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How to Choose Health Insurance – Startup Edition

blog.getsimplyinsured.com

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Re: How to Choose Health Insurance – Startup Edition

#41

Post by Stratoscope »

dot wrote: post #12

These premiums actually look pretty good. I was under the impression that non-employer based plans were much more expensive... Is there a catch? Do they have to cover pre-existing conditions in CA already? Are there coverage caps? Thanks for putting together the article, very helpful!

I imagine those premiums are for Tier 1 customers (in good health without pre-existing conditions). Insurance companies also offer plans at higher cost for various pre-existing conditions. Once you apply they evaluate your medical information and place you in a rate tier. Blue Shield for example has tier 1 through tier 6 (plus a special tier 7 for minors).

If you meet some other qualifications (in particular have had coverage for 18 months and have used up any COBRA options you have), you are entitled to a guaranteed issue plan in CA if you are declined for an underwritten plan:

http://www.hmohelp.ca.gov/dmhc_consumer/hp/hp_cobra.aspx

http://www.hmohelp.ca.gov/dmhc_consumer/hp/hp_hipaacp.aspx

Re: How to Choose Health Insurance – Startup Edition

#42

Post by daguar »

These folks don't appear to understand the health insurance market: if you have ongoing medical conditions, basically none of these options will be available to you at these premium levels.

Insurers underwrite applicants in the individual market, meaning that for someone with preexisting medical conditions, these options will either:

1. Simply not be offered (they will deny you coverage)

2. Offer coverage, but exclude coverage of any preexisting conditions (usually for at least 6 months)

3. Charge a much higher premium rate than those shown here

Not to be harsh, but this analysis is dangerously misleading. Do they have domain knowledge of this area?

Re: How to Choose Health Insurance – Startup Edition

#43

Post by green_dye_00 »

As a part-time member of the National Guard, I pay $54 (fifty-four) a month for private health insurance. The family rate is $192. It's subsidized by the taxpayer (thank you).

The Guard is not for everyone, but it has been great for me, on so many different levels. It has never substantially interfered with the three start-ups I've been in.

The inexpensive health insurance is a huge comfort for the periods where I work independently or before we get funding: it's like a massive drop in burn rate!

There are cyber opportunities (variable by geography), so talk to your local recruiter.

Re: How to Choose Health Insurance – Startup Edition

#44

Post by samspot »

daguar wrote: post #42

These folks don't appear to understand the health insurance market: if you have ongoing medical conditions, basically none of these options will be available to you at these premium levels. Insurers underwrite applicants in the individual market, meaning that for someone with preexisting medical conditions, these options will either: 1. Simply not be offered (they will deny you coverage) 2. Offer coverage, but exclud…

I read this article as being targeted toward founders picking a provider for their company. Did I misunderstand the target audience?

Re: How to Choose Health Insurance – Startup Edition

#45

Post by daguar »

samspot wrote: post #44
daguar wrote: post #42

These folks don't appear to understand the health insurance market: if you have ongoing medical conditions, basically none of these options will be available to you at these premium levels. Insurers underwrite applicants in the individual market, meaning that for someone with preexisting medical conditions, these options will either: 1. Simply not be offered (they will deny you coverage) 2. Offer coverage, but exclud…

I read this article as being targeted toward founders picking a provider for their company. Did I misunderstand the target audience?

Based on the description, it sounds like they're purchasing for themselves (founders purchasing individually, not pooling into a small group plan for a company).

The premiums bear this out.

Re: How to Choose Health Insurance – Startup Edition

#46

Post by king_jester »

twoodfin wrote: post #21
thezoid wrote: post #19

Earlier quoted context omitted.

It's nice to not have to worry about these things though. It would be pretty awesome to one day see the US have a public health care.

