Are you a 1099 contractor, a real estate owner or a small business owner? This information is for you.
“So sorry Ma’am, I can’t help you.”
“You’ve got to have more than 2 employees to qualify as a small business for an ACA plan”
“Yes sir, your health insurance premium IS more than your mortgage.”
If you run a small business, you have probably heard these words from the “1-800-dial-one-for-english-lines you have called during the open enrollment season.
Since ObamaCare went into effect premiums have grown for the small business owner by a whopping 75%. Thankfully, there have been a few changes to help compensate for the lack of funds that so many are currently facing, we will discuss these below.
The most common thing that business owners do is call the marketplace and look at ACA plans. These plans are designed to be all-inclusive as they are Government/State approved, and for many people with pre-existing conditions are a fantastic option. However, one of the biggest struggles for anyone with under 10 employees is the high payment, the high deductible, and, depending on which plan a business owner may choose, can severely limit the doctors covered in the plan.
Purchasing an HMO versus a PPO (read more here)\
HMO: Have to stay within the network and usually requires a referral from your primary care Dr.
PPO: You can go to any Dr or Hospital without the need for a referral from your primary care physician.
Individual Private Plans- that are customized plans designed to your specifications as an individual. This option is becoming much more common among 1099s, and for W2’s who have under 40 employees. The payouts are very high and can be written off-your-business as an expense and with the same tax benefits as an ACA plan. The cost is usually significantly lower than an ACA plan for anyone under 10 employees and can be added at any time during the year, in or out of open-enrollment.
The deductible is usually $0 to $1,000 depending on which plan you choose. It can be up to a 3rd less in cost than an ACA plan. And nearly all of them are a PPO, which allows the employees to go to any Dr or hospital that they choose. The caveat here is that each person has to be underwritten, which means it takes your pre-existing health history into consideration for premium amounts. If someone is generally healthy this is a great option for folks with minimal health issues like high-blood-pressure. These plans can also help supplement a high-deductible plan for individuals who are already on an ACA plan. This is the way of the future for many, and a great option for small business owners who are struggling with high payment plans.
Shareplans: Shareplans are designed to work outside the general rules of health insurance and are treated more like re-imbursement plans. Patient goes to the Dr. Gets treated and is reimbursed by the shareplan for their treatment. It’s a system that tends to work very well in theory but there have been a few cases where it is simply not the most feasible option for folks. Especially if those individuals have a pre-existing condition. Most shareplans will NOT accept pre-existing issues. I have found however, that a lot of shareplans are a great option for people with Lyme disease and diabetics as most shareplans will cover alternative treatments. It is also a good option for extremely large families who cannot otherwise afford standard health insurance plans. The other downside is that shareplans do not get the same write-offs or tax benefits as an individual and ACA plan.
There are many paths to getting insured, and unfortunately the best ones are often the least obvious. That’s why it’s important to work with an insurer who understands the market as well as your individual needs. As a small business owner myself, I can help guide you through the process and to the ultimate best decision. It’s my priority to help people in your exact position, so reach out to Good Faith Health Insurance today and schedule a personal, one on one consultation.