Author Topic: Self Employed Health Insurance  (Read 5783 times)

Crazydude

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Self Employed Health Insurance
« on: May 11, 2017, 02:09:07 PM »
I am self-employed, and I currently have health insurance through my wife's employer. She is quitting this summer as we are expecting in November, and she will be a stay at home mom. We are looking to switch to private insurance. My business is an LLC and outside of me and my wife, we have just one part time employee. From my research, looks like we'll have to get private insurance. We don't qualify for a subsidy, and I've been told we shouldn't have an issue switching while she is pregnant.

Wondering if anyone out there has had a similar experience switching insurances while pregnant, especially if switching to individual/private insurance.

Also curious if anyone uses a Christian health-cost sharing program like Christian Healthcare Ministries or Medi-Share.

Heroes821

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Re: Self Employed Health Insurance
« Reply #1 on: May 11, 2017, 02:48:38 PM »
I'm self employed and use insurance through healthcare.gov.

We have no employees, but two policies. My wife (pre-existing conditions and pregnant) and step-daughter (ADHD meds) are on a normal medical insurance plan $650 a month then $40 for Dental. 
Myself and my Step-son (no current issues) are on an HDP w/e plan for HSA. $700 a month plus $50 for Dental. All count as business expenses as my CPA explained it so while that is crazy expensive the cost is at least made with pre-tax dollars. Plus we get to put $6750 in an HSA per year.

bunchbikes

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Re: Self Employed Health Insurance
« Reply #2 on: May 12, 2017, 06:28:42 AM »
Also curious if anyone uses a Christian health-cost sharing program like Christian Healthcare Ministries or Medi-Share.

I use medi-share. It's cheap.  $200/mo premium for the 4 of us.  This is on a high-deductible plan, and with 2 young healthy adults.

SwordGuy

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Re: Self Employed Health Insurance
« Reply #3 on: May 12, 2017, 02:16:37 PM »
Also curious if anyone uses a Christian health-cost sharing program like Christian Healthcare Ministries or Medi-Share.

I use medi-share. It's cheap.  $200/mo premium for the 4 of us.  This is on a high-deductible plan, and with 2 young healthy adults.

Took a look at the site.  Looks interesting.

Legally, not an insurance company.   Would want to know what kind of regulations it operates under.

Also, they don't refer to paying the doctor, they refer to "publishing your bills to share".   EXACTLY what does that mean?   Are members of the site choosing to pay your bills or not based on their accumulated contributions?   Or is that just legal mumbo-jumbo to avoid claiming they will pay, since they are not an insurance company?

Axecleaver

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Re: Self Employed Health Insurance
« Reply #4 on: May 13, 2017, 07:37:35 AM »
Best plan for you is to go to healthcare dot gov and buy an ACA plan; they will still be in effect until the end of 2018 at the very worst. Depending on your income, you may qualify for subsidies, as well, and going through the Exchange is the only way to get them.

Exemptions for the Christian healthshare ministries are written into the ACA; the plans pre-date the ACA, but it isn't certain how stable they will be if the ACA is repealed. They enjoyed a huge enrollment increase when the individual mandate was enacted. It is likely that many people will leave now that they aren't required to have insurance.

The biggest problem with the healthshares is how distributed they are: they don't enjoy the negotiating power of a private healthcare payor to lower provider prices. So the whole group is paying a lot more for the same services. You can negotiate your bills, but it's difficult and providers have little incentive to give you the best deals.

Prescriptions in particular are difficult to negotiate down. Healthshare ministries typically partner with a discount Rx plan, but you're still paying about 4-10x (sometimes more) compared to what the PBM's are paying for the same drugs.

High level article: http://www.christianitytoday.com/ct/2017/february-web-only/future-of-christian-healthcare-ministries-after-obamacare.html

They're great for healthy people. They are not good ideas for people with expensive prescriptions or significant health problems.

Crazydude

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Re: Self Employed Health Insurance
« Reply #5 on: May 13, 2017, 08:16:35 AM »
Best plan for you is to go to healthcare dot gov and buy an ACA plan; they will still be in effect until the end of 2018 at the very worst. Depending on your income, you may qualify for subsidies, as well, and going through the Exchange is the only way to get them.

Exemptions for the Christian healthshare ministries are written into the ACA; the plans pre-date the ACA, but it isn't certain how stable they will be if the ACA is repealed. They enjoyed a huge enrollment increase when the individual mandate was enacted. It is likely that many people will leave now that they aren't required to have insurance.

The biggest problem with the healthshares is how distributed they are: they don't enjoy the negotiating power of a private healthcare payor to lower provider prices. So the whole group is paying a lot more for the same services. You can negotiate your bills, but it's difficult and providers have little incentive to give you the best deals.

Prescriptions in particular are difficult to negotiate down. Healthshare ministries typically partner with a discount Rx plan, but you're still paying about 4-10x (sometimes more) compared to what the PBM's are paying for the same drugs.

High level article: http://www.christianitytoday.com/ct/2017/february-web-only/future-of-christian-healthcare-ministries-after-obamacare.html

They're great for healthy people. They are not good ideas for people with expensive prescriptions or significant health problems.

