Finance Forward
Tips, Tricks, and Insider Peeks into the Finance Industry May, 2009
Dear Terry,

Continuing our review of health insurance in the U.S., here are some notes about employer sponsored group insurance. Next issue we will review new options recently available for individuals and families.
 
The Cost of Employer Funded Health Insurance 
This benefit is no longer free, and costs continue to climb.
According to a recent survey by Professor Paul Zane Pilzer, the average cost of employer funded group health insurance in the U.S. is $14,000 per person. And yet you can purchase your own individual plan for an average annual cost of $2,076. (See Appendix A.)
 
Worse yet, costs have been increasing 15% per year, and this has been passed on to employees in the form of larger employee contributions. In addition, employers have significantly reduced their contributions for the employee's spouse and children.
 
Should you consider purchasing your own individual or family policy? Each case is unique and it depends on several factors, including the percentage of the total cost being paid by your employer, and whether or not you have serious pre-existing conditions.
 
Many people will realize savings if the employer is contributing less than 50% of the total cost. It often makes sense to obtain a separate policy for the spouse and children, as many employers only contribute a small portion of this cost. Some employees obtain their own policy as insurance against losing their jobs. Which brings us to the next topic... 
   
 
If You Lose Your Job... 
... what happens to your health insurance?  
The COBRA Act of 1985 requires an employer-funded plan to offer continuation of coverage for 18 to 36 months. The rub is that this coverage is usually very expensive, as we discussed in the first article.
 
If you lose your job, you have up to 60 days to apply for COBRA coverage. You then have up to 45 days to pay your first premium. Meanwhile, you are covered during this 105 day period. If you suffer a major health crisis during this period, and before you have obtained new coverage, all you have to do is pay your COBRA premium to access your coverage.
 
The HIPAA Act of 1996 is extremely important to employees who have a family member with a serious pre-existing condition. With regards to changing employers or losing your job, HIPAA generally does the following:
 
1. Guarantees continuous health insurance coverage for a pre-existing condition if it was covered by the previous employer.
2.  Limits to 12 months the time period a new employer can exclude a pre-existing condition if the previous employer did not cover it.
3. Requires each state to offer some type of coverage with no exclusions for pre-existing conditions to those who have exhausted COBRA coverage.
4. Prohibits discrimination against employees on the basis of their health.
 
Losing your job would be very painful but, let's face it, it happens. If it happens to you, pay close attention to the requirements and time frames surrounding continuing coverage and pre-existing conditions, Also, start your research now into individual health insurance policies, so that you have all the facts in front of you, if you have to make a quick decision.
 
BudgetLife.com, on the Internet since 1996, provides consumer services for mortgages, insurance, and annuities. As independent agents, we have access to hundreds of lenders and life insurance companies. So consumers will always receive the absolute best deal available for their financial needs.
 
Best wishes from our family to yours,
 
All The Burts
BudgetLife Financial Services
(800) 505-9412
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