Copyright 2006 Lisa Ip
If you are a sole proprietor or small business owner and require health insurance for you or your employees, there are many options available that will provide coverage for a reasonable premium. You will, however, be required to carry out a good amount of research before finding an insurance company that will suit your needs, as there are a lot of choices out there. In addition, you have to ensure that the company you choose for your health insurance coverage provides the kind of plan that will be most beneficial in times of greatest need.
Individual Health Insurance
Individual health insurance is coverage intended for one person. If you are self-employed or run your own business, you don¡¯t have access to a group health insurance plan through an employer, and must purchase your own coverage from one of the many health insurance providers located in your state.
There are some pitfalls to obtaining your health insurance from the private sector. For instance, limitations exist that might make it difficult to derive guaranteed benefits from a private insurance policy as an individual. Private companies have a right to ask you for information regarding your current and past health, and are also allowed to reject you for insurance purposes based on your health status, or impose limitations on your coverage.
Blue Cross Blue Shield, on the other hand, is required by law to sell individual health insurance to any resident regardless of health status. This is referred to as guaranteed issue. They must also refrain from charging you more due to any current or preexisting conditions ¨C this is called community rating. HMOs are also required to sell health insurance to any individual during the 30-day open enrolment period that occurs each year.
Individual health insurance policies can vary depending on the company. There are no laws that force private companies to offer the same health insurance products so coverage plans from different providers can offer quite different coverage. But certain benefits for health insurance must be provided in the coverage, including mammograms and diabetes care.
Group Health Insurance
For small employers (2-50 employees) group health insurance plans are a good idea if you want to provide adequate coverage for yourself and your small group of employees. According to guaranteed issue, insurance companies must sell small employers small group insurance under most circumstances. If you and your group fall within the participation requirements you cannot be turned down. An employee is considered insurable if he/she works for you a minimum of 24 hours a week on a regular basis ¨C this includes household workers.
Usually a group health insurance plan requires that a certain percentage of your employees participate in the plan and you might have to contribute a minimum percentage of their premiums. Luckily, guaranteed renewability makes it so that you cannot have your coverage cancelled if one of your workers becomes ill. This is definitely a plus so you always have access to continuous group coverage and are never left by the wayside without the proper insurance.
HMOs and Blue Cross Blue Shield, again, are prohibited by law from charging more due to the health status of one or more employees. At the same time, private companies are allowed to charge higher rates if they deem it necessary.
In addition, someone who is self-employed with no other workers may be able to purchase small group health plan coverage from Blue Cross Blue Shield. Specifically, sole proprietors are given the option of buying ¡°group-of-one¡± policies from this organization. Other insurers also offer this type of coverage but are not required to offer it. You are a sole proprietor if you: are a resident of your state, work at least 30 hours a week and gain at least 50% of your taxable income from your business.
In addition, self-employed individuals can have 100% of their health insurance premiums deducted from their federal income tax. If you are a member of a professional or trade association you might be able to receive group coverage under the organization¡¯s insurance umbrella.