To make a very long story somewhat shorter, I have a job offer from a small law firm on the table. It is generally a quite attractive offer for a number of reasons, but as I haven’t worked for a small employer for quite some time, there are a couple of things Í have questions about.
First, health insurance: the employer apparently offers an individual rather than a group plan, for which I have to be screened by the insurance agent, but for which the employer pays the premiums. How do individual plans in Illinois work re: preexisting conditions? (I have no idea what the coverage is as yet, and plan to ask, but would like to have the other info first.)
Second, profit sharing: I’ve never worked for a company with a profit-sharing plan, though I know they are somewhat common among smaller companies in this field. How do they work, or does it vary too much from one employer to another to be able to generalize?
What else should I be asking? I have a call in to a former colleague who knows this employer professionally, so I can do some intel, and will probably delay my decision until after I have an interview tomorrow with another firm in any case, but still want to iron out some of these details, preferably before I go into this other interview.
The profit sharing thing is going to vary a LOT by employer, I doubt we could be of much help there.
Individual insurance plans also vary. Some companies do pre-existing conditions (or, as I like to call them, pre-enrollment conditions, since they didn’t really exist before they existed, just before you enrolled). Some don’t. Sometimes it’s up to your employer.
Well, I’m mostly concerned with Federal and/or Illinois law, and what can or cannot legally be excluded, provided an employer offers health coverage at all. FTR I have had continuous group coverage for 10 years, which is about as long as it’s been since I worked for a small employer, and so I have no clue what the practical differences are between group and individual coverage.
I am mostly concerned with the prospect of catastrophic medical expenses. I’ve been burned before, but it could have been much worse; almost 10 years ago, I shattered my left tibia and fibula in a stupid accident, 2 days before my health coverage took effect at my new employer. Thos 2 days cost me several thousand dollars out of pocket, but if IL law hadn’t required group plans to provide coverage for preexisting conditions, I would have been stuck with probably $100k in medical bills and probably would have had to declare bankruptcy. THAT’s the kind of thing I’m worried about, not $20 for my albuterol inhaler.
I’m pretty sure that under the Federal COBRA law, if you have had prior group insurance within the last 60(?) days, that they cannot penalize you in any way for pre-existing conditions. IANAL YMMV
That’s what I’m thinking, as well. Continuation of coverage laws I think mean that they can’t dock you for pre-existing conditions in our plan (in Ohio). BUT, not a lawyer. Not an expert.
As for profit-sharing, I can only say what my company does, where the profit-sharing is based on profit (sorry for the duh moment) and there’s a rate established for each position with premiums for crew leaders, etc. and penalties for things like missed time.
I just got a profit sharing check this morning. Go fiberglass!
I ain’t a laywer. And I’m not current. I think that pre-existing conditions can be a problem with individual policies, in a way that they’re not with group policies. It’s not a company-provided plan, it’s just the company paying your premiums? That sounds like a bad set-up from the company’s point of view… and yours. For one thing, the premium amount could be viewed as taxable income to you, if I’m understanding this.
From the perspective of a patient, there’s not much difference between group and individual coverage: that is, the benefit levels can be the same. You’d want to know about things like maximums (annual and lifetime), what’s actually covered, what the coinsurance rates are, and so forth. From the cost/premium point of view, there’s a huge difference.
It would be cheaper for the company to set up a group plan. You can do so with as few as five individuals – or that used to be the minimum. Group rates are MUCH cheaper than individual rates, by a factor like 20% or more. So, it would be cheaper and easier (and possibly better tax treatment) for the company to set up a group plan.
On profit-sharing, there are several different arrangements. And lots of variation among companies. There’s cash profit-sharing where the profits are distributed as taxable cash at the end of the year. There’s deferred profit-sharing, that works like a 401(k), where the profits accumulate until retirement, and tax is deferred until you receive the payments. That’s a very good deal, depending on the amount of company contributions. You should also check the vesting schedule: what happens if you leave the company?
Would you be able to ask the employer what the name of their medical insurance company is? If it’s anything like what I had (Medical Mutual’s SuperMedOne), those policies are made for individuals and have nothing to do with groups or businesses so you can find out everything you need to know online. Ultimately you just have the bill sent to your employer.
Before we got a group plan, our 3 employees here had single coverage. I didn’t “manage” it per-se but I suggested it to everyone and I wrote the checks for it every month. We all had to apply ourselves then just put the company as the billing contact. It was sort of expensive but waaay less than COBRA for me. The way we did it was that the employee was not taxed on those payments and it did not come out of their paycheck but I may have been bending some law with that, who knows.
I do recall I was turned down initially because I wrote on my app that I took birth control for PCOS. They didn’t like that. I spoke with someone at the insurance company that said “is that documented that you have PCOS?” and I said not really and she said to leave it off. So if you DO have a problem signing up - talk to someone. Don’t just lie - get them to tell you to lie
Anyway I got turned down and I don’t remember being asked about previous insurance (which was COBRA) but it may be because I wasn’t getting COBRA from my previous job, it was because I’d graduated college.
My thinking is you’re going to have to apply yourself and get it set up yourself, and your employer will consider it a “fringe benefit” to pay it for you.
I can’t help with medical insurance or profit sharing, but do take the time to check on the financial status of the firm, and its general reputation overall. I’m sure they’re OK, since law firms don’t tend to be fly-by-night or professionally unethical outfits. But “do your intel,” speak with your former colleague, and make sure however you can that this firm intends to be in business for a while.
I’ve been burned once in the past for not doing my homework this way. Many years ago, the small PR business I joined proved to be a bad place–their ethics were few, their accounts were fudged, and the owner was looking to sell the business to whomever would be dumb enough to buy it. Anyway, a couple of pay cuts, then some bounced paychecks, and I decided it was time to get out. So I did.
