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Individual or Company Insurance
Apr 21, 2012

I currently work for a small company that doesn't offer health insurance (they did increase my salary to compensate) however I am still covered under parents insurance. My employer is currently thinking about a company policy. (4-5 employees) If the company does a group plan will they be able indirectly figure out my health status? Would it better for me to shop for my own coverage?

Response from Mr. Chambers

A good question, and as in most situations the answer "depends."

First, in what state do you live? In some states, although insurance carriers are required to accept everyone regarding of their health in an employer sponsored group health plan, some states allow the carriers to ask health questions of employees of small groups so they can set the rate, usually limited within a limited range.

If that is the case in your state, the problem is that the enrollment form is usually turned into your employer and they can see your health issues right there. Otherwise however, there is virtually no way the employer can learn details about what treatments you are receiving and why.

The drawbacks to employer provided coverage is that you are at the mercy of the employer. If they want to switch to a poorer (read cheaper) health plan, you have to go with them. If they decide they can't afford to continue the program and terminate it, your choices are limited on what plan you can continue.

If, however, you are being treated for being HIV+, you will not be able to purchase individual health coverage for any plan requiring health questions on the application.

If you have been without health insurance for at least six months and are otherwise uninsurable in the health insurance market, each state has set up a Pre-Existing Conditions Health Plan (PCIP) that you are eligible to join. You can learn more about them here. Click on Find Your State.

With individual coverage, you have more control of your benefits, but you have no control of future rate increases and your medical condition will continue to limit your ability to change plans, although that problem will hopefully end with the implementation of the Affordable Care Act in 2014.

You can learn more about them here

Good luck, Jacques



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