Benefits consultants Hewitt Associates says its research indicates that more than 60 percent of workers will simply default to the choice they made the previous year. This may not be the best choice. If you do not make a choice at all your employer may choose for you and they will probably pick the option that saves them the most money but may cost you more. Here are some tips that were detailed in the business section of our local paper.

1. Do your homework and seriously evaluate all benefit options and weigh them against your specific needs. Look over what you did last year and see where you could improve other than not ever getting sick. In other words – did you put enough dollars in your flexible account, did you use docs covered under your plan, how much did you spend in co-pays and out of pocket costs. Most employers can provide access to past medical and dental claims so you can estimate what the costs this year might be.

2. Think about any life changes that may affect the benefits you select this year. Are any of your dependents no longer eligible for coverage or will you have a new dependent.

3. Use the tools available to you. Many employers offer health care cost estimators that allow employees, to comparison shop for health insurance by evaluating two or more health care plans at a time. Users an compare monthly premiums, co-payments, deductibles and coinsurance payments.

4. Read the fine print. More employers are changing the rules of the annual enrollment process, and it’s up to you to make sure you fully understand if and how those rules may affect you.

5. Assess your family’s needs. More companies are requiring employees to pay a bigger portion of the cost of coverage for their dependents. You should assess if your spouse or partner can get coverage under an employer plan. It may be more cost effective for each of you to take coverage under your own employer health plan if that option is available.

6. Consider participation in health and wellness programs, like smoking cessation, weight management or physical fitness. It could improve your health and save you money.

7. Take advantage of tax free benefits like flexible spending accounts and dependent care spending accounts.
Looking to save money on your car insurance too? See our post on Cheapest Cars To Insure

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According to the article, a good place to start is a Web site run by the Georgetown Univeristy Health Policy Institute, www.healthinsuranceinfo.net Click on your state, and you can get summary information on consumer protections and what private insurers may and may not do. When considering the options for personal health insurance, experts recommend focusing on protecting yourself against ruinous medical expenses and worry less about having your routine expenses paid. It’s better to take the high deductible and get good coverage for the big problems, than get one that pays for routine visits but has limited coverage for major events like surgery.

You should also look for a policy that is renewable at your option. A lot people buy a temporary policy because they assume they will get a job and be able to drop the individual coverage. Experts say though if you don’t find a job or have permanent coverage by the time your 6 month policy expires, you could have a problem renewing. If you have no claims, you can renew but if something happens 3 or 4 months into your policy, you only have coverage for a few more months. Then, when you try to renew, you can’t. Temporary policy are a risk and should be avoided if at all possible.

You should look at internal caps and limits the policy may contain. What is the lifetime maximum the policy will pay? Experts say ideally there should be no limit, but $2 million should be the least you should accept. But then there is the premium. To get a sense of range of premiums for your particular profile you should go to a website that quotes insurance rates. I like  http://www.bestquoteus.com/best-individual-health.html 

Finally, if a policy looks good, you should find out if the insurer will sell it to you. In most states, that decision rests with the insurer. Different carriers have different rules so you should shop around. But according to the article, if you are refused coverage, ask your state insurance regulator if there are companies offering “guaranteed-issue” policies for which you can’t be turned down. The downside is that these policies are expensive.

As I mentioned finding individual health insurance  can be a difficult and frustrating experience. But this is a situation where you really need to persevere because there is nothing more important than your health.

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Why doesn’t everyone choose COBRA when they are in this situation? Because you now have to pay not only your share of the insurance premium but the part that your employer was paying and possibly a two percent administrative fee. Our local newspaper reported that the amount can be over $1,000 a month for a family, based on the average cost to employers of $12,000 per employee for health insurance last year. The article also noted that only about 20 percent of workers who were eligible for COBRA chose the COBRA option.

What the article said that I found interesting was that if you had a good plan at work, you should take the COBRA, because it is likely to be better than anything you can get from the individual health insurance market. Insurance experts say especially if you have a pre-exisiting condition – take the COBRA.  If you take the COBRA option it not only gets you the coverage you are used to but it also “preserves your right to buy insurance.” Keeping up your coverage with COBRA makes you “HIPPA-eligible” when you enter the individual market. HIPPA stands for the Health Insurance Portability and Accountability Act of 1996. The HIPPA requires states to have at least two policies available with pre-existing conditions exclusions.

If a state doesn’t have those two policies available, then it must set up an assigned risk pool. Assigned risk pool means insurers in the state share the coverage for people unable to buy a policy on the open market. Some states regulate what the assigned risk pool can charge as a premium but other states do not.

The other important thing the article mentioned was COBRA  and HIPPA have deadlines. It said you have a right under the law to COBRA benefits, but you lose that right if you fail to exercise it within 60 days of the termination of your group coverage. You have 63 days from the expiration of COBRA coverage to apply for HIPAA-eligible coverage.

Check our post on individual health insurance at bestquotes.com best-individual-health-plan

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