It wasn’t a law firm (I’d hope, in spite of the common perception, that a law firm would be more ethical), but it was a bad experience overall. Since then, I’ve been very careful about working for small businesses, and I’ve looked as far as possible into their financial dealings as well as their professional reputations before signing on officially. Most have been fine. But that one… I could have avoided some tough times had I avoided that place.
I’ve done some intel, and the attorney in question is very highly reputed, both in terms of professional abilities and in terms of ethics. And as far as ethics, in law one has the advantage that an attorney can potentially be disbarred for unethical or fraudulent behavior. This attorney has been in the business a long time (though for most of it, not in solo practice), and I haven’t turned up any complaints about her ethics. I’m not worried about that as much as the possibility that the insurance company would come up with some insane exclusion for preexisting conditions. I have no reason to believe that any preexisting condition will rear its ugly head and cost anyone a significant chunk of change, but it sure would suck if that did happen and I weren’t covered for it.
Sounds like you’re well set up then; at least, in the “doing your homework” regard. Whatever your decision turns out to be, I hope that everything turns out well for you. Good Luck!
I run a family resturaunt and we indiviudual coverage in Illinois so I know about this. COBRA has limits.
First you need to ask will your new employer cover your insurance or do you share cost. COBRA generally provides that continued coverage from group plan to group plan. It does not provide group to individual. BUT what COBRA says is you can take the group plan your company has an use it as your own individual insurance.
What we do since so many of our employees are part time and don’t get coverage, if someone wants it, we let the employee find an individual plan and if it’s reasonable we pay for 90% of the cost.
You need to check on pre-existing conditions. IF and IF your new plan has an exclusion period it will normally be for one year. What you do is you KEEP YOUR COBRA and pay for that AND you start your individual plan at the new company. COBRA is good for 18 months. So after 12 months you quit COBRA and the individual plan kicks in.
IF there is an exclusion and the new company wants you, I bet you could get them to cover the cost of your COBRA payments AS WELL as the new insurance. Just remember most insurances do not allow dual claims. So while you could have TWO insurances you could only submit a claim to one of them.
Also if you need coverage, check to see that your new company is eligable for COBRA so if in the future if you leave you can get that. Small companies, under a certain amount of full time employees don’t have to offere COBRA.
One last thing, this was awhile back, I applied for a position in a hotel, and they told me to get an individual policy. When I got one and applied they went back and found out I had an HIV test and denied me coverage. Back then they could do that. I used to work till 3am, so one night I got sick and went to the Emergency Room. At that time (though not anymore) everyone in IL was given an AIDS test, that went to the ER. Somehow that information is on a file somewhere and still is. Although the law is changed IF and IF you have had a condition DO NOT LIE about it, because somehow these things are tracked and if the insurance company finds out you lied, they can not only not cover you for that condition they can revolk the entire individual policy
This has not been my experience. When I started working for CAT I signed up for their “company sponsored” health insurance. The company paid all suitable claims and was my “primary” insurance. I also had Kaiser coverage through my husband’s job. Dual-coverage. Only did this for a little while, my company used to FULLY PAY for all insurance for their employees - only having the employee pay if there were dependents.
Worked GREAT with dental visits, what one insurance called my deductible, the other would pay. So the primary would pay their typical 50-80% and then the secondary would get a bill for the remainder, of which then they would pay their 50-80%. Going to the dentist at that point in my lfe had never been cheaper. I think the insurance companies actually made money on me!
FF to the birth of my first son. At that time I had my own company sponsored Kaiser plan, as well as the DH’s Kaiser “family plan”. Kaiser’s accounting dept was absolutely stupid for about a year. They’d send me several billings, I think they totalled over $30K. When I’d receive say, a $9000 bill for a part of the birth, they’d rattle off how I actually owned closer to $30K. I’d call them and tell them yet again about the dual coverage, that I owe nothing and they needed to secondary bill “themselves”. It got fixed, eventually, and I did in fact owe nothing.
Dual coverage was a great thing, cash wise.
I’ve never had “individual coverage” unless you count the comletely company sponsored coverage. I’d talk directly to the insurance company and request all their docs defining “pre-existing” and amount of coverage. Prolly available online if they’re a halfway decent-sized company.
The offer provides that the new employer will pay the premium for the insurance. I have no idea what the coverage is yet - I also have an interview with another company this morning, which I’d previously scheduled, and will talk to the first company once I see what happens with the second interview. If anyone can think of a way to word some of these questions when I do talk to the first employer, by all means, let me know!
The practical issue here is how do I check on preexisting condition coverage without a) first accepting the offer, or b) revealing any info about my medical history? Like I said, I have no reason to expect that I will require massive medical expenditures for any reason, but if I did because of any past issues, no matter how long ago they occurred, it would really suck not to have them covered.
Yeah, I could keep COBRA, but it’s likely going to cost a chunk of change; I left my old job very recently, so I don’t even have the numbers yet, but I imagine at least $300 a month.
They are far too small to be covered by COBRA. Illinois has its own state insurance continuation law; I have to check into that and see what size employers it covers and how it works, and whether it covers individual vs. group plans.
How long ago was this? That’s generally not the case anymore, nowadays, insurance companies look at thow whole bill, deduct their amount, and leave you with the rest. Paying for 2 insurance companies, in general, isn’t as helpful as it used to be.
So I had my other interview this morning, and while I was still on the bus on the way home, the senior partner called to say they wanted to make me an offer. It was a tad better than my other offer, so I accepted, and it’s a larger firm, so the group vs. individual insurance issue isn’t relevant anymore.
I’m still kind of curious about the answer to this question, though, so feel free to chime in if you have relevant info.
