How To Get Health Insurance For Yourself And Your Employees
January 15th, 2008 · No Comments
by Tisha Nemeth-Loomis
Deira was 34 when she left a management job at a large publishing company to open a jewelrydesign studio. “My company offered COBRA for health insurance,” she said. “A year afterward, the coverage expired and I faced the unbearable costs of insurance. My choices were limited: pay a monthly premium of $300 or try Medicaid, a longer process that left me frustrated.” As a single person living in New York, this was a Herculean challenge. It’s also a problem that all too many women in the U.S. face. In our survey of more than 5,000 Ladies Who Launch members, 46 percent said they were reluctant to leave their full-time jobs because it would jeopardize their health coverage. So is this why more women aren’t launching their dream careers? If so, we want to help change that: Below are several insurance options for you to consider. Saying Goodbye to Corporate America If you’re launching a small business and have left your corporate job, you may have COBRA, continuing health coverage for former employees. If so, you have 60 days after leaving your job to decide whether to take on COBRA coverage. You’ll then have 45 days after opting for coverage to pay the initial premium to keep your insurance going for up to a year.
You can also maintain your prescription medication coverage. National groups such as Partnership for Prescription Assistance help women find prescription-medication and other patient-assistance programs. Squeeze the Government Agencies When your coverage stops, sometimes the immediate route to relief is taking what you can from state agencies. If you have children, you can opt for Medicaid, which will cover you and your family. If you’re single without children, the Health Insurance Flexibility and Accountability initiative uses Medicaid to cover uninsured adults. Kaiser Permanente has a Web site that describes the process. If you’re chronically ill or temporarily disabled, SSI (Supplemental Security Income) is another federal program that provides some income for basic food and housing, contingent upon your financial status and if you qualify. Private Insurance Options for Those Going Solo Based on your location, age, and health conditions, you may be eligible for health insurance for under $100 if you’re opting for individual coverage. One carrier offering this is Humana. There are also newer options for those in their 20s and 30s. Blue Cross has a new health plan, Simply Blue, especially for 20- to 30-year-olds. If you want coverage that fits your wallet, Aetna offers plans with a monthly rate just under $100, and provides for free gynecology exams to women (but it does not offer maternity coverage). State Farm Insurance has comprehensive choices for individual medical coverage, short-term medical, and students. The Freelancers Union is also a great place to explore insurance options. Join a Small Group Small group health insurance plans will cover anywhere from two to 50 employees. According to the America’s Health Insurance Plans 2006 survey, 80 percent of small groups polled had 10 or fewer employees in their health insurance plans, and the average monthly premiums for individuals was $330. Firms with 26-50 employees paid $287 a month for single premiums, according to MarketWatch.com. Try companies that specialize in very small groups, like Blue Cross Blue Shield, or investigate money-saving insurance options at Ehealthinsurance.com. Also, companies such as Blue Cross Blue Shield are providing qualified minority-owned and women-owned businesses and small and small disadvantaged businesses with the opportunity to conduct business nationally with BCBSA and with its participating Blue Cross Blue Shield companies, making it easier for women-owned businesses to get help with health insurance. Beware the Fine Print If you’re thinking about starting a family, carefully consider group plans vs. individual plans. Maternity insurance benefits can be cut out of individual plans to keep costs lower, making a group plan a better choice if you’re ready to have a baby. If you opt to have an insurance agent to help you navigate your initial choices, it doesn’t come for free–their services will add on an additional cost.
Even if you have traditional insurance, you’re still responsible for paying out-of-pocket copayments for each office visit you make. “I had the biggest nightmare over health insurance, even though I was covered,” explains one 30-year-old Ladies Who Launch member in Chicago who chose to remain anonymous. “During 2006 I was diagnosed with a chronic ulcer, severe migraines, and pulmonary problems after my divorce. Since I required specialty physicians for my serious health conditions, the COBRA coverage I had from my ex-job did not cover the highend doctors I needed for more specific care. I didn’t realize my insurance only covered 70 percent of my costs. Tests I had, such as CT scans, blood tests, and MRIs, left me with payments as high as $3,000.” Future Push Toward Wellness One advancement at today’s health-insurance companies that benefits women is the preventative care initiative. “Women’s wellness is a huge issue that is covered in full,” says Linda Krupta, a health-insurance specialist at Master Benefits. “A big push in the insurance industry requires patients to complete health assessment/risk forms, giving a comprehensive profile of that patient’s individual needs. A health coach then contacts the patient and provides free health resources and advice.” This service is offered by the likes of Aetna, Blue Cross Blue Shield, United Healthcare, and Humana. One caveat: You’ll have a slightly higher deductible for these specialized services. Another Option: Health Savings Accounts Today, health savings accounts are becoming a trend for owners of small businesses. An HSA is a new form of health coverage pairing a high-deductible health plan with a tax-free savings account for medical expenses. They’re designed to reduce health-care insurance costs for both employers and employees. These tax-exempt accounts are used to pay for medical expenses and may reduce your small business health insurance costs. It will also give your employees tax breaks. To start, you must have a high-deductible health insurance plan. In 2007 the minimum deduction for individuals was $1,100; for families, $2,200. That means that you or your employees would have to pay $1,100 out of pocket for health-care expenses ranging from doctors’ visits to prescriptions before you are reimbursed by the insurance company. In 2007, employers, workers, and their families were able to contribute up to $2,850 for individual health savings accounts, or $5,650 for family accounts. Contributions and withdrawals are tax-free, and individuals can claim tax deductions on their 1040 forms–this means employees don’t need to itemize to get tax breaks. Employer contributions are tax-deductible as well. These HSAs benefit healthy employees who do not often see doctors. You or your employees can opt to have health insurance that specifically covers certain diseases or illnesses, accidents, dental, and vision care. For more info, visit HSAdeposits.com or check out the Small Business Guide to HSAs. Shop Around for Deals
Comparison shopping for different providers can reduce your small business health insurance costs. Searching the Internet is a good start, and remember that you can always ask other small business owners what they’re using and what they recommend. Tisha Nemeth-Loomis is an editor and writer based in Chicago.
For more articles like this, visit www.ladieswholaunch.com, the first company to provide resources and connections exclusively for women entrepreneurs.