When you're in HR, one of the things you find yourself counseling friends and family on is how to work COBRA to their advantage when they are between jobs or going out on their own. You know the drill, work the retro period of 60 days, now the grace periods for payment, etc.
And whatever you do, don't have a gap in coverage of over 63 days, because that's how you lose the exemption from the ugly side of pre-exiting conditions. That's just stuff me and my peeps know, because we've seen the drill up close and personal.
Still, if you want to play in the man's COBRA game, you've go to pay to play. That'll be 100% of our cost plus a 2% admin fee. 102% of cost for those of you scoring at home. Which means that many people, especially if starting their own business, seek to find alternatives to COBRA.
Alas, many of them are kicked in the teeth by trying to shop as an individual. Here's your 80/20 PPO. That'll be $1,600 for family coverage. Thanks for shopping!
It's that reality that grabbed my attention on a group of freelancers rallying around the family to get group power on benefits. More on healthcare for clustered freelancers from the New York Times:
"By many measures, the Freelancers Union has been a success — the Brooklyn-based organization has 92,000 members; it provides health, dental and disability coverage to thousands of freelancers; and its founder, Sara Horowitz, won a MacArthur “genius” fellowship.
In mid-November, she proudly announced that the Freelancers Union had set up a state-approved health insurer — the Freelancers Insurance Company — that offered significantly lower premiums and better coverage than freelancers could generally obtain on the open market.
A month ago, Ms. Horowitz wrote to 19,000 members who had obtained coverage through the union’s current plan with Empire Blue Cross and Blue Shield, telling them that they had to choose from the new company’s five health plans — or look elsewhere for coverage. That move sparked considerable criticism, and even inspired a Web site, upsetfu.blogspot.com."
Is it good or bad coverage? As the players in the audience know, the reality is found at the intersection of price and value, and it would seem to be a reasonable deal for the freelancers in question. More from the NYT:
"Certainly many freelancers are happy about the new plans. Molly Pesce found herself in need of health insurance for her family of five after she lost her job as host of the television show “iVillage Live” after NBC canceled it. She was delighted to discover a Freelancers Union plan with premiums of $753 a month, compared with $1,675 a month for her old plan, under Cobra, and at least $1,000 a month for other plans.
“It’s fantastic,” she said. “The Freelancers Union is a group of people who got together saying, ‘Maybe we can get cheaper group insurance.’ ”
Rick Maiman, a freelance photographer, had heart surgery at Lenox Hill Hospital last June that cost $97,000. But all he had to pay out of pocket was $750.
He grumbled that under the freelancers’ new health offerings, his premiums for the best plan would rise by $24 a month, to $455, and his out-of-pocket maximum would rise to $4,000. But he said those premiums were $4,000 a year lower than he could find elsewhere."
Not sure what they're buying, but it feels like a 90/10 PPO to me. So, the next time your family is getting the band back together, sticking it to the man, and needs benefits, tell them to research clustering with a group like this. Just tell them to do what it takes - sell the wide screen, etc. - to avoid a 63 day gap in coverage....
