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Health insurance protects your most important business asset – you – Health insurance can pay for:
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First, what you can afford to pay? Second, what health care providers and services do you and your family use? If you will be offering insurance to your employees, how much can they pay each month and what health care services do they need? What providers do your employees use?
The following worksheets will help you. Download and use them to choose your health insurance plan.
- How do you use health care? (Excel or PDF download)
- Determine your current budget.(Excel or PDF download)
- Business information needed to compare health plans.(Excel or PDF download)
- Comparing health plans. (Excel or PDF download)
Both individual health insurance and small employer (group) health insurance have different plan options. Be sure to read the fine print – details matter!
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HMO – A health maintenance organization (HMO) provides and manages your health care in return for a fixed paid premium. You choose a primary care physician (PCP) from an approved provider list. The PCP will be responsible for routine care and referral to specialists. Services are paid for when authorized by the PCP. You will usually have an office co-payment (for example, $20 per office visit) and other co-payments for prescription drugs, emergency room visits, etc.
PPO – A preferred provider organization (PPO) is a network of providers who contract with a health plan to provide services. There is usually a lower cost to you if you use providers in the approved network and a higher cost to you if you use providers outside the approved network.
Indemnity – Also called a fee-for-service plan, an indemnity provides reimbursement for actual expenses of covered services. There is usually a deductible amount you must pay prior to coinsurance being paid by the carrier.
High Deductible Policy with Health Savings Account (HSA) -- This combines insurance (high deductible policy) with a non-insurance product (HSA) to pay for health care expenses.
A high deductible policy is meant to cover a high cost incident, such as hospitalization, over a long period of time. These policies usually cost less than other types of policies since you must pay all expenses up to the deductible amount. For example, if you have a $5,000 deductible policy, you must pay the first $5,000. A high deductible policy is usually used with a health savings account (HSA).
A health savings account (HSA) is a special type of savings account. Banks, credit unions, insurance companies, and other financial institutions can be trustee or custodian of these accounts. To create an HSA, you must:
- have a health insurance policy with a high deductible (at least $ 1,100 for an individual or $ 2,200 for a family)
- be under age 65
You can use the HSA for medical expenses not covered by the high deductible policy – co-payments, deductibles, and certain other medical expenses. Annual (for 2007) out-of-pocket expenses under the health insurance (including deductibles, co-payments, and co-insurance) cannot exceed $5,500 for the individual or $11,000 for a family.
The amount you can put into your HSA is capped. For 2007, the combined amount that the employer and individual may contribute cannot exceed the amount of the plan deductible, up to a maximum amount of $2,850. For example, if you are an individual with a $1,050 deductible policy, you may only contribute $1,050 to your HSA. If you are an individual with a $5,000 deductible policy, you may only contribute up to the maximum allowed. For 2007 that amount would be $2,850 for an individual or $5,650 for a family, even though your deductible is higher.
Other Types of Insurance to Consider
There are other types of insurance you may want to consider for you and your business. Each type serves a specific purpose, which you should discuss with your agent or broker.
- Short-term disability (STD) insurance
- Long-term disability (LTD) insurance
- Life insurance
- Long-term care insurance
These products can provide financial resources to you, your family, and your business in the event of a short- or long-term illness, condition, accident or if you died. They serve as a safety net and can provide financial security and stability when you and your family need it most.
Health insurance is complex. MicroCredit-NH recommends that you use a licensed health insurance agent or broker. They can help you find the best options at the best cost and will be your partner throughout the process.
Keep the following tips and cautions in mind:
- Shop carefully. Health insurance policies differ widely. Ask your agent or broker to get several quotes from carriers. If you decide not to use an agent or broker, you should get several quotes from the carriers yourself.
- Use an agent or broker who is licensed by the NH Department of Insurance.
- Be sure the carriers you are considering are licensed by the NH Department of Insurance.
- Be sure the health insurance you buy covers what you want or need – carefully read the fine (and not so fine) print.
- Ask yourself:
- What will be paid for (covered services) by the carrier?
- What won’t be paid for (exclusions) by the carrier?
- How much will I (and my employees) have to pay out-of-pocket before the health insurance pays?
- Are the providers I (and my employees) use in the carrier's network?
- How much is the monthly premium? When is it due? What is the grace period?
- How much will my employees be asked to pay for the premium? Can they afford it?
- Beware of single disease or single condition insurance policies (for example, cancer-only).
- Beware of purchasing health insurance on the Internet. If you do:
- Update your browser with the best security features
- Use only a secure website to transmit information
- Make sure the carrier is legitimate through the NH Department of Insurance
- Be sure the carrier has a good record when dealing with complaints by checking with the NH Department of Insurance and the Better Business Bureau
- Take extra precautions when paying with a credit card
- Keep detailed records including copies of forms, checks, and quotes from carriers.
- Get as much information as possible before you make a decision.
Small employer (group) health insurance is only available to the self-employed (group of 1) and small businesses with up to 50 employees. If you will be purchasing small employer group health insurance, you will need to complete an application form from the carrier and prove that you are a business. Each carrier has its own application form and material that must accompany it. They are available through your agent or broker carrier
- A signed application form for the business
- Wr-1/Quarterly Wage Statement or Small Business Confirmation Form
- Individual enrollment forms including the State of NH Standardized Health Form
- Waiver forms (for employees not wanting coverage through your business)
- A premium deposit
Your agent or broker will have copies of these forms and can help you understand and complete them.
