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Ask HN: What healthcare options exist for entrepreneurs?

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Re: Ask HN: What healthcare options exist for entrepreneurs?

#41

Post by 1123581321 »

greggeter wrote: post #34

I pay $150/mo using a health sharing service called Christian Healthcare Ministries. There are others not religious in nature like Liberty Health Share. Would be $450 for entire family.

I vouched for this dead comment. I know a few self-employed consultants or business owners who use this kind of mutual expense sharing for their insurance. (I learned about the concept from my auto insurance agent several years ago.) It seems like something entrepreneurs actually use and may be more viable than high deductible insurance for people who would actually use their insurance (but more expensive than Medicaid.)

Re: Ask HN: What healthcare options exist for entrepreneurs?

#42

Post by jjeaff »

kxyvr wrote: post #32
jjeaff wrote: post #30

Earlier quoted context omitted.

There is nothing false about his comment (maybe it was updated). ACA is fully based on projected income for the year. Previous year's tax returns are one way of substantiating your projected income. But not required. If you are living off of savings and not making a profit yet on your business, you can pay yourself a small salary and qualify for full subsidies from ACA. If you file as a C Corp (which you can do with…

Yes, ACA is based on projected income: https://www.healthcare.gov/income-and-household-information/... However, for most people, the primary number to estimate this is your adjusted gross income, which they explicitly instruct to use line 7 on the 1040. It's not entirely clear to me who the regulatory authority is now that the tax penalty has been taken away for not carrying insurance, but I'm pretty sure it's going…

He didn't imply you should lie about your income.

Most early businesses don't make much profit if any. Mine did not and so we kept our income right in the sweet spot to get max subsidies.

We paid ourselves that small salary and plowed every bit of the remainder into growing the business. In other words, there was no profit at the end of the year.

We had absolutely excellent coverage for around $100 a month total for a family of two. In one year we had $70,000 in expenses from a broken ankle that needed major surgery. And the next year a complicated pregnancy that cost $40k. We paid our max out of pocket those two years of $1500 each year.

Re: Ask HN: What healthcare options exist for entrepreneurs?

#43

Post by rcalafato »

eappleby wrote: post #23

I run a 1-person LLC in NYC. I initially used healthcare.gov for my coverage, but once my business started making money, I found that I was paying a lot for mediocre coverage. The providers I used also stopped offering coverage after 2016/2017, so I decided to switch to TriNet. They are an HR service, but also offer health insurance, which is all I use them for. I also looked at Gusto and JustWorks, but they required…

How did you get just the insurance? I reached out to them and was told I needed a full service plan ($500/mo before the insurance) with them to get the insurance. I have a 2-person LLC partnership, and we don't need the business services.

How'd you do what you did?

Re: Ask HN: What healthcare options exist for entrepreneurs?

#44

Post by e1g »

1123581321 wrote: post #41
greggeter wrote: post #34

I pay $150/mo using a health sharing service called Christian Healthcare Ministries. There are others not religious in nature like Liberty Health Share. Would be $450 for entire family.

I vouched for this dead comment. I know a few self-employed consultants or business owners who use this kind of mutual expense sharing for their insurance. (I learned about the concept from my auto insurance agent several years ago.) It seems like something entrepreneurs actually use and may be more viable than high deductible insurance for people who would actually use their insurance (but more expensive than Medica…

It is worth highlighting the major difference: these products are not at all health insurances, and they cannot be labelled as such.

When you have a contract with an insurance company, that service provider has to pay up or you can sue them if they don't. Sure, there might be a co-pay or a high deductible, but if you draw an unlucky card with cancer / heart / cardio disorders, they will fork out six-seven figure sums to get you better.

"Christian Healthcare Ministries" and the like have no obligation to pay out and you are gambling on their goodwill, which can be revoked at any moment with no recourse. Further, they often have _lifetime_ caps of ~$100k per diagnosis/condition, and in case of any serious illness this will be chewed up in 3-4 months, then you are on your own.

Re: Ask HN: What healthcare options exist for entrepreneurs?

#45

Post by 1123581321 »

e1g wrote: post #44
1123581321 wrote: post #41

Earlier quoted context omitted.

I vouched for this dead comment. I know a few self-employed consultants or business owners who use this kind of mutual expense sharing for their insurance. (I learned about the concept from my auto insurance agent several years ago.) It seems like something entrepreneurs actually use and may be more viable than high deductible insurance for people who would actually use their insurance (but more expensive than Medica…

It is worth highlighting the major difference: these products are not at all health insurances, and they cannot be labelled as such. When you have a contract with an insurance company, that service provider has to pay up or you can sue them if they don't. Sure, there might be a co-pay or a high deductible, but if you draw an unlucky card with cancer / heart / cardio disorders, they will fork out six-seven figure sums…

Yes, that all is important to consider. My understanding is that this was especially true before the ACA, when certified continuous coverage was a big deal.

