I guess this is the best forum for this question.
After paying our own health insurance for almost thirty years, we can no longer afford it. My rep with the Western Pennsylvania Small Business Association called to tell us about the new rates going into effect on July 1st. The plan we have is going up 87% to over $3000 a month plus co pay.
So we need to find alternatives by the end of June.
Any suggestions?
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Health Insurance Update
Back in May, I posted about health insurance because we had just received notice that our plan was going up to over $3,000 a month as of July 1st. The previous year, we had taken a reduced rate plan and we were paying just over $1,800 a month instead of the $2,200 a month our insurance was to go up to, but even that turned out to be almost impossible to manage, more than once leaving us with the thoughts of bankruptcy.
Highmark (Blue Cross) in Pennsylvania has what's called "guaranty issue" which is a reduced rate program that doesn't use preexisting conditions as a qualifier. The rate we are now paying with our converted plan is $1,118 a month plus deductible and co pay. We've also found out the hard way that anything considered mental health isn't covered, like sleeping pills and Valium along with some other more expensive medicine.
Now for the issues. We canceled our old group plan with the SMC (small business of Western PA) almost a month before July 1st when our plan was to change. We actually faxed in our cancellation from the Highmark store where we were signing up for the new plan and we wrote a check for the first month. We were told that the coverage was uninterrupted. Thinking we were insured, I had two major tests done in July not realizing that there was a 28 day "gap" in our coverage, the new policy not taking effect until July 28th. During the "gap" period, we were to continue using our renewal policy insurance cards and everything was to be covered.
Highmark screwed us. What we didn't realize was that the renewal plan we had canceled but still were supposed to be billing against had a deductible which we were responsible for, though the plan was canceled. And when Highmark saw our cancellation of our previous group policy, they reinstated our group with a new phantom group number which some of the tests and medical work got billed against requiring us to meet a deductible there also. So during that 28 days in July, we're ending up having to pay at least twice what our monthly payment would have been. Had I know this, I would have scheduled my tests in August instead.
I am sorry Larry. It seems for those of us taking care of our own insurance it is getting more difficult instead of easier. Now we are going to be taxed on company medical benifets as well. Each state is different, and it is difficult to get a straight answer from insurance companies. When I have called insurance companies before they tell me they can only read the info to me and I have to interpret it myself. Good thing we are paying for a call center to read for us.
Larry Berman > Melanie RolfesNovember 2, 2010 at 11:09am
Have you checked out your local Chamber of Commerce? We became members and then were eligible to be part of their "group." Didn't even have to pay to join the Chamber -- we gave them artwork for their office. I believe the Best of Missouri Hands has a policy, or connections for artists to join a group. I remember a newsletter of theirs a year or so ago where several resources were listed. At one time I had a "direct" policy with Blue Cross here in Michigan which was very reasonably prices.
Don Crozier, a member here, very active in BOMH, may also be able to lead you to an answer.
Egads! Was this group or a family policy? I know that Colorado mandates business insurance for groups as small as one so you can get the group rate. I am fortunate enough to have insurance through my husband, but folks I know out here make their plans "affordable" by going with high deductible policies ($10K deducible and higher), but they still have premiums in the $600 to $800 per month range. The popular one out here for that is Anthem Blue Cross. We also have a "fall back" in Colorado through the state where if you can't afford an individual plan or get turned down for pre-existing conditions you get on the state sponsored group plan, but the premiums are still $600 plus per month from what I've heard. But it is better than the $3K per month you were quoted. Does your state have a similar plan? It might be worth a few phone calls.
Replies
Back in May, I posted about health insurance because we had just received notice that our plan was going up to over $3,000 a month as of July 1st. The previous year, we had taken a reduced rate plan and we were paying just over $1,800 a month instead of the $2,200 a month our insurance was to go up to, but even that turned out to be almost impossible to manage, more than once leaving us with the thoughts of bankruptcy.
Highmark (Blue Cross) in Pennsylvania has what's called "guaranty issue" which is a reduced rate program that doesn't use preexisting conditions as a qualifier. The rate we are now paying with our converted plan is $1,118 a month plus deductible and co pay. We've also found out the hard way that anything considered mental health isn't covered, like sleeping pills and Valium along with some other more expensive medicine.
Now for the issues. We canceled our old group plan with the SMC (small business of Western PA) almost a month before July 1st when our plan was to change. We actually faxed in our cancellation from the Highmark store where we were signing up for the new plan and we wrote a check for the first month. We were told that the coverage was uninterrupted. Thinking we were insured, I had two major tests done in July not realizing that there was a 28 day "gap" in our coverage, the new policy not taking effect until July 28th. During the "gap" period, we were to continue using our renewal policy insurance cards and everything was to be covered.
Highmark screwed us. What we didn't realize was that the renewal plan we had canceled but still were supposed to be billing against had a deductible which we were responsible for, though the plan was canceled. And when Highmark saw our cancellation of our previous group policy, they reinstated our group with a new phantom group number which some of the tests and medical work got billed against requiring us to meet a deductible there also. So during that 28 days in July, we're ending up having to pay at least twice what our monthly payment would have been. Had I know this, I would have scheduled my tests in August instead.
Larry Berman
Digital Jury Services
http://BermanGraphics.com
412-401-8100
Larry Berman
Digital Jury Services
http://BermanGraphics.com
412-401-8100
Have you checked out your local Chamber of Commerce? We became members and then were eligible to be part of their "group." Didn't even have to pay to join the Chamber -- we gave them artwork for their office. I believe the Best of Missouri Hands has a policy, or connections for artists to join a group. I remember a newsletter of theirs a year or so ago where several resources were listed. At one time I had a "direct" policy with Blue Cross here in Michigan which was very reasonably prices.
Don Crozier, a member here, very active in BOMH, may also be able to lead you to an answer.