through his current gig (a small self-funded software start-up). We'll be loaning the business (C-Cocorp) $$ to pay the premiums until he lines up investor funding (the company is in the early stages and just started producing revenue). We'll be paying b/t $1200-1400/month (so about the same as COBRA - $1300) for average to good family coverage (best plan United Health Care offers here in Colorado to small groups). He should find a good insurance agent who's used to working with small businesses (eventually he may want other insurance products like long term disability, key man coverage (if he ends up with investors they sometimes require this), liability coverage depending on type of business, etc.).

[BillK]

I canceled out our group plan here at my office due to skyrocketing cost about 2 years ago. Fortunately my employees and my family were all healthy and able to qualify for medically underwritten individual plans (that I continue to pay for for my employees).

The coverage isn't nearly as good as our old group plan (Keystone Blue HMO) - but the premiums are much lower.

For me, my wife and our son I pay $390.15/mo. (I'm 39 - they use age of the oldest participant for rating purposes)

This is for a typical 80/20 plan with a $500 annual deductible per person - and $1,000 out of pocket max per person with a $3500 family maximum. Our annual prescription deductible is $100/each and is then 80/20 coverage with a $3000 out of pocket max. The plan also had a 12 month preexisting condition clause when we took it out.

In my experience - individual medically underwritten plans are much less expensive than "guaranteed issue" group plans that don't medically underwrite. The individual plans don't offer as good a coverage as most group plans - but there again - you have look at the price difference between the two.

[jenmcadams]

Bill brings up a good point. Individual, medically underwritten plans are much cheaper, but they are more restrictive and do require you to disclose medical information or even undergo a physical (so if you have any health issues you normally won't qualify or it won't be any cheaper than a group plan). In our case, one of my husbands partners is expecting their first child and his other employee's wife is hoping to start trying in the next 6-12 months for their second child. Most plans that include maternity (or at least include it after the first 12 months) are much more expensive (although you still might be able to find something cheaper than a group plan with a higher deductible) and many individual plans count pregnancies as pre-existing conditions.

[BillK]

The pp is absolutely right. Most (if not all) individual plans count pregnancy as a pre-existing condition. I don't blame them at all for that either - why on earth would a health insurer want to sign someone up for say a $500/mo health plan only to be handed a guaranteed $5k+ hospital bill within 9 months - assuming there are no complications? I sure wouldn't want to if it were me.

I've actually had several young women come to me over the years to buy an individual health plan get up and walk out of my office when I explain to them that there's no coverage if they're currently pregnant.

[Tondi G]

we had a Blue Shield individual family plan that was a $750 deductible PPO. The prices went up to over $1200 a month. That was more than what DH's company is contributing to his flex plan account so we raised our deductible to $2000 and our rates went down to just over $500 a month!

We pay a little more in copays and the percentages chnaged a bit but what we are saving in monthly payments will cover the additional cost overall!

Good luck.... I HATE health insurance.... it's such a ripoff!

~Tondi

[hillview]

Contact your Small Business Association. My parents got insurance through a group plan they suggested. They have some GREAT plans. They pay 500 a month each (they are in their early 60s). There was no preexisting exclusion.
HTH
/hillary

[jamierush]

I work in a small office that has done both way, we bought our own individual policy an dthe reimbersed us a portion and then finally we moved to a group policy due to the rate being raised on our Ind,. plans.

Depending on your State Insuance regulations, many companies will not offer group policies for under 5 people. At least in my state they dont. This year we looked at changing.

Currently we have 4 people and we are all "rated" differently as individuals. We all have the same coverage, but United charges differnet rate per individual based on age and sex.

I am 37 and have my children on my policy. If I got a family policy with DH then it would increse about $289 (priced out last Sept)

I pay $403 monthly for a $1500 deductilble for ANYTHING outside of a doctors office. I have a $35 co pay for any office visits and any lab work drawn in the office. After that I have a 90/10%

My coworker who is 24 and no kids pays $234 for example

We looked at switching policies and going to a "group rated" group policy though Aetna, but unfortunately 1 person in my office takes meds for depression and anxiety and that sent our rates sky high after we filled out the applications, which ask for medical history.So we stayed with out our current provider United

If you chose a "small" group policy of ryour new biz venture then recognize that what they "quote" you to start is subject to change based on filling out your aplications and your medical history. Normal visits and meds are not usually an issue but some things are red flagged.

I would encourage you to get a referall to a good insurance broker who can have honset talk with you about what your options are.