The lifetime limit is more complicated than that as they seem to have separate programs for up to a maximum and everything beyond that. For example, Samaritan Ministries (one of these programs) costs ~$500/mo for a family for everything up to $250,000 and about $500/year to cover $250,000 with no limit. I’m guessing that’s done because they have members who live in inexpensive countries, but it seems like the extra annual cost should just be rolled into the monthly so no one makes the wrong choice about how much to cover.

Re: Ask HN: What healthcare options exist for entrepreneurs?

#46

Post by dawhizkid »

celdon25 wrote: post #35
dawhizkid wrote: post #13

Earlier quoted context omitted.

Why do you say One Medical is for "wealthier people"? Outside of the $200 annual membership fee, it's no different than seeing any other physician if they are in-network for your insurance plan.

I had several doctors from One Medical and they were not the best. However, there were a number of things that made up for it. Setting up appointments was easy, the locations were convenient, and you could even talk to the doctors via messaging on the website. Viewing and downloading test results could be done via their website also, and I've had to jump through hoops to get test results elsewhere. However, to call i…

For me, the best thing about One Medical is that they have walk in labs and you can do your labs in their office without going to a Quest Labs or LabCorp office, which are not pleasant at all and usually have long waits.

Re: Ask HN: What healthcare options exist for entrepreneurs?

#47

Post by nutjob2 »

kxyvr wrote: post #32
jjeaff wrote: post #30

Earlier quoted context omitted.

There is nothing false about his comment (maybe it was updated). ACA is fully based on projected income for the year. Previous year's tax returns are one way of substantiating your projected income. But not required. If you are living off of savings and not making a profit yet on your business, you can pay yourself a small salary and qualify for full subsidies from ACA. If you file as a C Corp (which you can do with…

Yes, ACA is based on projected income: https://www.healthcare.gov/income-and-household-information/... However, for most people, the primary number to estimate this is your adjusted gross income, which they explicitly instruct to use line 7 on the 1040. It's not entirely clear to me who the regulatory authority is now that the tax penalty has been taken away for not carrying insurance, but I'm pretty sure it's going…

I don't know why you latched on to the notion that I was suggesting something dishonest.

You might be prioritizing developing your product over making income, or reinvesting income rather than spending that income personally. Or you might have savings or existing investment funding. There are many common scenarios such as these and none of them involve fraud.

You can be building up a substantial asset and living frugally and it doesn't affect your eligibility because of the lack of an asset test and because any capital gains are not realized) or assessed) until the business is sold.

Also as a single person you can earn up about $12K and not pay any premiums under Obamacare, or get up to about $48K and still get a subsidy. If you have a family of 4 these figures and $23K and $96K respectively. So obviously you don't have to get your income down to $0.

Re: Ask HN: What healthcare options exist for entrepreneurs?

#48

Post by eappleby »

rcalafato wrote: post #43
eappleby wrote: post #23

I run a 1-person LLC in NYC. I initially used healthcare.gov for my coverage, but once my business started making money, I found that I was paying a lot for mediocre coverage. The providers I used also stopped offering coverage after 2016/2017, so I decided to switch to TriNet. They are an HR service, but also offer health insurance, which is all I use them for. I also looked at Gusto and JustWorks, but they required…

How did you get just the insurance? I reached out to them and was told I needed a full service plan ($500/mo before the insurance) with them to get the insurance. I have a 2-person LLC partnership, and we don't need the business services. How'd you do what you did?

I pay for the full service plan (it is less for me since I am just 1 person), but I don't use any of the other services. Even with the fee, it is still a good deal.

Re: Ask HN: What healthcare options exist for entrepreneurs?

#49

Post by jjeaff »

nutjob2 wrote: post #47
kxyvr wrote: post #32

Earlier quoted context omitted.

Yes, ACA is based on projected income: https://www.healthcare.gov/income-and-household-information/... However, for most people, the primary number to estimate this is your adjusted gross income, which they explicitly instruct to use line 7 on the 1040. It's not entirely clear to me who the regulatory authority is now that the tax penalty has been taken away for not carrying insurance, but I'm pretty sure it's going…

I don't know why you latched on to the notion that I was suggesting something dishonest. You might be prioritizing developing your product over making income, or reinvesting income rather than spending that income personally. Or you might have savings or existing investment funding. There are many common scenarios such as these and none of them involve fraud. You can be building up a substantial asset and living frug…

Those minimum/maximum rates are different depending on if you state has medicaid expansion or not.

But I think the rates you posted are federal poverty level for a family of 4. Obamacare coverage kicks in at 138% of FPL all the way up to 400% of fpl.

Below 138% FPL disqualifies you for obamacare because you would qualify for state medicaid coverage.

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