Group Does Not Have Any Major Med,only Reimburses for Indie Plans

[jonaldomo]

I'm talking with a county government and find out that they do not offer major medical for the 42 employees on a group basis. They do however reimburse 50% of a max up to $125 for any individual plans that they purchase.

I am relatively new and was wondering if there is anything wrong with this idea.

Also are there any other arrangements that can be made so that everybody has access to major medical?

Thanks in advance.
John

 

[ABC]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

First you need to check with your state laws to see if that is legal. Some states will not allow an employer to contribute to individual plans.

The other issue is since the employer is contributing to the individual premium is this now considered an employer sponsored plan? If it is then someone could comeback on the employer and say they were never offered coverage and sue.
They would have a legit case.

Since you are dealing with a county Gov. There is a reason why they don't have a group health plan. Ask questions to the controller and you will find out why.

You can set up a major medical plan. Its called a group plan.

Good luck

 

[djs]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

Now I'm curious???? What county only has 42 employees?
Depending on the state regs, there can be a lot of problems with using IFP when group is called for, ESPECIALLY with 42 employees. 5 of these are probably uninsurable on individual plans.

Dan

 

[jonaldomo]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

First you need to check with your state laws to see if that is legal. Some states will not allow an employer to contribute to individual plans.

The other issue is since the employer is contributing to the individual premium is this now considered an employer sponsored plan? If it is then someone could comeback on the employer and say they were never offered coverage and sue.
They would have a legit case.

Since you are dealing with a county Gov. There is a reason why they don't have a group health plan. Ask questions to the controller and you will find out why.

You can set up a major medical plan. Its called a group plan.

Good luck

ABC, I agree with you. I see the legal issue. The problem is that the county only wants to spend $125 per person per month. So what would you show them a HDHP/HSA? Could you even recommend a HRA that they put $125 a month in?

djs, what is even more interesting is that I am in contact with a couple of other counties who do not have anything in place with fewer employees. My only pitch to them is a group HSA. Right?

Thanks guys.

 

[djs]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

If you want any real advice, you need to tell us what state you are in. Different states, different rules, different solutions.

Dan

 

[somarco]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

What county only has 42 employees?

I think Mayberry only had 3.

Sheriff, deputy and mayor

 

[ABC]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

ABC, I agree with you. I see the legal issue. The problem is that the county only wants to spend $125 per person per month. So what would you show them a HDHP/HSA? Could you even recommend a HRA that they put $125 a month in?

djs, what is even more interesting is that I am in contact with a couple of other counties who do not have anything in place with fewer employees. My only pitch to them is a group HSA. Right?

Thanks guys.

Ok
For $125 a month the only plan that might work for you is a Hospitllization and surgical plan. Understand the product before you pitch it. You

You need to know what you are talking about when you meet with this client. Hook up with your carrier reps. Tell them you have a 42 life group you need some advice on. They should meet with you even though you are a rookie. 42 lives will get most small group sale reps off there a$$. You need to have atleast a census on the group and be able to get a face to face meeting.

Forget HRA's or HSA's due to cost.

Like I said before there is a reason why this group does not have a group health plan.

 

[djs]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

I think Mayberry only had 3.

Sheriff, deputy and mayor

Mayberry is a town (or at least was). Raliegh was in the county, so I assume they still had at least 42 county employees. Of course, this was all back when government had a different role than it does today.

Dan

 

[warrenins]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

Ask for advice and don't give the details. Someone might "steal" it. What a waste of energy.

 

[jonaldomo]

Re: Group Does Not Have Any Major Med,only Reimburses for Indie P

Ask for advice and don't give the details. Someone might "steal" it. What a waste of energy.

sorry guys, didn't mean to get you so worked up. it is a county in missouri. i have been having problems loading the insurance-forums.net so i gave up on checking it at the end of last week.

thanks for the advice.