I appreciate all the feedback on this thread. I've checked out healthcare.gov, I know I do not qualify for subsidies as my income is too high. I'm leaning towards trying out private, regular insurance until our kid is born, probably even 6 months after, then switching to a healthcare sharing program.

bunchbikes

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Re: Self Employed Health Insurance
« Reply #6 on: May 14, 2017, 04:11:28 AM »
Or is that just legal mumbo-jumbo to avoid claiming they will pay, since they are not an insurance company?

This.

It's an insurance company that uses different vocabulary for everything, so that it is legally not an insurance company.


I was skeptical at first, but they have a solid long-term track record.

Papa bear

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Re: Self Employed Health Insurance
« Reply #7 on: May 14, 2017, 07:15:48 AM »
Check your local chamber of commerce.  Ours has a group insurance plan for all of the small businesses to join.


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bunchbikes

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Re: Self Employed Health Insurance
« Reply #8 on: May 14, 2017, 07:35:50 PM »
Check your local chamber of commerce.  Ours has a group insurance plan for all of the small businesses to join.

Awesome tip, I've never heard of this.

TBH, I never even knew what a "chamber of commerce" did.

Crazydude

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Re: Self Employed Health Insurance
« Reply #9 on: May 15, 2017, 10:52:31 AM »
Check your local chamber of commerce.  Ours has a group insurance plan for all of the small businesses to join.


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I called mine, they said businesses/individuals use to get preferred pricing by going through the chamber of commerce. But since the ACA that is not the case.

wearfannypacks

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Re: Self Employed Health Insurance
« Reply #10 on: May 15, 2017, 07:23:39 PM »
If you have a part-time W-2 employee you might qualify for a group insurance plan through Simplyinsured.com I use them. I have 2 part-time W-2s. They opted out of the plan, so it's just my family. It's expensive, but stronger coverage than we qualified for through the healthcare marketplace.

Proud Foot

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Re: Self Employed Health Insurance
« Reply #11 on: May 17, 2017, 03:55:11 PM »
CrazyDude,

It might not hurt for you to look at and consider joining a Professional Employer Organization .  They could get you on a cheaper group insurance plan but you would have to weigh the insurance savings against the cost of joining.

COEE

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Re: Self Employed Health Insurance
« Reply #12 on: May 19, 2017, 07:29:15 AM »
Why not have your wife work until the baby is born?  Then you can take advantage of FMLA benefits (assuming she meets certain labor requirements) - then at the end of the FMLA time quit.  You keep your insurance the entire time during the birth of the baby if you do it this way.  Your wife will then also have the option of going back to work at the end of the time. 

Some companies offer further benefits when you take FMLA time off.  When I took FMLA, my employer offered me 12 weeks off (I believe mothers got 24 instead of 12), they paid for the first 2 weeks off (mothers were paid 4 weeks), and had vacation sharing programs for the other 10 weeks off.  I ended up taking 4 glorious weeks off with my family.  2 weeks paid 2 weeks unpaid.  And I was planning to take advantage of the vacation sharing program if there were major complications forcing me to extend beyond the 4 weeks I took off.

https://www.dol.gov/general/topic/benefits-leave/fmla

Proud Foot

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Re: Self Employed Health Insurance
« Reply #13 on: May 19, 2017, 07:43:28 AM »
Why not have your wife work until the baby is born?  Then you can take advantage of FMLA benefits (assuming she meets certain labor requirements) - then at the end of the FMLA time quit.  You keep your insurance the entire time during the birth of the baby if you do it this way.  Your wife will then also have the option of going back to work at the end of the time. 

Some companies offer further benefits when you take FMLA time off.  When I took FMLA, my employer offered me 12 weeks off (I believe mothers got 24 instead of 12), they paid for the first 2 weeks off (mothers were paid 4 weeks), and had vacation sharing programs for the other 10 weeks off.  I ended up taking 4 glorious weeks off with my family.  2 weeks paid 2 weeks unpaid.  And I was planning to take advantage of the vacation sharing program if there were major complications forcing me to extend beyond the 4 weeks I took off.

https://www.dol.gov/general/topic/benefits-leave/fmla

Another thing is if she has short term disability.  If she already has it she will be able to receive short term disability payouts but would most likely lose coverage if she quits her job.

FIREby35

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Re: Self Employed Health Insurance
« Reply #14 on: May 20, 2017, 05:47:49 PM »
I'm with Medi-Share. I probably fit in the Alex Cleaver line of, "Great for healthy people." We've  had it since Obamacare resulted in our prior plan being cancelled and significant increases in premiums. We had one child on Medi-share and two on regular plans. Medi-share was by far the cheapest (Christians love babies). We have no pre-existing conditions in the family.

I agree the lingo is weird and the religious part is not my bag, but it has saved us a bundle. It has worked for us when we needed it. Thankfully, we needed it for the baby and not much else.

Finally, although it has been stated to me many times that medical bills sharing is not stable because it is not subject to government regulations, I can't help but wonder if given the political shenanigans it is actually the more stable option because it is not subject to government regulations. I'm just saying.

 

Wow, a phone plan for fifteen bucks!