So, after always having health insurance choices made through work or school, we’re running our own company (in downstate NY, if that makes a difference) and need to get a policy.
We’ve done a lot of research on what different things mean (doesn’t mean we understand what different things mean), but are still faced with the rather daunting challenge of picking the “right” company with the “right” package of services.[sup]*[/sup] Figuring that there are a lot of self-employed family members on the boards, and that there are a lot of people posting questions about starting businesses and whatnot, this would be a good place to turn for insight, recommendations, horror stories, or advice. Anyone?
Thanks,
Rhythm
[sup]* There are cutesy quotes around *right * because we realize there is no such thing—everyone has different priorities and whatnot. That’s why this is here in IMHO and not GQ.[/sup]
We are buying policies right now too, my husband got laid off and we can’t afford the COBRA, plus he is thinking about working for a small business so we might have to pay for our own then anyway. If you can get a good agent that helps a lot. We have someone giving us recommendations and advising us how to apply. There are so many plans out there that I was overwhelmed on my own.
We ended up getting a high-deductable policy that covers a few well visits up front. My husband got denied coverage from 2 different companies because he used to take wellbutrin for ADHD (over 2 years ago, but any history is enough to get denied, apparently). We ended up buying a short-term policy for him that is renewable for up to 6 months. So be aware that if you don’t have perfect health you can have trouble getting coverage. Also things like maternity and prescription riders are not included, and very expensive. Often you have to pay for them for a while before they kick in.
If you get a high deductable plan you can start an HSA to save up for your deductable. Some plans offer to start one for you in the application. If you have full time employees you may be able to qualify for a group plan, then you get better coverage and they don’t make you do the health history, but those plans can be expensive. If you are the only employee then you can’t buy a group plan, unless the rules are different in NY.
I guess my main advice is get an independent rep to help you. I can usually figure out insurance speak and such, but I was so confused after reading 10 different policies that I needed someone to help me, plus she was able to steer us clear of companies that she knew were difficult to work with.
First off, congrats on the new business. Best of luck to you in future success with that.
Now as to insurance…a disclaimer. Though I am a licensed health insurance agent, I’m in california and not overly familiar with what all is available in New York or New York law regarding health insurance.
That being said, there are a few basic question I go over with new prospects.
How often do you use medical service? A good gauge of of this is to look at the last 5 years and see how often you go to the doctor, have you been hospitalized, been to the emergency room, do you take prescriptions?
Are you more interested in a lower monthly premium or lower out of pocket costs when you use medical service? (the answer to question 1 helps on this one)
The answers to those two questions can help narrow down what you’re looking for, if you use a lot of medical service you want more comprehensive coverage (low or no deductible, good hospital coverage etc), if you don’t use much service and want lower monthly costs you can look at higher deductibles, HSA plans or more limited coverage. You might also want to contact your accountant and see if you qualify for a section 125 (cafeteria) plan if you’re running the plan through the business. If you have other questions feel free to ask.
I’ll tell you this: New York has some fucked up laws regulating health insurance. You’re probably going to end up with an HMO, that’s about all that’s left in the state.
Heh, why does that not surprise me? Let me tell ya, CA law is no picnic either. Plus our insurance commissioner is running for lt. governor and resigning as commissioner…I’m not sure I really care for either of the two that are up for the job.
