Ways to get into a group plan when employer doesn't offer one

[jgombos]

What is the name of your state? IN

For folks whose employers don't offer healthcare, what can they do to get into a group plan? I was told someone can form a corporation such that they are the sole employee, and get group coverage that way. Someone else told me to same is possible, but at least 3 employees must be involved. I'm figuring it depends on the healthcare provider - but just want to get some feedback on what all my options are. I'm also thinking schools tend to offer group plans, so I might be able to enroll in classes, and get coverage from a university. Any other options I'm overlooking?

 

[ecmst12]

Business owners can sometimes get coverage through local small business associations. Members of unions can get coverage that way. To get a group plan, you have to be part of a GROUP. A "corporation" of 1-3 "employees" is not going to fit most health insurance company's definition of "group".

Students can get access to "student health" which is not true health insurance (or intended to replace it) but just means they can go to the university clinic for treatment of minor illnesses or injuries. It doesn't pay for them to go to the hospital in case of serious injury or illness.

If you make too much to qualified for Medicaid, have you shopped around for individual plans? Some of them are not much more expensive than (or about the same as) plans you'd get through a small business association or similar small group. The reason health insurance through employers is cheap (to the employee) is because the employer is usually paying a portion of the premium. The actual premium cost is still usually pretty high, in the neighborhood of $300 per person per month. And you can get individual coverage for less than that in some cases.

 

[cbg]

Additionally, not all states will permit a group of only one employee.

 

[CraigFL]

I don't know about IN but in FL a group can be 3 employees. I use Blue Cross/Blue Shield (BCBS)for my company. Unfortunately, the rules here say the employer must pay at least 50% of the premium as well as have a minimum percentage of employees enrolled. This of course means you couldn't approach your employer to start a group because it would be a significant investment-- most likely to keep employees from forming a group. Here in FL, on TV, BCBS advertises that they can provide affordable "group" insurance for individuals. Another option is professional organizations can provide group rates for members that are not covered elsewhere.

 

[jgombos]

Thanks for the feedback folks. I'm skeptical of going for an individual plan. From what I can imagine, personal health insurers probably collect urine, drug test, cross examine applicants with a battery of questions, half of which are probably about the health of ancesters (thus difficult to answer accurately with any certainty). I might go for the intrusive inconvenience of all of that to get quotes if I had an expectation of getting a down to earth premium, but I'm figuring with my health history, and the fact that I drive a motorcycle and fly single engine planes, they will end up finding that I'm much higher risk than that of an average person in a group plan.

I've had plans with decent healthcare in the past, which were paid mostly by my employer. But recently I've been working jobs that offer higher wages with reduced benefits. Sometimes I have the option to buy into a catastrophic group plan, and pay the full $300/mo ticket, where the employer probably doesn't contribute more than the cost of adminstration of the plans - and that's pretty much what I'm after. As of now, my current employer doesn't even offer the option to buy into a plan. So I just wanted to find out how I might get into a somewhat hassle-free group plan, and pay the rate of an average person without revealing how high of a risk I may be. Nothing in my medical history really makes me high risk, but I think the insurance companies will think otherwise, combined with my risky lifestyle (bikes/planes).

Also, my current employer says their office is considering offering health insurance options, but in the meantime I want to drive my motorcycle. Are there any policies out there that might simply cover injuries connected with driving a motorcycle? I'd like to get something like that for the summer, or until my employer makes something available.

 

[moburkes]

That would be called a special lines policy, which covers accidents involving you on a motorcycle. Call Progressive or Safeco. Health insurance doesn't cover that.

 

[jgombos]

That would be called a special lines policy, which covers accidents involving you on a motorcycle. Call Progressive or Safeco. Health insurance doesn't cover that.

I'll look into it, but in the past, my motorcycle insurance policies are lousy when it comes to my own medical. It's often a $2000 limit, which barely covers the ride to the hospital in most cities. I've laid my bike down several times, and every time my health insurance has covered it - back when I was covered by a decent employer sponsored group HMO. By "special lines", are you saying this is different that a conventional motorcycle policy, which would supplement the medical coverage that motorcycle policies omit?

 

[cbg]

Just as an FYI, while I am not in your state, I have been covered on an individual plan for some years now (two different ones and am in the process of changing again (sigh) ) and I have yet to be asked for any kind of blood, urine, or drug tests; nor have I been asked for any family history beyond my parents. Don't assume.

 

[moburkes]

I'll look into it, but in the past, my motorcycle insurance policies are lousy when it comes to my own medical. It's often a $2000 limit, which barely covers the ride to the hospital in most cities. I've laid my bike down several times, and every time my health insurance has covered it - back when I was covered by a decent employer sponsored group HMO. By "special lines", are you saying this is different that a conventional motorcycle policy, which would supplement the medical coverage that motorcycle policies omit?

Motorcycle is a type of special lines policy. If you keep falling off your bike, you need to stop riding. In the meantime buy a life insurance policy.

 

[TIMMAAYY]

Here is what you can do:

1) Start up a company. A legit company. Something that you will have as a legitimate business and receive and EID for taxes. You pay your spouse in benefits only, as long as the spouse does a legitimate task such as bookkeeping, etc.

2) Contact a broker for "group plans". A group of 2 is all that's required for group insurance.

3) Set up a 105 plan so that all of your expenses, premium, out of pocket, etc. are taken off on Schedule C.

If you need any help, I can give you further assistance.

If you are healthy, you don't want group. It's a huge ripoff. Get individual insurance instead. It's much less expensivem, but you have to qualify and fill out an application for each carrier you want to "shop".

For individual plans, there are no drug exams or anything that you posted "might be" involved in getting individual insurance. You will fill out an application, and if more information is needed, they will ask you or your doctor for it, or both. It's not as bad as some people ( group brokers ) would like you to think.

If you want pricing on plans, go to any site, like say... anthem .com.... and use their "get a quote" function. Individual is by far the least expensive between group and individual, and it's the same coverage ( outside of maternity ). But, in most cases, by the time you pay for maternity coverage, you may as well have saved the money and paid for it yourself.

 

[moburkes]

I had group health insurance where the premiums were $24/month. I'd LOVE to know how that is a ripoff.

 

[TIMMAAYY]

Really? What did you get for $24 a month.... ? That would be interesting to know. Outside of some silly "discount" plan, like a mini med, I don't see it.... ever. Even with HSA plans. In the past ten years the only plans out there with MAJOR MEDICAL coverage in that price range would be a $10,000 deductible plan for a child under 18.... maybe.

I'm calling shenanigans.

 

[moburkes]

Really? What did you get for $24 a month.... ? That would be interesting to know. Outside of some silly "discount" plan, like a mini med, I don't see it.... ever. Even with HSA plans. In the past ten years the only plans out there with MAJOR MEDICAL coverage in that price range would be a $10,000 deductible plan for a child under 18.... maybe.

I'm calling shenanigans.

As an insurance agent, I don't believe in silly discount plans. It was a group plan, as stated, through my employer. I just ran across someone with 7 kids, who has a great 2nd job, but can't quit his first one, because his insurance is $24/bi weekly, and he has a child with medical issues. My deductible, by the way, was $0. And, I'm not a liar.

 

[ecmst12]

How much was your employer paying towards the premiums though?

 

[moburkes]

How much was your employer paying towards the premiums though?

I don't remember exactly, BUT, they used to send out a health benefits statement each year which showed just how great our benefits were, and I know that it was around a few thousand each year. It wasn't super high. $3000 comes to mind, but, like I said, I can't be sure.