I take it from your question that the PPO plan has a high deductible? If so, I’d look beyond the deductible to the out-of-pocket cost structure on the plan. For example, some high deductible plans have free primary care doctor visits and lower costs for pediatric wellness visits...those factors could drive down your…

It depends on whether the HRA is the only option or one of a few offered by your company. Just one note: the HRA is fully funded by the employer (unlike, for example HSAs and FSAs which also includes dollars you contribute). So if you left the company, it’s true the HRA belongs to the employer...but it wouldn’t…

Hi Paul - that sounds like a reasonable course of action. One note though: childbirth and maternity costs can add up, so if that’s something you know to be coming up in the next year, you might want to look into lower deductible plans and compare the expected out-of-pocket costs between the two. HSAs have an annual…

The small business health insurance marketplace is available to business with 50 or fewer employees (see here: https://www.healthcare.gov/small-businesses/employers/). The other factors relate to rules around small business tax credits and possible exemptions.

Totally understand. If you’re paying that much of your income toward health insurance premiums, have you checked into your subsidy eligibility? (Or switching to the lowest premium / highest deductible plan)? While rising premiums do present a financial hardship to people, I’m also concerned about uninsured folks…

Hi there - there are a lot of rules and eligibility criteria for small businesses and the health insurance requirement, as well as the availability of small business tax credits. It depends on a number of factors including number of employees and average annual wages. A good place to start to understand the small…

While pure math may indicate that paying the tax penalty saves you money versus paying for health insurance, that requires having perfect information about the future. While one might be healthy now, that situation can unexpectedly change. Generally, I advise everyone to have some sort of major medical insurance in…

Hi Melissa - there used to be a time when consumers had to be paranoid, but now all health insurance plans are required to cover people with pre-existing conditions and procedures required to treat them. You should certainly feel free to call your health insurance company to talk about these procedures, and what…

If you’ve got health insurance through your employer, you do not need the health insurance your car insurer offers. I doubt they’re offering major medical (which is what employers provide) - they’re probably offering some type of supplemental coverage (like accident or critical illness). You can take a look at the…

Congrats on the new venture! First, if your spouse has employer-provided health insurance coverage, I’d start there to see whether you and your children can enroll on that plan (and at what cost). Employer-provided health insurance is often (but not always) the less expensive route for families. If that’s not an…

Hi Meredith - that depends on whether your insurer is continuing to offer that plan in 2017. Check any mail you’ve received from your health insurer about whether they’ll auto-renew your coverage or whether you have to switch plans or take any action. If you bought your own health insurance on the marketplace, just be…

Congratulations on your growing family! Regarding the health insurance decision...it really depends on how you and your husband’s employers structure health insurance contributions. I’d first look to see which of your employers contributes more toward dependent health insurance...employers can pay 0% all the way up to…

A lot of insurance companies have opted to reduce plan offerings (sometimes just offering one plan on the open marketplace) in an effort to keep down costs...administering multiple plan designs adds to a health insurance company’s costs. Sometimes there are more options if you go ‘off-exchange.’ Off-exchange plans can…

As a general rule, high deductible plans (with an HSA) are good for people who: 1) need to keep fixed monthly costs (ie, the premium) low for budget reasons and/or 2) rarely if ever go to the doctor. High deductible plans generally have lower premiums and higher out-of-pocket costs (copays and coinsurance). If,…

Great question. For a business owner/sole employee, you can start by looking at your state’s health insurance marketplace. (Just google your state and “health insurance marketplace” to find it). Each state has a small business health insurance marketplace where companies with under 50 employees can see plans available…

Good question. If you have to contribute to the cost of the health insurance plan (i.e., your employer doesn’t cover 100% of the premium), the first thing is to make sure you can afford the contribution. After that, it really depends on what type of healthcare consumer you are. Do you go to the doctor a lot or have…

The good news is you can stay on your parent’s health insurance plan until you turn 26 - so you’ve got some time. Your 26th birthday counts as a special qualifying event - meaning you can shop for a new plan even if it’s outside of open enrollment (which is Nov 1 - Jan 31). On average, consumers spend ~5% of their…

Looking forward to answering your health insurance questions!

Hi, we’re adding car insurance in the next couple of months.

Not necessarily...to open an HSA (health savings account), you must have a high-deductible health insurance plan. That means you’ll have more out-of-pocket expenses (compared to a lower deductible plan), but with the HSA, you can cover those expenses with pretax money. Qualified health expenses with an HSA would…