30 Second Insurance Tips©

Tip #337 – Individual Or Group?

With the start of the Open Enrollment Period (OEP), last week’s Tip focused on the limited choices consumers have in the individual market.
Not surprisingly, we’re getting inquiries from small businesses that previously haven’t offered an employer sponsored health plan. Consider:
  • In the individual market, a single male age 37 earning $42,000 would pay about $205 for a high deductible plan with a limited provider network ($420 premium minus a $215 tax credit).
  • If a group plan is offered, the business owner must pay at least 50% of single coverage; on average, about $225/month. And, that would be for a solid Co-Pay plan with a broad PPO network.
Look at that. From the employee’s point of view, it’s about a push on cost but for much better coverage.
Here’s another twist; in some cases, a group can be just one person, if at least one other full time employee is offered coverage but waives.
The Affordable Care Act requires insurers to accept all applicants for both individual and small group plans, regardless of pre-existing conditions. As noted last week, the OEP for individuals ends December 15.
A small group plan however, can be started any month.