Please, Please, Please can we get Universal Health Coverage

March 1, 2007 8:18 PM

I'm going to be opening a restaurant soon, and I want to provide health insurance to our employees. Will my health and pre-existing conditions be a factor in the type of insurance and rates that we can get?

Essentially, my insurance covered about $15,000 in expenses last year, and I'm going to continue to spend that much every year for the foreseeable future. If that's going to hurt our ability to get good group coverage, then I may opt out of the LLC. The business could be run by my husband and our partner only, with myself as an employee. Either way, I'd be on the insurance. I'm just wondering if my being a member of the LLC is going to send up an immediate red flag?

posted by saffry to work & money (4 comments total)

You'll need to get quotes from several different companies in order to make a decision... The quotes will be based on factors such as the number of people in your "group" and a mystery formula based on pre-existing conditions (which are harder for them to elicit now that HIPPA laws are in effect) and projected costs... Ask different insurance companies for quotes based on having you in the group and having you not in the group, and base you decision on their quotes.
posted by amyms at 10:28 PM on March 1, 2007

How many employees will you have on the plan? At my company, we had six altogether and there were no medical records turned over at all before we got our group coverage. We were a corp. but I don't think that would matter.

Call a good insurance broker. And good for you for offering insurance. As someone who worked in the restaurant industry for years, and only received healht coverage from a single employer, I know how unusual and commendable that is!
posted by miss tea at 4:10 AM on March 2, 2007

Most certainly your current medical history will influence whatever rates you are quoted on the new plan. If your current coverage is through a group plan, HIPPA requires that your pre-existing conditions be covered under the new plan...though they can be covered at much higher rates.

I'm not sure how things are handled if you are coming from a private plan into a group plan. HIPPA rules involving private plans tend toward the "sucks to be you" side of things.

I don't think your being either a partner in the LLC or just an employee has any bearing on the quotes. Everyone is lumped into the same group, regardless of rank or status in the organization.

And I second Miss Tea on the kudos for offering insurance. It's an onerous burden on any employer, these days...especially so for small businesses. I hope you are able to pull it off. I've had to buy high-deductible, private coverage and just got socked with a 28% rate increase after one year of not using it. Gotta keep those record profits flowing-in for the investors, I guess. My kid's wounds will heal on their own, right?
posted by Thorzdad at 5:24 AM on March 2, 2007

As everyone said, get some quotes. In my experience it will effect the price.

When the last company I worked for offered coverage (it was around 6 people) it was me, a healthy single guy in his 30's, and 5 women from 35-50, all smokers with various health issues.

I decided not to join the plan since I could get the exact same policy for about half the price. I didn't feel like letting my decent health subsidize their smoking and drug abuse.

If you are offering your employees coverage that -you- pay for, it will be a decent deal. If you're offering it as it was offered to me, something they could take out of my pay check pre-tax if I wanted, then your employees would be paying pretty bad rates in most circumstances.
posted by Ookseer at 10:20 AM on March 2, 2007