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770-449-7369 / Fax: 770-449-1093 info@cdainc.net

As economic uncertainty puts many of our jobs at risk, health insurance coverage has become a major concern.  Some of us are fortunate enough to have continued coverage provided by our employers even if we are being furloughed or having our hours reduced.  Others are not so lucky and are scrambling to keep health insurance in force.

There are six immediate options right now, some are better than others. First, if we have at least 2 people in our company a primary option will be to review a group insurance medical plan. There are certain circumstances where we can enroll as a 1-person group, but that 1 person cannot be the owner of the company. Fortunately, there is one carrier who is willing to enroll husband/wife only groups as long as the company has an additional employee (even if that employee will not enroll in the plan.)  If you believe this may be a possibility, contact our office at your earliest opportunity to begin the discussion.

As a second option, we can enroll in one of the Affordable Care Act (ACA) compliant programs through Ambetter, Anthem BlueCross, Care Source, KaiserPermanente or, on the western side of Atlanta, Oscar. Be vigilant in seeing whether we must access care through the facility system that exists across the greater Atlanta area and / or if our providers participate in the network of the carrier we select.

Our third possibility, for those who own a business, is to enroll in a PEO that offers medical coverage (not all PEOs offer medical coverage). We will be medically underwritten, so we will have to exhibit good health, but this is proving to be an opportunity for expanded health plan designs and competitive premiums. This proposal will require a thorough conversation to determine suitability.

A growing group of religious-based programs is offering a low cost alternative to medical insurance. Those who choose to enroll must share the faith, lifestyle, and health requirements of the group. Some plans are contracted with large provider networks, but it can be entirely up to the consumer to negotiate payment with providers or dispute claims. The claims processing/paying procedure is also different from what the majority of us are accustomed to, so please conduct good research before opting into one of these plans. There is no insurance or re-insurance built into these programs, so our office does not participate with this coverage option.

A fifth option is to enroll in a short-term policy. Individuals will need to qualify through medical underwriting at the time of application and will also need to account for pre-existing conditions limitations, exclusions and the possibility of being declined outright. Although the premiums are dramatically less expensive than Affordable Care Act compliant policies, please read carefully the details of how these plans differ from the traditional coverage we are used to as these plans are NOT Affordable Care Act compliant.

The last opportunity is to cobble together a series of supplemental benefits / indemnity policies. Taking a hospital/surgical policy and pairing it with an accident policy and critical illness contract may provide less expensive (although not as comprehensive) coverage as a short-term plan and undoubtedly less comprehensive than an Affordable Care Act contract. These additional products are intended to be used to supplement either a high deductible ACA plan or a short-term medical plan, but they can be utilized as a minimum coverage/lowest premium option for those willing to take the risk of having no limit on the cost of their care.

In all, options are limited, and we will continue to try to find additional creative solutions to what looks like a very difficult benefit year.

Please let us know how we can help you navigate through these difficult decisions and to make the best selection for your situation.