Health Insurance?

[riser4]

i am somewhat english, yates is a surname for gatekeeper.

i'd appreciate it, if you would not insult my mothers profession,

and the four generations behind her.

thank you.

What ain't no country I ever heard of.

[DBdude]

Are you still in Boston? Looks like we're moving to Westport if we don't get divorced or someone gets murdered first. I think the company will work it's probably about a year early for a person of your caliber right now though.

Here's their site, it's only been up for a week or so, there's issues but they will get fixed: 2betties.com

good luck!

[Conundrum]

Okay, not posting drunk from a late night taco bar so I can think a little better. The following advice may not work in your state due to states regs but worth looking into. Looks like your east coast and I've only done work in western states so you'll really want advice from someone who knows the state rules you're playing by.

Went to your wife's website. Looks like they are both working there which is perfect. Most states require two employees for an employer based plan. Some insurance companies require a SUTA form (quarterly unemployment filing showing taxable wages). For start ups, some companies will let you slide with articles of incorporation and reports showing a few cycles of payroll. If you think an employer plan is an option you want to consider, your wife will probably want to set up payroll sooner than later. Insurance companies require this documentation to prevent people like your family claiming an eligible business just to purchase an employer plan instead of going with an individual plan.

Employer plan premium is a business expense write off for taxes, you will get better benefits for less premium, usually a more comprehensive provider network, and depending on wages/salaries, under 10 employee groups can qualify for the SHOP small business tax credit. More details than I want to type but it could be huge for you so google the requirements to qualify and the incentive. If your wife formed as an S-Corp, you'll want to get your accountant on the phone as well.

Steve is correct. There are non-compliant ACA plans. Short term/gap policies and the are also some shyster companies selling minimum essential coverage and catastrophic plans that don't meet minimum value for ACA so you open yourself up to the tax penalty for no coverage which can be pretty steep depending on your household MAGI. All ACA compliant plans are on the exchange but you can generally purchase direct from the company if you know you won't be receiving subsidy. The subsidy is based on future income so you have to estimate. If you don't have much taxable income, you could get a fat subsidy. Too low, and you might be below subsidy level so you qualify for Medicaid. If your state, didn't expand their Medicaid offering, you're fucked and have to pay full premium to get a plan.

Also sounds like COBRA won't be an option unless her company is leaving the plan in place as part of the severance. If they dissolved and discontinued the health plan, no option there.

[DBdude]

i don't qualify for subsidies on VT Connect (OBama care, silver plan) and when I have looked into it, it was cheaper than Cobra and a comparable plan. I had a really good plan through that employer. I went without for six months

If I had to do it now, and I might, the silver plan, is better and cheaper than the Cobra plan I would be eligible for

[iceman]

Above and beyond, Cono, thanks.

[riser4]

Go with the Republican plan: Don't get sicks.

[iceman]

It doesn't matter what this year's income is because the ACA subsidies are based on what you predict your next year's income will be. This happened to me. I had a higher income, then it went down and I had to write a letter with a detailed explanation to the ACA telling them why my income was going down and doing my best to predict what it would be.

There's a little more to it...when you register for the ACA coverage, you need to select the option about having a "life changing" event or something like that, i.e. job loss, decline in income for whatever reason. If you don't do that, they won't read your explanation letter and they'll keep sending you notices that you're not qualified (based on your previous year's income).

Good luck with it. If you have no income next year, and you can convince them that's the case, you'll have some damn cheap health insurance for the time being.

Belated shout-out, thanks for your help.

[iceman]

Go with the Republican plan: Don't get sicks.

I was thinking about that as I never get sick. However I seem to fall on my head with some frequency so I think some coverage would be advisable.

[yeahman]

Belated shout-out, thanks for your help.

No problem, I've been buying through the exchange for several years so let me know if you have more questions. In general my experience with the healthcare.gov bureacracy has been not too bad.

[iceman]

@ anyone: BTW, do't get cowed into stuff you don't need in the ER. I got knocked in the head, that shit has happened to dudes all throughout history. But I had two CT scans, an MRI and a cerebral angiogram, I haven't seen the bill yet, they're apparently still adding it up. It must be a fortune. I needed some stitches and an ice pack. Yeah they didn't know it then but still.

How you figure out what you need is a good question I don't know the answer to. But I was awake, alert, and didn't even have a headache so it seems like it was excessive to me. But whatever.

[Cono Este]

Don't cheap out on Health insurance. Think of all the stupid bills you have and think of this as an umbrella policy. You're not getting a subsidy and you don't want to trigger capital gains on anything restructuring your portfolio, just be glad you have it and know you are probably on the winning end of the deal

Check your doctors and your drugs, then call carrier direct and get a silver plan if you have any considerable meds. The results will speak for themselves.

When you get on medicare, buy the best priced plan g in your state, look up your meds on medicare.gov and don't answer the phone for the 6 month around your 65th b-day.

