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

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ecmst12

Senior Member
$3k per year is $250 per month. Add what you were paying and the total premium would have been about $275. Which isn't super expensive but it's a lot more then $25! Group rates for the companies I have worked for have all been in the neighborhood of $300 per month, some a little more, some a little less. My contribution has been anywhere from nothing to $50 per month. I used to pay nothing towards the premiums for insurance at my current job, that doesn't mean the group plan was free! Just free to me :)
 


moburkes

Senior Member
$3k per year is $250 per month. Add what you were paying and the total premium would have been about $275. Which isn't super expensive but it's a lot more then $25! Group rates for the companies I have worked for have all been in the neighborhood of $300 per month, some a little more, some a little less. My contribution has been anywhere from nothing to $50 per month. I used to pay nothing towards the premiums for insurance at my current job, that doesn't mean the group plan was free! Just free to me :)

Oh, I agree with all of that. TIM was making statements that people don't want group, if they are healthy. I was in a group, I was healthy, and I only paid $25/month. That was all I needed to pay. So, his statement was inaccurate.
 

ecmst12

Senior Member
But the premium is much higher, and if you're getting a group plan on your own with no employer paying part of the premium for you, you're going to be paying the full premium yourself.
 

moburkes

Senior Member
But the premium is much higher, and if you're getting a group plan on your own with no employer paying part of the premium for you, you're going to be paying the full premium yourself.

Oh, I know that. I'm an insurance agent, remember?:D

I've also helped both of my parent's businesses get group coverage. The rate were less than, or similar to the individual rates for most people.
 

cbg

I'm a Northern Girl
I'm in one of the few states that allows a one-life group.

I have been pricing individual coverage for several months., I just signed up for a group policy under my consulting company that only covers my husband and myself. We could have gotten an individual policy, for three times what we are paying, or an HMO for slightly more than double what we are paying.
 

TIMMAAYY

Member
Oh, I agree with all of that. TIM was making statements that people don't want group, if they are healthy. I was in a group, I was healthy, and I only paid $25/month. That was all I needed to pay. So, his statement was inaccurate.

My statement is NOT innaccurate. You show me a group plan, where the ENTIRE premium is known, and compare that to individual rates. There is no WAY ( unless you have an entire group of young single males, 25 and under ) that the group rates are going to be less expensive than individual. Small group is guarantee issue. They have to give it to you. Individual, you have to QUALIFY to get. You have to be healthy enough to get it. Group rates are NOT less because of "having more risk to spread around". Last time I checked, General Motors is a group through Anthem, and they have some of the highest rates around.

You may have only paid $24 a month for your portion of it, but I guarantee you your single rate was at LEAST $300 a month if you had NO DEDUCTIBLE and no other out of pocket. You are paying the carrier to take on all your risk, no matter what, and that's just ridiculous. They make more money off managing the first $5,000 in claims than they do anything else. Why? Most people won't even come close to that, so you are basically handing them your money for nothing. Example:

$300 a month - no deductible -Worst case is $3600 a year, best case is $3600 a year. (you)

$70 a month - $2500 deductible - Worst case is $3340, best case is $840. (me)

Who's winning that game? :confused:

Group insurance is a complete joke, especially if you live in any state with a state insurance plan like Indiana or Kentucky. Employers can still provide and pay for the premium for individual insurance, give everyone the same benefits they had before, even with some folks on the state plan. They save much more than they risk. It's simple math. But who doesn't agree with this? Group agents who make money on commision bonuses and overrides, that's who, and the insurance carriers that they provide with billions in excess premium every year.... actually, more like about a trillion dollars wasted in the United States every year.

No one needs group insurance. It's just that buying group insurance is what has been crammed down our throats for so long, most people think they don't have any other options. I have groups with members of the same group on medicare, individual, and HIPAA plans. But guess what? ALL of their benefits are EXACTLY the same as long as they are employees. And, the employer is now paying less than half of what he was paying in total for group insurance.

The only people who will argue that group insurance is better are those that make a huge amount of money on it. What incentive do they have to show their clients anything else? Do you honestly think they want to cut their own commissions?

Funny thing is, I make more money on a group with MY strategy, than your typical group agent does, and my clients pay anywhere from 20-50% less out of pocket. I make more money, the customer saves, the employees have the same benefits.

Who's winning THAT game? :D



Also, for those that want to retire early... good luck! With group, your most likely only possible choice will be COBRA for 18 months.... then what? Good luck! WIth individual, you OWN the policy. Do you want to buy a house and rent the land? Or do you want to own the land also? Your choice.

The simple fact is this: if you can get individual, get it. It's always yours as long as you pay the premium. If your employer have been told that they can't pay for your individual premium without having to count it as taxable income, they're wrong about that, too.
 
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TIMMAAYY

Member
I'm in one of the few states that allows a one-life group.

