1. Understand how medical underwriting of small
group plans differs from those of individual and family plans: If
you apply for a small group health insurance plan the insurer will
medically underwrite your policy, which means they'll review the
health status of everyone on the application order to determine what
to charge you each month for your coverage.
Health insurance plans for families and
individuals are also medically underwritten, but if the insurer
determines that your medical risks are too high they can deny your
application for coverage.
The benefit of buying individual or family
coverage is that those plans are, on average, approximately
sixty-percent less expensive than group plans(2). The downside is
that applications for coverage can be denied.
2. Understand how small group plans differ from
family plans: Family plans are typically designed for one or two
adults and any children or "dependants" you may have. Once children
turn 18 they're usually no longer eligible for your family plan
unless they become full-time college students. Full-time students
can stay on a family plan until they graduate; different policies
have different age caps for college students.
A small group plan requires at least two people in
most states, and the second person can be a spouse, provided they're
an employee of the business. Insurance companies require proof of
employment, which means you may have to provide some form of
documentation.
3. Understand the tax advantages/disadvantages
between small group plans and individual/ family plans:
eHealth is
not qualified to provide tax advice, but there are few basic things
you should know. Individual and family health insurance products are
typically not tax deductible, even for the self-employed.
On the other hand, if you have a small group
health insurance plan the money you spend on premiums for yourself,
your employees and any dependants can often be tax deductible.
A licensed health insurance agent can answer basic
questions about the tax treatment of small group health insurance
premiums in your state, as well as at the federal level. If you have
detailed questions about the tax treatment of different types of
health insurance policies and how they'll impact your business it's
also a good idea to consult a tax expert.
4. Get the basics on HSAs and Business HSAs:
Health Savings Accounts (HSA) are tax-advantaged accounts you can
use in conjunction with qualified high-deductible health insurance
plans. HSAs allow you to deposit a portion of your pre-tax income
into an account which can grow tax-free and use those funds to pay
for qualified medical expenses.
You can find more information on HSAs at
eHealthInsurance's HSA Resource Center.
Find an HSA plan that's right for you.
5. Understand how pre-existing conditions can
impact your eligibility for individual and family plans: If you live
in New York, New Jersey, Massachusetts, Maine or Vermont, you cannot
be denied individual and family health insurance coverage due to
pre-existing conditions.
In other states your health insurance may be
medically underwritten and you could be denied private coverage.
But, it's important not to assume you won't qualify. Some
pre-existing conditions can, and are, insured every day. A good
agent can direct you to carriers that are more likely to provide
coverage to you even if you have a moderate pre-existing condition,
like a back problem or asthma. If you do not qualify for coverage,
we encourage people to contact the eHealthInsurance call center at
1-800-977-8860 or to contact the Foundation for Health Coverage
Education at www.Coverageforall.org. Experts at eHealth or the FHCE
can help you find free or low-cost alternative sources for medical
coverage when mainstream options are not available.
About eHealth eHealth, Inc. (NASDAQ: EHTH) is the
parent company of eHealthInsurance, the nation's leading online
source of health insurance for individuals, families and small
businesses. Through the company's website, http://www.eHealthInsurance.com,
consumers can get quotes from leading health insurance carriers,
compare plans side by side, and apply for and purchase health
insurance. eHealthInsurance offers thousands of health plans
underwritten by more than 180 of the nation's leading health
insurance companies. eHealthInsurance is licensed to sell health
insurance in all 50 states and the District of Columbia. Through its
eCommerce On-Demand solution (eOD), www.ehealth.com/eOD, eHealth is
also a leading provider of on-demand e-commerce software services.
eHealth's eOD platform provides a suite of hosted solutions that
enable health plan providers and resellers to market and distribute
products online. eHealth's eCommerce On-Demand solution is currently
available to health plan providers in all 50 states and the District
of Columbia. eHealthInsurance and eHealth are registered trademarks
of eHealthInsurance Services, Inc.
(1)Results from an ongoing survey administered
from eHealthInsurance Services' customer care center. Beginning in
February 2008, eHealthInsurance began emailing a voluntary survey to
any customer calling in to its customer care center.
(2) The sixty percent statistic was calculated
using data from the Kaiser Family Foundation's 2008 Employer Health
Benefits survey, which reported, "In 2008, the average annual
premiums for employer-sponsored health insurance are $4,704 for
single coverage and $12,680 for family coverage." That data was
compared with eHealth's 2009 Summer Cost Report for Individual and
Family Policy Holders, which showed that in February 2008 the
average premium being paid for an individually purchased health
insurance plan was $159 ($1,908 over 12 months) for an individual
and $369 ($4,428 over 12 months) for a family.
* Kaiser Family Foundation's 2008 Employer Health
Benefits survey: http://ehbs.kff.org/pdf/7790.pdf
** eHealth's 2009 Summer Cost Report for
Individual and Family Policy Holders:
