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Health Coverage for Traders


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Health Coverage for Traders

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  #1 (permalink)
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Currently trying to budget for this and having kids it is a big issue for me. What are full time folks doing on this front?

I know that the ideal structure for group health under new laws is 10-50 employees and was wondering if folks had ever created a corp/association for traders to avail themselves of the benefits of hitting a group plan in that sweet spot?

Anyone have any recommendations on coverage, policies, structuring etc.? Is it best to form a company and get a small business group plan so pre-exstings and coverage cant be dropped?

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  #2 (permalink)
Market Wizard
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I have a health insurance business and while it looks like you are in MD where I am not appointed, I could answer your general questions and point you somewhere beneficial.

In IL 2 qualify as a "group". However almost all 2 person groups are created because someone will not qualify for individual/family coverage. Group health insurance is typically WAY more expensive than comparable and similar individual coverage.

The major carriers in IL will not write an "association" group. In many cases that language should be a warning that you are looking at an indemnity plan NOT major medical health insurance. Additionally there are quite a few items that are required to create a group. That means the grey areas that you might think would allow you to get it done are quite black and white.

Depending on your state there will be sponsored options that your kids may qualify for. Also, if you are a sole prop and making some money an HSA compatible plan will give you a decent above the line deduction to agi (tax break).

Most states have a plan for people that have exhausted COBRA continuation benefits and have no other access.

As far as the children and pre-ex go...because of PPACA Obamacare the carriers must issue coverage the includes all children regardless of pre-ex....but it will probably cost more than an arm and a leg as the idea like most of that "law" where terribly ill-conceived. Remember that some pre-ex for adults will have a waiting period of 12 months so it is better to have the rest of you covered than none of you at all.

There are a few conditions that are deemed "auto-decline" meaning that the carrier will not issue coverage at any price.

If you want to talk specifics of your situation send me a PM. I'll try to help sort things out if you like. DB

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  #3 (permalink)
annapolis USA
 
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wow - what a response. thanks. Can one trust individual retail health plans?

Reliable (ie a carrier that wont drop you if you or your kid gets some aweful disease) health coverage is all that i am really concerned about.

What type of retail plan would you recommend? High deductible with very high catastrophic coverage and limits?

I would have thought group plans were cheaper on balance.

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  #4 (permalink)
annapolis USA
 
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looks like you have a lovely family congrats....

What is the best state for broader backup coverage? I am domicile agnostic and already leaning toward florida for tax/asset protection reasons.

Since you are a health guru is there a country you recommend? would love to live in the UK time zone for their trading hours.

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Market Wizard
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are guaranteed issue, meaning that they can NOT eliminate coverage for pre-ex. So their risk profile generally is wider than plans that can just say no.

Also maternity MUST be included in group where that is often an elected coverage on the individual side.

The FIRST consideration should always be...Is the carrier a name I recognize and is that a name I can trust. Next you look for info on how they pay their claims...an easy way to do that is ask the billing person at your docs office who is best and fastest paying there claims? Who is the easiest to deal with for you? Those two questions will generally reflect the culture at those companies. The giant companies generally have too much to lose by jacking people around.

IDK about which plan type because IDK your specific situation financially or health wise.

Generally if you are earning or have a bit of money and are reasonably healthy I would say that you want to align your position in the relationship as closely to that of the underwriter at the carrier. They spend millions to do the math that prices their product in a way that should maintain their margins.

My family has Blue Edge Individual HSA 2600 individual ded/5200 family deductible with 80% co insurance. We have had that plan since 2004 and just now pay $500 per month in premium.

We contribute the legal maximum to our HSA account to grab the best tax advantage possible. I invest the HSA balance in SPY and occasionally use options for that purpose. When my market assumption is strong I pay my medical expenses with my regular check book and let the tax free HSA deposit accrue. When I don't have any idea or suck at executing I use the tax free dollars to pay claims under my deductible.

Smallest, most manageable expense footprint (premium) and the greatest option for other advantage to include lower agi and a nice tax deferred market return.

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  #6 (permalink)
Market Wizard
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greenroomhoo View Post
looks like you have a lovely family congrats....

What is the best state for broader backup coverage? I am domicile agnostic and already leaning toward florida for tax/asset protection reasons.

Since you are a health guru is there a country you recommend? would love to live in the UK time zone for their trading hours.

you must be a friend of someone in my inner circle or a government agent.

