I thought I knew what to expect.
After all, I spent over 30 years working for providers, insurers, and employee benefits consulting firms.
- I understood the high cost
- I knew I wouldn’t have as many options
I am like the doctor who has become the patient. The other side of the bed is painful.
Health Insurance Nightmares
The following are the three worst things about buying your own health insurance (from my perspective).
#1 – No Help Paying Premiums
When you purchase your own insurance, there is no help paying the premium (unless you receive a tax subsidy from health reform).
As much as people complain about their employee benefits, it still trumps you paying for it all yourself.
People love to ask the worst part about being a freelancer. My answer (like many small business owners) is paying for health insurance.
I knew that going in, probably better than most, but I think it doesn’t have to be so painful. Which leads me to my other worst rankings.
#2 – Not Having the Same Tools
Because of my experience in the employer group market, I know about some great tools for managing health care.
- Employee Assistance Programs (EAPs) that offer free, confidential counseling and assistance with work/life challenges
- Wellness incentives that reward individuals who take certain healthy behavior actions
- Interactive enrollment tools that personalize the experience for the individual
I know employers sponsor many of these perks. I didn’t say it was a rational complaint. Just something I hate about individual insurance.
Because the E in EAPs stands for employees − and an employer pays for the program − I understand why I have no access to an EAP.
On the other hand…
Wellness incentives that promote healthy behavior benefit both the individual and the insurer. So, why doesn’t the individual have an opportunity for lower premiums or deductibles in exchange for a qualifying action?
Interactive enrollment tools that personalize the tasks for the individual do not need to be exclusive to employer group plans. There are far too many innovative, techie people out there who could help.
- Hello Healthcare.gov.
- Are you listening?
#3 – Incomplete Information
The lack of transparency in health care and insurance is an industry-wide problem. However, as an employee, you typically have access to online or print material that provides all your options.
When you purchase your own health insurance, you have to jump through hoops to get the information you want. Let me give you an example.
Supplemental insurance products
You know the Aflac duck? It quacks about short-term disability insurance.
Additional products like hospital, accident, cancer or critical illness policies, help fill in the gaps left by large deductible health plans.
If you think those are great policies but wonder about the cost, you sacrifice your phone number to a sales person to obtain that information.
- There are sites (and really good ones) that offer side-by-side comparisons but only for certain products
- Most public health reform marketplaces aren’t there yet for offering supplemental policy comparisons
As a licensed broker (who no longer sells/services insurance), I support working with a broker. However, what I have found is supplemental products are often confined to a specialist and feature only one company’s product lines.
Kiss Your HR Staff
Okay, maybe a handshake would be more appropriate than a kiss in the workplace.
If you are an employee who has employer-sponsored benefits, your human resources (HR) staff help bring you what you need.
- Employer’s contribution towards premiums
- Tools for enrollment and health care management
- Information to make informed decisions
Maybe I should fire my HR person. Oh wait, that’s me.
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Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.