- 3,384
Lately I am starting to see more and more employers dropping group health coverage. It's kind of scary right now.
Individual vs. Group Question
- Thread starter asianguy86
- Start date
Lately I am starting to see more and more employers dropping group health coverage. It's kind of scary right now.
- 17,048
Speaking from personal experience as a consumer, I would never want group coverage again unless it was a last resort.
If you have individual coverage and at age 40 you get cancer or another serious health condition, you still have your health insurance whether you can work or not. It's also MUCH more portable if you want to change jobs.
Group coverage is very limiting (employment-wise) and will end if you get serious health problems and can't work.
I'm no expert in health insurance but it's my opinion that group is ALMOST always more expensive then comparable individual IF you buy the individual coverage when you are healthy.
If you have health concerns, group is the better deal.
If you have individual coverage and at age 40 you get cancer or another serious health condition, you still have your health insurance whether you can work or not. It's also MUCH more portable if you want to change jobs.
Group coverage is very limiting (employment-wise) and will end if you get serious health problems and can't work.
I'm no expert in health insurance but it's my opinion that group is ALMOST always more expensive then comparable individual IF you buy the individual coverage when you are healthy.
If you have health concerns, group is the better deal.
- 2,103
Health ins. became a "must have" benefit somehow, for the employee, when in reality, the employee is actually extremely lucky to have a job at all, let alone a job that offers health insurance.
- 4,096
CA is tough.
Here in Indiana a small group can get .650 if they are healthy but a max load is 1.35.
I just wrote a 4 life group with a diabetes that pushed the rate to 1.01 which increased the premium $700+ a month for the group. The employer decided to go with the plan because the person with the health condition was a key employee.
This employee could not get an indiviudal plan or I would have put them all on indiviudal.
Here in Indiana a small group can get .650 if they are healthy but a max load is 1.35.
I just wrote a 4 life group with a diabetes that pushed the rate to 1.01 which increased the premium $700+ a month for the group. The employer decided to go with the plan because the person with the health condition was a key employee.
This employee could not get an indiviudal plan or I would have put them all on indiviudal.
- Thread starter
- #15
asianguy86
New Member
- 12
Sorry guys, I'm fairly new to this business and have some questions
Dave,
What are RAFs?
Newby,
Are you saying that if you have group coverage and then you get sick and can't work anymore, then you wouldn't be able to purchase individual health insurance cheaper like you would if you had individual health insurance when you were healthy and then became sick and renewed your individual health plan?
Also, what is the deal with COBRA? Don't they kick in if you were to lose group coverage.and do they include preexisting conditions?
Also for group coverage, do they typically cover preexisting conditions because i know that individual health insurance such as United don't always cover preexisting conditions?
Dave,
What are RAFs?
Newby,
Are you saying that if you have group coverage and then you get sick and can't work anymore, then you wouldn't be able to purchase individual health insurance cheaper like you would if you had individual health insurance when you were healthy and then became sick and renewed your individual health plan?
Also, what is the deal with COBRA? Don't they kick in if you were to lose group coverage.and do they include preexisting conditions?
Also for group coverage, do they typically cover preexisting conditions because i know that individual health insurance such as United don't always cover preexisting conditions?
Last edited:
- 9,744
That's the Royal Air Force, silly....
- 3,384
Her Majesties Royal Air Force..Rule Brittania..wot wot 
RAF= Risk Adjustment Factor. This is the percentage of the standard premium a carrier charges on group business. Example, 1.10 is 110% of standard premium or a 10% rate increase above the standard. In CA, RAF on small groups ranges form .90 to 1.10 so + or - 10% of the standard premium depending on risk.
As to an earlier post, group-->COBRA/MiniCOBRA-->HIPAA. Most people experience an increase in premium from group/COBRA to HIPAA.
RAF= Risk Adjustment Factor. This is the percentage of the standard premium a carrier charges on group business. Example, 1.10 is 110% of standard premium or a 10% rate increase above the standard. In CA, RAF on small groups ranges form .90 to 1.10 so + or - 10% of the standard premium depending on risk.
As to an earlier post, group-->COBRA/MiniCOBRA-->HIPAA. Most people experience an increase in premium from group/COBRA to HIPAA.
- 2,103
I have seen people's premiums on cobra go higher than Oprah's paycheck. Well, not that high, but fairly high. When in cobra, that's when people start shopping for individual. They had no clue it was going up that high when they left, retired, got laid off, whatever.
- 3,384
Yes, but only because they are paying 100% of the premium, well actually 102% on federal COBRA. People are so insulated from the real premium cost of their group coverage, it is only when the go onto COBRA that they find out just how much the employer was paying.
- 4,132
It's going to depend on what state you write business in. Can you tell us what that is so somebody can actually help you?
In my state, everything is guaranteed issue. Individual is medically underwritten and group is not. Rates for group are not as bad as individual, they actually in most cases are better. We have a high risk pool for people who can't score low enough on the state mandated health questionaire (327 questions) if they stay under the points system, they can get individual coverage from a provider. IF they can't they go to the pool which is more expensive but still far far better than "NO".
We also offer portability (wing walking) for coverages and in several situations you can go from group to individual without health screening.
But again, what state are you in? Then somebody can help you rather than confuse you....
In my state, everything is guaranteed issue. Individual is medically underwritten and group is not. Rates for group are not as bad as individual, they actually in most cases are better. We have a high risk pool for people who can't score low enough on the state mandated health questionaire (327 questions) if they stay under the points system, they can get individual coverage from a provider. IF they can't they go to the pool which is more expensive but still far far better than "NO".
We also offer portability (wing walking) for coverages and in several situations you can go from group to individual without health screening.
But again, what state are you in? Then somebody can help you rather than confuse you....
Similar threads