I have been pricing individual coverage for several months., I just signed up for a group policy under my consulting company that only covers my husband and myself. We could have gotten an individual policy, for three times what we are paying, or an HMO for slightly more than double what we are paying.

Is that because you are unhealthy and couldn't get a standard individual plan? I'm not familiar with MA plans or carriers, but that seems highly unusual. Was the individual plan offered to you from a carrier and not a "state plan" or "HIPAA plan"? In discussing why individual plans are less expensive, I am talking about for the healthy who qualify for a carriers standard individual plan. The guarantee issue plans ( state, HIPAA,etc. ) can be more expensive on an individual basis. But 3X? :confused: Also, are you paying 100% of the group plan premium? If you are only paying a portion of it ( and your employer is paying the remainder ) I can easily see you thinking that individual costs more, because in most cases, employers have been told they can not pay for your individual policy, at least not without a tax consequence to you as an employee. That, however, is incorrect according to the IRS.
 
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cbg

I'm a Northern Girl
No, it's not because anyone is unhealthy. MA is a guaranteed issue state, even if someone were.

Both my husband and I are self-employed. We do not qualify for the state plans. Yes, we are paying 100% of the cost.

I've been doing this for a great many years. I know what I'm talking about. You seem to think that I'm some jill off the street who doesn't know how insurance plans work. That is very much not the case.

The fact of the matter is, individual plans are not always cheaper than group plans for the same coverage and the sooner you accept that, the better.
 

TIMMAAYY

Member
My apologies, cbg. I am not familiar with MA insurance law. If it's guarantee issue, that would make sense.

That also helps me make my point in all of the OTHER states, where small group is guarantee issue. Guarantee issue makes it more expensive. :D
 

cbg

I'm a Northern Girl
If guaranteed issue makes group more expensive, how do you explain the fact that I received cheaper quotes for single-life group than for individual?
 

TIMMAAYY

Member
If guaranteed issue makes group more expensive, how do you explain the fact that I received cheaper quotes for single-life group than for individual?

It is most likely because of your age banding.( just a guess on your demographics for the group). If you are at a certain age, there will be certain individuals in a group whose individual rates WILL be more than the group rate for that particular group. They are in the minority by a longshot though.

Example:

One of my groups has a lot of younger people in it, maybe an average age of 30. For a couple of the employees, their individual rates would be more than the individual-group rate. However, for the employer who bares the burden of the majority of the premium, he is still being taken to the cleaners.

What we did, was go all individual. They still have the same benefits as before, regardless of the new policy. The one or two that actually cost a little more, are more than offset by the savings incurred by the rest of the group. If two people cost you an extra $1,000 a year, and twenty other people save you $7,000 per year, you still save $6,000.

Employees who are at retirement and still choose to work, go on Medicare as primary. Their benefits are actually BETTER than the plan document, and this changes the overall age of the group, lowering it, and helping to lower rates for the group. It also shifts risk away from the employer. If they go on Medicare, they either get a Medsup or a MAP, which the employer can also pay for, just like the group premium. Even it it's a wash on premium cost ( it usually still a savings ) the employee has zero effect on the group, and still has the same benefits ( or better in most cases ), and no exposure to the employer for anything other than the doughnut hole on the PDP.
 

ecmst12

Senior Member
I'm sorry, but if a person over 65 is still working, then Medicare is NOT primary over a plan they get from their employer.
 

cbg

I'm a Northern Girl
I'm not convinced, and I'm not going to be convinced. Everything I have learned in 26 years and in my own recent experience still tells me that for the most part, group is cheaper, and it is the exception when an individual plan is. Unless there is a TREMENDOUS difference in benefits, in which case anything goes.

You are free to disagree, but you're wasting your time trying to convince me otherwise. The entire point of group insurance is to spread out the loss history and keep the rates lower for everyone.

I won't be back to this thread so don't waste your time telling me I'm wrong again. I'm not, and I'm tired of listening to you try to tell me otherwise.
 

TIMMAAYY

Member
I'm sorry, but if a person over 65 is still working, then Medicare is NOT primary over a plan they get from their employer.

ecmst12,

Allow me to explain what I am getting at...

The company opts them out of the group plan because, just like the spousal coverage, they have other coverage available. They are still enrolled in the COMPANY (105) plan however. They are no longer at of your "group" plan that you buy from the carrier. Medicare eligible, goes on Medicare.

Regardless of what plan sits in the background as a stop loss, be it an individual plan, group plan, HIPAA plan, Medicare, spouse's plan, etc.... they all have the same guaranteed "benefits" through the 105. The 105 plan defines what their benefits are, regardless of which "insurance" sits in the background. All the insurance company does is two things... provide a network for discounted rates, and provide a stop loss. That's it.

CBG, I am not trying to force anything on you, I am just giving you examples of what is possible, at least in the states that are not completely guarantee issue states.
 

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