Hits & Misses – 2009/6/1
Solution to pre-existing conditions problem: In some states you can start a business and become a one-person group.
Obesity update: financial rewards don't work. [Study gated with abstract.]
Cooking has evolutionary survival value: something even Darwin didn't think of.
I hear all the time that the insurance agent is a “friend” and made a married couple a group of 2 so they could get health insurance. I just show them they both have to work 30 hours per week to keep their insurance. If one person gets too sick to work they both lose their insurance.
If a group of one has a heart attack and wants to sell his business can he keep his group of one insurance?
Ron, what would you suggest as an alternative for these couples, given that they don’t qualify for individual coverage?
At least in CA they can fall back on HIPAA coverage if they no longer qualify as a group.
A one person group is a joke. It is a ruse to allow individuals to buy insurance in the small group market where there is guaranteed issue. Allowing sick people to buy insurance at the same premium paid by healthy people is not a solution to the social problem. It only makes the problem worse.
Bart, when I switch them off a group of 2 they qualify for Individual Medical (IM). Why do you insist that everybody on dangerous employer-based health insurance is uninsurable?
If the wife is 5’7″ and tops the scales at 250LB we will add a rate-up but she is insurable. When she gets down to 204LB we will take the rate-up off. Then she can stuff herself again because once the rate-up is removed it can’t be added back on. Same with smoking.
I tell people get low-cost portable health insurance so if they get cancer they will be safe. These insurance salespeople that sell these dangerous groups of 2 have not been trained properly.
Ron, to answer your question, I never have. If they can find better coverage in the individual market, they should certainly run with it.
Why do you insist that everybody with employer-based coverage is insurable in the individual market? And if they are insurable, why would they consider a group of two in the first place?
Bart, they get a group of two because some smooth talking insurance agent sells it to them without full and proper disclosure. That’s why you need a good health insurance agent Bart.
I never said that everybody on dangerous employer-based insurance is insurable. Rush Limbaugh with his drug problems would probably have some issues when it comes to insurability. That’s an understatement.
So only people with drug problems or other moral shortcomings are uninsurable. Thanks for the clarification.
Bart, I never said “only people with drug problems or other moral shortcomings are uninsurable.”
When someone gets cancer, like Tony Snow, and they are too sick to work they they are terminated off their dangerous employer-based insurance and they are uninsurable for low cost portable individual health insurance. As it should be. This is exactly the reason a couple should not be a group of two.
Bart, is there anything you can understand?
…and then they have a valid reason to shop as a group of one or two. I’ll pass on the ad-hominem.
Bart, do you suggest that the insurable spouse join the uninsurable spouse on the group of two?
The article said, “Sara Brown, a 51-year-old massage therapist in business for herself, didn’t think she could qualify for group health insurance when she moved to North Carolina from California last year. But after an insurance company quoted her an individual policy that cost $1,200 a month and excluded coverage of her anxiety disorder, for which she takes daily medication, she sought help from Maura Carley, president and chief executive of Healthcare Navigation LLC, a Fairfield, Conn., firm that provides health-insurance advocacy for individuals, families and businesses.
Ms. Carley showed Ms. Brown that she was able to qualify for group coverage as a “sole proprietor.” Now she pays $800 a month for comprehensive coverage. “Group coverage is the only way to get coverage you can possibly afford” with a pre-existing condition, Ms. Brown says.”
An anxiety disorder did not make her uninsurable as the article states. With her anxiety [rate up] HSA individual insurance is available in Charlotte, N.C. for $354.75 per month instead of the $800 she is paying. Yes, the anxiety medication would be a covered expense.
The N. Carolina high risk pool would cost her $426 for HSA qualifying coverage.
It’s all online, check it out.
http://www.nchirp.org/
“Group coverage is the only way to get coverage you can possibly afford” with a pre-existing condition, Ms. Brown says.”
Ms. Brown is wrong even after her “expert” advise.
Unless you disagree Bart.
> Bart, do you suggest that the insurable spouse join the uninsurable spouse on the group of two?
Not without good reason. There doesn’t appear to be one here.
NC Plan A, which might be more comparable to her comprehensive group policy, was $786. $1,037 if she smokes. Hopefully she won’t get cancer and fire herself.
The individual insurance is $354.75 per month so she would save $445.25 per month or $5,343 a year which is higher than the decreasing deductible.
Bart once you save more in premium than the size of your deductible it’s impossible to lose. Trust me, her group of one has co-pays and out-of-pockets as well.
It’s simple math, individual insurance is a wiser move than the group of one. I’m sure her group of one doesn’t keep her rates constant for 24 months like the individual insurance does either.
Ron, I agree with much of what you say. But not all of it.
Bart, I strive to bring clarity to complexity. What did I say that you disagree with?
I do think the UAW employees are being scammed into paying $1,400 a month for dangerous employer-based family health insurance when the security of HSA insurance is available for $198 a month in the free and open markets with a 24 month rate guarantee.
The UAW employees will buy anything. They must be knee deep in ShamWows.