Without question domicile in Argentina and apply for citizenship in Uruguay.

* Argentina between Euro and NY so you get the MEAT from both sessions ...perfection.

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  #7 (permalink)
annapolis USA
 
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next time im in chitown on business i owe you dinner....

interesting so you basicly go out of pocket for basic maintenance and pay that with pre tax cash...

"IDK about which plan type because IDK your specific situation financially or health wise."

3 kids family in perfect health so far no pre-exists.. know that wont last.

"Generally if you are earning or have a bit of money and are reasonably healthy I would say that you want to align your position in the relationship as closely to that of the underwriter at the carrier. They spend millions to do the math that prices their product in a way that should maintain their margins. "

I dont understand "align your positoin in the relationship as closely to that of the underwriter at the carriers"?

Argentina - LOL - Ill float that by the boss. another state is going to be a tough sell but i guess i could just give her the option of getting a full time job and see how that flies.

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  #8 (permalink)
Market Wizard
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you should be set.

Go to the Blue Cross Blue Shield of Maryland site directly. Do NOT type your personal information into a collection site on the net....you will get 5 calls before a minute passes and those agents are generally not sage experienced pros.

You can purchase directly from the carrier and I would recommend that unless you have or can identify a trusted adviser in your local community. Do not integrate with the carriers HSA. Use HSAbank out of Sheboygan WI or someone like them....where their ONLY business is HSA accounts. You national or local bank will SUCK as far as information and service. At HSAbank, I think they have a selection of brokers that you can link too.

Choose an initial deductible that does not cause you or your wife undue stress if you had to write a check to cover that amount. Move your deductible higher every year as your deposit balance in the HSA account grows until you have the 5000/10000 deductible. Start with that plan if you can swing the maximum deposit of 6000 and 4000 from another source if you had a big claim. The idea is to keep your money in your control and optimize the benefit you get from your effort.

By being on the same side as the actuary...what I mean is they have access to all the data. Their job is to look at historical claims and the breadth of their risk book and determine rates for each product that round their business in a way that meets their margins.

A simple statement that the average claims per person is running about 1400 per year should point you initially to the first deductible higher than that.

If you look at the cost in premium versus the additional risk of a higher deductible you should get a basic view of the sweet spot for consumers.

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  #9 (permalink)
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Some communities have a Chamber of Commerce, sometimes they offer health coverage for their members. You would just need to join your local Chamber. Not all offer this service so check first.

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Market Wizard
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typically indemnity plans. They may be major medical but be careful of indemnity plans.

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wldman View Post
Those are typically indemnity plans. They may be major medical but be careful of indemnity plans.

You've mentioned this before. Can you eloborate on the difference between indemnity and major medical?

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Market Wizard
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An indemnity plan typically is one that pays a specific fee per service. Historically they have not been bad per se...as long as the consumer understands that in many cases most of the financial liability stays with them not the "insurance company".

Today many plans like this are aggressively marketed as low cost health insurance insurance, when they are neither low cost or actually insurance.

You might see the phrase accepted at ANY hospital...that is the bait. The actual benefit might be something like $500 per ER visit and $300 per night in a hospital. The doctors services are paid on a rate scale that can leave huge claims as the responsibility of the consumer.

Generally they are marketed as "group insurance", that is because they make you join an association to qualify. They will say that there are no pre-existing condition exclusions or waiting periods and that is generally true.

Generally there is a separate deductible for each covered individual for each covered service.

The plans are what they are and they do have their place. Sometimes the legit indemnity plans are called mini-med plans. Often though the sales people represent the plans as if they where comprehensive major medical plans like those offered by say Blue Cross Blue Shield, Humana or United Healthcare.

There is a ton of info on the wen about what to look out for.

This link takes you to the exposed scams that have been very popular. Mega Life Health Insurance Complaints, Scams, & Lawsuits

Again the plans are what they are and they do have a place but they are often marketed in a way that is way beyond omission of detail.

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A while back a trader recommended checking out the Free Lancers Union for health insurance. It maybe for New Yorkers only. But it appears, according to their latest blog post, they are eventually going to offer CO-OP insurance services in a few states: NY, NJ, OR.

It might also be worth mentioning there may be more CO-OPs opening in other states in the near future thanks to the health care reform law.

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