By Jordan Malik, MBA/MS & Award-Winning Amazon Pro Merchant & eBay Top Seller

Thursday

My Self-Employed Healthcare Coverage Adventure

NOTE: This blog has moved to: http://www.HonestOnlineSelling.com

Many of you probably have 'real' full-time jobs and are thus receiving health care coverage through their current employer.

But I am sure there are a few of you, like me, who are self-employed and thus have to pay out of pocket.

I am about to sign up for health insurance directly (=pay for it all myself) because my COBRA coverage (a generously subsidized 15-month run of $350 per month for health, Dental, and vision - one of the things Obama did right) expires by this August 31.'

So for those of you who are seeking out purchasing health coverage directly (because you're considering quitting your job, or starting your own buiness, etc.) this post might help you a little.

Please don't regard this post as an official health insurance resource. Contact a local health insurance broker (just do a search for 'health insurance broker' and the name of your city/town, on Google.com. Be sure to check your local broker out on the BBB.org site, before you contact them, to make sure they're legit.)  

I am not endorsing or promoting the Health Care organizations mentioned in this article.
  
Some things I discovered:
> Basic health care coverage is 'decently' affordable (not super cheap, not super expensive. Lots of room for improvement re: affordability, but not an impossible dream for many folks)... I had quite a few choices:

New York state has a program for individuals in lower income brackets, called Healthy NY , 'Health insurance for small businesses and working individuals'. Basically it's state-mandated discounted coverage by the major NY providers. I didn't qualify,  though, because of their income restrictions -  for me and a spouse, we have to show proof of total income less than $36K. Had we qualified, 'Couple' (husband-and-wife or partner) coverage would have been bout $850 a month with some restrictions and deductibles. Overall, not exactly a bargain, but not through-the-roof expensive either.

Separately, Empire/Blue Cross Blue Shield sent me a pamphlet on TraditionPlus Hospital Program (NY ONLY). Let's say you're extremely healthy but you can't qualify for subsidized health care or Cobra, or Medicaid or group health care coverage or whatever, and you need some coverage in the short-term. Empire's TraditionPlus is full emergency/hospital/child birth coverage only, and, a husband and wife/partner rate would have been around $400/month. That's one-step above 'going without', but with zero coverage for physician visits, routine care, specialist care, etc.

Then I used the U.S.-wide resource set up by the White House, healthcare.gov. This was a very easy-to-use website that explained all my options - Government-subsidized, State-subsidized, and regular private insurers - how much they cost, what their plans looked like compared to one another, etc. For me, the site was missing some information on some private insurers, but overall it was very good.

Then I used ehealthinsurance.com, which is a private company that compares rates and profits from all the major insurers in your state. I actually spoke with an ehealthinsurance rep on the phone and, expecting to be connected to someone in India, she was a U.S.-based rep (who was, in my discussion, not biased toward any one provider) and I got lots of questions answered. eHealthInsurance.com DOES get paid a commission from the health insurer company if the subscriber signs up through them. So they're not a 'provider-neutral' company, but I did find them useful, comprehensive and trustworthy.

My income level put me in a rather sticky spot - I earn too much (whether I apply as an individual or as a sole-proprietor) to qualify for subsidized/government-aided coverage; but I earn too little to be ok with paying Empire/Blue Cross Blue Shield $2500 to $3500 a month to continue my current coverage after Cobra expires.

I did find that, as a business owner (which many healthcare organizations refer to as a 'Sole Proprietor', even if your business is an S-Corp or LLC or whatever), I could join a local organization (like a local chamber of commerce) and thus be entitled to their 'Group' Rate, if they offer health insurance to their members.

Thus, via ehealthinsurance.com, I discovered Emblem Health, which offered me comprehensive health coverage, and very basic dental coverage, for $1100 a month. Again, not exactly a bargain, but it's manageable. (Realize that I live in Long Island, NY, which is like the 2nd-highest region in the U.S. in terms of cost of living. Everything's high here.) Emblem connected me to a local insurance broker. I'm in the process of signing up now. I have to prove (=provide tax records via my CPA) that I'm a business owner. I don't have to show proof of income (there are no income requirements). All I have to do is prove my business is in NY state and that I'm a NY State resident).

Here are some resources you should use:

NAIC - Official Directory of every State's health insurance regulations site, regardless of where you live.

healthcare.gov. U.S. Government's site to healthcare info. Very comprehensive and a good place you should start.

ehealthinsurance.com - A comparison site that lets you shop among different health care providers, regardless of where you live in the U.S.

Some tips:

> Prepare to do lots of calling, surfing the web, and digging around for info. None of this was 'easy'. I had to REALLY dig around, and talking to some of these Insurance companies is like talking to a prison warden who doesn't want to give you any info.

> Don't be afraid to use your state's resources to see if you qualify for subsidized care. Actually that should be your first stop. If you were fired recently and your household income dropped significantly, you may very well be able to get state or federal-subsidized health care.

> Even if you were just terminated, apply for Cobra anyway.Your employer by law has to give you the COBRA insurance application paperwork within 30 days of terminating your employment. COBRA is federal-mandated coverage that you're entitled to receive if you've been terminated (there are some exceptions, i.e. if you quit voluntarily you're not eligible - but make sure you apply anyway.) Official U.S. Cobra site here: http://www.dol.gov/ebsa/cobra.html. Getting Cobra was the best thing that came out of my last job with the dummies that fired me. With the money I saved by paying the 'COBRA' rate, I poured into my business. And here I am.

>Get a reliable accountant or CPA, if you own a 'real business'. Ask him/her if your health insurance costs can be a form of tax-deductible expense. Also, if you are applying for health insurance (like I did) as a 'sole proprietor', you may have to have your CPA involved by providing proof of income to the insurer IF you are a brand new business for 2011 and thus don't have any recent tax records that legitimize your business.

Good luck! And please post your comments below, I would love to hear your feedback.

-J.B.

1 comment:

The Paul McCartney Blog said...

This was very informative. Thank you. I was the OP on the OFB forum thread about health insurance.