The U.S. has public education, and people still worry an awful lot about whether their kids' schools are any good, to the point of some spending a premium of literally hundreds of thousands of dollars on housing in the "right" districts, or on private education. The poor are still underserved, racially-measured outcome disparities are substantial, etc. None of this is directly an argument against public health care,…

I agree, the education system in the US has several problems, some of which are being made worse by attempt to "fix" those problems (Race to the Top I'm looking at you).

I would point out that these kinds of things are about trade offs. As a society we are much worse off without a national education offering, even if it has significant problems to overcome. At this point in time, private health insurance tied to employment have clearly failed as a way for US society to have decent health care, as we spend more for lower quality service than most other nations in our economic class. Universal health care programs are not so much about a panacea, but something that doesn't suck as bad.

Re: How to Choose Health Insurance – Startup Edition

#47

Post by zach »

awolf wrote: post #33

This post gives terrible advice for those in the Ongoing Medical Conditions category. For most pre-existing conditions there's very little chance of getting approved for any of the plans they recommend. A bit surprising coming from a company that should apparently know what they're talking about. As an independent software developer with Type 1 Diabetes, COBRA from my previous employer is my only option. Fortunately,…

Be sure to double-check on whether you can get California's extended COBRA if you were working for a large company.

I was lazy about getting my company's own insurance and contacted my former employer (Activision Blizzard) about how to get Cal-COBRA coverage.

Turns out I wasn't eligible, since their health plan is self-insured. Whoops, I didn't know that — who would?

I managed to line up coverage to avoid a gap, but I imagine a lot of people are caught by surprise by this exclusion. Details here:

http://www.insurance.ca.gov/0100-consumers/0060-information-...

Re: How to Choose Health Insurance – Startup Edition

#48

Post by rdl »

Stratoscope wrote: post #36

Here's a bit of info about HSAs (Health Savings Accounts) since there are a few questions about them. In particular I'll contrast them with FSAs: Like an FSA, pre-tax money goes into an HSA, and you can withdraw from it tax-free for qualifying medical expenses. You can also make taxable withdrawals with no penalty for non-medical purposes after age 65. Unlike an FSA, an HSA is a real savings account and not a use-it-…

The annoying trick once you have an HSA is that you basically need to put $3k balance into it to keep from paying recurring fees on a decent savings account (HSA or Sterling, I think), or you have to have over a certain amount to then be allowed to use it to either buy funds (often overpriced) or do self-directed trading (also usually on subpar terms).

It's essentially a Roth IRA; it actually makes sense, due to compounding, to pay cash for anything your insurance doesn't cover, and max out your HSA every year, keeping it in there, and reinvesting. Well, it makes sense if 1) you have enough income or assets to want to shift an extra $3k/yr into Roth IRA equivalent and 2) you don't fear the law will change before you retire or need lots of uninsured health care money.

Re: How to Choose Health Insurance – Startup Edition

#49

Post by bsims »

Stratoscope wrote: post #36

Here's a bit of info about HSAs (Health Savings Accounts) since there are a few questions about them. In particular I'll contrast them with FSAs: Like an FSA, pre-tax money goes into an HSA, and you can withdraw from it tax-free for qualifying medical expenses. You can also make taxable withdrawals with no penalty for non-medical purposes after age 65. Unlike an FSA, an HSA is a real savings account and not a use-it-…

I recently moved to California and was surprised to find that HSA were not deductible here, although federally it is considered a deduction. Wouldn't be the first time California as bucked Federal rules though. =)

http://www.benefitscafe.com/hsa/articles.html

Re: How to Choose Health Insurance – Startup Edition

#50

Post by swohns »

carterschonwald wrote: post #20
swohns wrote: post #10

NYC has some great options: 1. Freelancers Union 2. The City has sponsored plans as well: https://www.ehealthinsurance.com

Indeed. Were I not under my parents plan I'd totally be getting the freelancers one

Freelancer is a solid choice for individuals, but if you're company is paying for it, the New York plans are surprisingly comprehensive. Nice to see the city supporting entrepreneurs like this!
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