Group Health Insurance Plans

Cobb County

Very different from securing your benefits through a chamber of commerce or association. That’s an option to research, of course, although make sure you understand the difference between a true group plan (like MBO — a real corporate group means everyone has the same rates, and aside from some exceptions around pre-existing conditions, everyone is automatically accepted) and a “group discount” plan, which is actually individually rated or age rated, but there is a theoretical group discount.

People out there who are trying to sell insurance will use the word “group” in deceptive ways. The thing to ask is, can my rates go up on just me?

In a real group, the rates are group rates. Jenny pays the same as me, I pay the same as Dave. [May differ by geography, and people will pay more to add dependents to the plan, of course.] If the rates go up next year, they go up the same for all of us, and hopefully not by much.

In an individually rated plan (group discount or no) your rates are specific to you, and if you make claims, your rates might go up more than someone else’s rates.
Some have morbidly called this a “death spiral” becuase the sicker you get, the more expensive your rates get.

Carrie, I can’t believe you had a policy that doesn’t cover the most common way people get hurt, and the leading cause of death for some age groups, car accidents. I think that’s nuts. Thanks for introducing the caveat, as it would never occur to me that an individual insurance plan would pull that kind of exception. Good for you in reading the fine print!

I’m not a benefits expert or a lawyer either, but I do recommend everyone shop for the absolute best program, and educate yourself. Even the healthiest people get hurt sometimes.

I have individual health insurance for a reasonable price, but after looking it over the details learned that it doesn’t cover injuries from auto accidents. I was able to increase the medical coverage on my auto insurance policy to fill that gap.

I’m so glad I figured this out before I ever needed it…

And keep an eye on your state laws. Here in Massachusetts we have universal health coverage–which means if you don’t have private insurance and fall below a certain income level, you are eligible for state sponsored insurance at reduced rates (under $200 per month for full coverage, including pharmacy, for an individual). Everyone is required to carry insurance–the penalty for not carrying health insurance is loss of deductibles on your state income tax. Of course, the Commonwealth is having a hard time financially at the moment, so we’ll have to see how this works out in the long run. So, on the basis of health insurance alone, I wouldn’t make plans to move to what some call The Peoples Republic of Taxachusetts anytime soon.

Great point, Debby. Research everything, folks, before you commit.

Thanks, Liz & Steve. Good stuff.

As a public service announcement, I can echo the need for E&O insurance and other business insurance.
http://www.articleclick.com/Article/How-an-Independent-Consultant-can-get-Business-Insurance/992163
The cost of defending a lawsuit — even if you’re innocent — if you don’t have E&O as an independent consultant can be over 6 figures. You can be perfect, and still get sued.

Incidentally, MBO provides complimentary E&O and GL business insurances for independent consultants operating through the Portable Employer of Record program. The cost of those insurances, if you were to go get them on your own, might be around $5,000 a year. So just that by itself offsets the PER program cost. MBO Partners also has medical, dental, vision, life, and disability insurances. The only thing on your list here that MBO can’t help with is the insurance on your home.

I can attest to the medical expense that a healthy person can end up with. I had a relatively minor motorcycle accident a few years ago — $30,000 in medical bills! Had I not been with a really amazing insurance program, I would have been sunk.

And just last fall I ended up with sudden gallbladder issues. A week in the hospital and a routine minor outpatient surgery later, and the bills were over $20,000. This time I was on MBO’s insurance. I think my co-pays and deductibles were just over $1500 for the whole episode, thank goodness, but had I been uninsured or had some kind of cruddy discount plan, I shudder to think how my finances might be. It’s hard enough taking time out of work when something happens.

Thanks again, this is a great series. -Liz