You own your own business, well done. You are living the dream, you are your own boss. You can work any 80 hours a week you want. Trying to cram 15 hours of work into a 9-10 hour day leaves little time for ancillary business tasks like health insurance. You know it's important, but paying the bills is your top priority. Rightfully so.
Good news, we have a list of eight tips that can give you a head start on the information you need to know about buying Health Insurance for yourself and/or your business.
1. There is No Such Thing as a Self-Employed Health Insurance Plan
Health insurance companies do not have a "Self-Employed Health Insurance" plan, there's no such thing. They have group plans or individual plans, that's it. If you have two or more employees you can consider a group plan for the company. If not, you will need to purchase a individual plan for you and your family.
Understanding this simple difference will save you plenty of confusion during your search. It's much easier to find what you want when you are looking for the right plan.
You might have even found this article by searching for self-employed health insurance.
2. You Need Two or More Employees for a Group
Like we just covered, you need to have a minimum of two employees to be considered a group in the state of Ohio. Only then can you look to provide the company with traditional group health insurance.
These plans include a more robust benefit package than what you can expect to find on the individual market, that is until next year when the Affordable Care Act levels the playing field for both.
3. You Have to Pay for Half the Cost of a Group Plan, Minimum
Adding to the increasing cost of that group health insurance plan is your 50 percent minimum contribution. that means, for all you mathematicians out there, if your employees' premium is $500 a month, you will at least have to pay $250 of it.
4. Individual Plans are More Affordable
Don't be too broken up about your lonely work environment, individual plans, at least for now, are much more affordable than group plans. In fact, they are about half the cost of a group health insurance plan.
They are able to achieve this by eliminating some of those "robust" benefits we hinted at above. They include guaranteed issue and maternity coverage to name a few. In 2014 there will be very little difference between group and individual plans as a result of health care reform.
5. Pay Attention to Your Out-Of-Pocket Maximum
This is a must for anyone, anytime when looking for health insurance. Outside of your monthly payment this is single most important number you need to concern yourself with.
Your out-of-pocket max is the total amount of money you would have to pay if serious medical treatment were needed. You will want to plan accordingly for that amount and make you are properly prepared.
6. Kids Can Stay on Your Plan Until Age 26
Like a boomerang, you sent your kids off to college but somehow they ended up right back under your roof after their higher eduction was complete. Don't worry, thanks to the ACA your kids can remain on your health insurance plan until they are 26 years old. Double thanks to Ohio's SB1 that allows your children to stay on for an additional two years until age 28.
However, often times it's more affordable for you to purchase your young adult their own individual plan instead of keeping them on your coverage.
7. You Can't Directly Pay for Your Employees Individual Policy
If you do have an employee or two hanging around the office and opted to forgo a group plan, you won't be able to directly pay their individual health insurance premium. You will instead have to increase their wages or provide them with a bonus check to cover the cost.
8. List Bills Allow You to Offer Coverage Without Paying For It
If everyone at the company purchases a plan from the same insurance company, you can set up a list bill. This will allow you to deduct the payment directly from their paycheck. That way you can make sure they are using the extra money to pay for their health insurance.
The other nice benefit is, unlike a group plan, you are not required to pay for any percentage of an individual policy. This allows you to offered health insurance without taking on extra costs.
The Bottom Line
If you are self-employed and looking for coverage for you or your business, there are plenty of subtle difference you need to be aware of. With more unknown changes and regulations forthcoming from the ACA, it's important to have someone you can trust to help navigate you through this unprecedented time.
Let's Hear It
What has your experience been so far trying to get coverage for you and/or your business?