Tuesday, October 19, 2010

 

Insurance when your COBRA expires

LOOKING AHEAD by Wally Dobelis



In this a post-recession period - or is not? More and more of our traditionally Democratic neighbors are worried and angry about protecting as well as regaining their jobs, and about expiries of benefits, such as COBRA. The American Recovery and Reinvestment Act provided an employer –provided health insurance continuation (COBRA) for employees who were involuntarily terminated , through May 31 , 2010, subsidizing the premium above 35% of the premium, for up to 15 months. This benefit is gradually expiring and unemployment benefits limit is nearing, and Medicare payments are curtailed, and doctors are opting out, and… and jobs are still scarce!.



Not only Obama is getting blamed, the pols as a whole are condemned – a local tradesman became very vocal in describing how the Socialist president gives the poor what they need by taking from the rich what they have, quoting Karl Marx, sort of; and how the Secretary of Treasury Geithner did not pay taxes, how Senator Dodd gave bonuses to traders from bailout funds, how stimulus funds are abused,, and how Gov. Bloomberg cripples the small businessmen by sending the cops to write tickets, to fix the shorts in his budget. Add to that the normally evenhanded David Brooks in the NYT blaming liberalism destroying itself by overpaying civil servants – Gov. Chris Christie cancels the $5B tunnel, because the state benefits packages for civil servants are 41% higher than those of a Fortune 500 company and are rising 16% per year; NY schools are strained, but we pay retirement benefits to 10,00 cops who have quit before age 50; California cannot afford water projects because 90, 000-state cops get 90% of pay when thy retire at 50, and correction officers earn $70K, routinely boosted to $100K a year with OT. And so it goes on; Brooks was not yet aware of another NYS governments’ debt, $200B owed by city and local governments for retiree health benefits, guaranteed without setting up adequate fund sources and reserves. This was revealed in an October 13, 2010 report by the Empire Center for New York State Policy, a research center that studies fiscal policy, you can look it up on the Internet. If you If you want to make the conclusions about liberal benefit policies international , think of the Greeks striking because the age 50 retirement at full benefits will be taken away for some; and the French, who are striking en masse parce que the retirement age she goes form 60 to 62. But I digress.



About the COBRA loss; one alternative is covered by the Health Care Reform Act of 2000, under which NYS established a Healthy New York program, requiring all group health providers so sell uniform low-cost coverages for individuals and small businessmen. In 2007 the providers were Aetna, Atlantis, Cigna, Empire, GHI, Health Net, Hip, and Oxford.



Please note that all prices quoted will be for individuals, adding children and spouses increases the numbers proportionately. Do not hold me to the numbers, conditions and restrictions are illustrative, and not attempted to be complete.



Oxford currently has a Healthy NY health policy for $294.19 a month, with restrictions, involving a $1,200 deductible, and $5,250 out of pocket expenses. Office visits cost $20 copay, and emergency and walk-in surgery etc copays are relatively higher. Substance abuse, mental health and some other impairments are not covered, and there are limits. Oxford states that this is decent in-between jobs coverage, and offers a network of 55,000 Oxford/Liberty physicians. There is also a HAS (health Savings Account) format. My insurance actuarial sources tell that Healthy NY policies are, although uniform among providers, not that easy to get, and the size an distribution of the MD network should be a determinant. One will have to choose a primary care physician from the network. For ex-COBRA beneficiaries there may be a lag period. It may help to buy Healthy NY coverage from your former provider of employer-subsidized insurance.



Oxford’s unsubsidized plans are pricey, as are all the private plans. Oxford’s personal HMO costs $1174.18 a month, office visit copay is $15. The next, Oxford POS costs $1729.56 a month ($10 copay). Oxford’s sales office is at 800-969-7408, very helpful, and they will email scads of coverage info, as I am sure will the other providers I named.



Another alternative, Freelancers Union was formed within the decade, to provide for the insurance needs of the freelancer, contractor and entrepreneur population, claimed to constitute 30% of the working population. It is a private firm, Barbara Horowitz is president, and Freelancers owns the Freelancers Insurance Company, licensed in NYS.. For out of state participants they have a .United Health Care Golden Rule Company connection.

FIC offers a range of five plans, the highest-cost, PPO1 charges a premium of $497/mo, $25 copay, $1,500 deductible ($4,200 for prescriptions, $6,000 out of pocket).

PPO2 costs $381/mo,$2,500 deductible, then, three plans below , the lowest-cost plan with $196/mo premium and $10,000 deductible with all other fees scaled up.

Application fee to join the plans is $50, annual maintenance $75, then premium. The phone contact number is 800-856-9981, they are located in Brooklyn Heights. Internet data are not fully accessible on Internet Explorer, you must use Mozilla Firefox or Google Chrome for detailed pages..

Wally Dobelis is not connected to any of the insurers cited.

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