Dear Tom and Alan:
Really need some help on this one!
I’ve got a job managing a business here in town.
The owners of the business are retired and live out of state. Since they’re my parents(!), they want me to have health insurance even though I’m only 28 and in very good health.
They also want me to find the very best coverage at the very best price.
OK, it’s a test of my management skills, but I don’t know what to do. Is there such a thing as a group of one?
What about Obamacare?
Tom: The Affordable Care Act (ACA/Obamacare) has some very strict rules against enrolling outside of the “open enrollment” period.
Last year, open enrollment was from Nov. 1, 2016 to Jan. 31, 2017.
During that time you would be accepted for anything you applied for.
We’re not in the open enrollment period now, so there would have to be some “qualifying event” to make you eligible.
I won’t list all of them now, but let’s just assume you can get on a plan through Covered California.
If you are single with no dependents and living on your own, it would make sense to apply to Covered California if your income is less than $47,500 per year.
It would make sense because you could qualify for a subsidy to help pay your monthly premiums.
Otherwise, you might as well go directly to the insurance company for coverage.
Al: On the other hand, if you are a salaried employee of the business you manage, you might be the only member on a small group health policy.
Here’s how it would work:
1. Find a company that will allow a group policy to consist of only one person (we usually contact a general agent that keeps up with many different companies).
2. Have your parents fill out the employer application.
3. You fill out the employee application. Since this would be a brand new group, there is no conflict with the ACA over the time of year.
The employer (your parents) could pay all of your premium and it would be a business expense for them.
I ran a quote for you on a Blue Shield Gold PPO plan. The rate comes to about $470 per month for one of the better plans available.
An additional bit of paperwork would be the DE 9, which is filed with the State Board of Equalization and shows employees and payroll tax deductions, among other things.
Tom: I ran a quote for you on Covered California as an individual not receiving a subsidy.
The Blue Shield PPO Gold would be $498.54, the Anthem Blue Cross EPO Gold would be $567.77, and the Kaiser Gold HMO would be $398.20.
These would be available for the next open enrollment.