[iceman]

65 is a few years off but thanks. I am all about solid healthcare, I've paid out of pocket for 10years for my GP, i'm fine with it, I'm mainly concerned about big events and the big bills associated with them. Like what happened a month ago.

[jono]

I bought insurance at the end of last year knowing I was staring at a big bill in 2017 (for chemo etc.) Agent advised me to go with a reasonably cheap plan with a low(ish) out of pocket max since that number was basically a given. I was a little surprised, but for most of the year that cheap plan has turned into 100% coverage. A more expensive plan would have just meant delaying the max out of pocket for maybe a month or something.

If you're really only concerned about big stuff it might be worth noting how big those items could be and planning to pay your max (if it comes to that) or pocket some savings on premiums. In my case I think it was a bronze HSA, but of course that's with a little advance knowledge that isn't typical.

[digitaldeath]

Lol

Op say

Should we do Obamacare?

[riser4]

I was thinking about that as I never get sick. However I seem to fall on my head with some frequency so I think some coverage would be advisable.

Ya. I agree. I was being sarcastic anyway. Maybe you should wear a helmet? I'd say watch six but I think for you, it's watch straight up 12. :0 Just busting. Best of luck man. I think most of us are closer to having to think about shit like this then we would like.would like.

[::: :::]

tis the season

I just got the annual "your health plan is not available next year" bullshit

they reduced coverage yet again and bumped the premium

$705/mo two years ago
$937/mo this last year
$1,018/mo proposed for next year

my yearly cash outlay went up 45% over two years, and my coverage has been decreased severely

now, there will be zero coverage for out-of-network on next year's "equivalent plan"
almost everything goes to my deductible first -- what the fuck am I actually paying insurance for?




fuck me

are there ways to get in on group health even tho i work for myself?

[wooley12]

We're shopping for our Med Advantage plan and thinking of buying a more expensive and better plan. I got this in the mail today. What are they trying to tell me?

[Conundrum]

tis the season

I just got the annual "your health plan is not available next year" bullshit

they reduced coverage yet again and bumped the premium

$705/mo two years ago
$937/mo this last year
$1,018/mo proposed for next year

my yearly cash outlay went up 45% over two years, and my coverage has been decreased severely

now, there will be zero coverage for out-of-network on next year's "equivalent plan"
almost everything goes to my deductible first -- what the fuck am I actually paying insurance for?




fuck me

are there ways to get in on group health even tho i work for myself?

Most states require two employees to form a group plan. Not sure about Oregon. A group plan is a way better option. If they need two employees (working more than 30 hrs/wk on average), they ask for proof that there are two. You might find a broker local to you and see if there are any options. If nothing else, you might look into offering yourself an individual premium HRA depending on your business structure. Here's a little info: https://www.shrm.org/resourcesandtoo...lone-hras.aspx You'll probably want to get a CPA involved here.

[Conundrum]

We're shopping for our Med Advantage plan and thinking of buying a more expensive and better plan. I got this in the mail today. What are they trying to tell me?

That plan comes with a free T-shirt that says "If you can read this, the bitch fell off"

[::: :::]

Most states require two employees to form a group plan. Not sure about Oregon. A group plan is a way better option. If they need two employees (working more than 30 hrs/wk on average), they ask for proof that there are two. You might find a broker local to you and see if there are any options. If nothing else, you might look into offering yourself an individual premium HRA depending on your business structure. Here's a little info: https://www.shrm.org/resourcesandtoo...lone-hras.aspx You'll probably want to get a CPA involved here.

there are actually two of us -- I assume W-2's are proof
i did not know that was an option
I will ask about it
thx!

[Conundrum]

there are actually two of us -- I assume W-2's are proof
i did not know that was an option
I will ask about it
thx!

If there are two, you should be good. They will ask for payroll records or a quarterly SUTA form. You're in OR right? Pacificsource is a group carrier in OR and ID. On their applications, they require a census of full-time employees that you complete and sign so you really don't even have to provide proof. Not sure if they're competitive premium-wise though. Depending on claimed annual salaries and how the business is owned, you might qualify for the SHOP tax credit for two years as well. Check this out too: https://www.healthcare.gov/small-bus...s-tax-credits/

[::: :::]

i just found the SHOP stuff
we don't qualify because we are partners (& family members to boot)

i'll check into pacificsource

[Conundrum]

i just found the SHOP stuff
we don't qualify because we are partners (& family members to boot)

i'll check into pacificsource

If the family members don't live at separate addresses, the insurance companies can be sticklers of proof of income but it's doable.

[::: :::]

not sounding all that positive

all the group health websites I find do have listings for "1-50 employees" but i'm getting the sense that partners don't fit that mold

our office is us - two partners who are the "employees" w/ appropriate documentable paystubs
but we do not employ anyone else

[Conundrum]

You might be in luck. As owners, you might be able to provide K1s as proof. Plus it looks like 1-50 so they might allow your partner to waive for other coverage so you might not disrupt what they're doing if they already like the plan they have.