Individual Health Insurance

Several carriers sell individual health insurance in New Hampshire. To be sure that a carrier is licensed to sell insurance in New Hampshire, go to the NH Department of Insurance website. Carrier websites offer basic information that you may find helpful. Some carriers will sell directly to you. Others will only sell through a licensed health insurance agent or broker.

Carriers offer different products – HMO (Health Maintenance Organization), PPO (Preferred Provider Organization, POS (Point of Service) and indemnity (fee-for-service) plans. Some offer high deductible health policies with a health savings account (HSA). The types of health services paid for, the amount you will have to pay out-of-pocket (co-payments and deductibles), and the amount of your monthly premium varies by product and by carrier – so be sure to read the fine print.

You may be able to continue your current health insurance if you are working for someone else. You may be able to get insurance through your spouse or partner.

Consider all of your options. Some will be right for you, others will not. Choose the one that best meets your needs and ability to pay the monthly premium.

Continuing Your Current Health Insurance

If you are currently employed, have health insurance through your employer, and will be leaving your job to run your own business, one way to have health insurance is to continue the group health insurance you have through your current employer. Depending on the employer, you may be eligible to continue your health insurance using COBRA, NH Continuation Coverage, or HIPAA. HIPAA also applies if you currently have individual health insurance.

COBRA (the Consolidated Omnibus Reconciliation Act) applies to employers with 20 or more employees. It continues group health insurance that might otherwise be terminated. Certain former employees, retirees, spouses, former spouses, and dependent children have the right to temporarily continue health insurance at group rates.

You will be responsible for paying the entire cost of the premium plus an administrative fee. This may be less expensive for you than purchasing health insurance as either an individual or as a small employer. To be eligible for COBRA:

• You must experience a qualifying event,
• You must have been enrolled in the employer’s health plan, and
• The employer’s health plan must continue to be in effect for current employees.

For more information about eligibility for COBRA, benefits, cost, and application process, contact your employer’s human resources representative or the health insurance carrier’s customer service department.

NH Continuation Coverage applies to companies with fewer than 20 employees. This is not insurance, but an option to temporarily continue existing group health insurance. You are eligible:

• If you voluntarily leave your job or are terminated by your employer for any reason other than gross misconduct, and
• If the employer continues to offer group health insurance to current employees.

You must pay the entire cost of the premium plus an administrative fee. This may be less expensive for you than purchasing health insurance as either an individual or as a small employer. For more information, visit the NH Department of Insurance website or speak with your employer.

HIPAA is a federal law that provides rights and protections for employees and beneficiaries in group health plans. HIPAA offers protections for both health insurance offered through an employer and for individual health insurance policies sold by insurance companies.

If you take a new job with an employer who offers health insurance, or if you are eligible for health insurance under a family member’s employment-based plan, there are protections that:

• Limit exclusions for pre-existing conditions,
• Prohibit discrimination against employees and dependents based on health status, and
• Allow a special opportunity to enroll in a new health plan to individuals in certain circumstances.

If you choose to apply for individual health insurance for yourself or your family, there are protections for individual health insurance policies that:

• Guarantee access to individual policies for people who qualify, and
• Guarantee renewability of individual policies.

While you are guaranteed health insurance, there is no limit on the premium that the insurance company can charge you for individual health insurance.

For more information visit the U.S. Department of Labor website.

Associations

Another way for small business to purchase health insurance is through an association. An association is a group of businesses, organizations, or individuals who join together for professional purposes such as professional development, advocacy, or group purchasing. An association may, as part of its activities, offer insurance products to its members. Examples of associations include the Chamber of Commerce, American Bar Association, American Association of Manufacturers, Retail Merchants Associations, Restaurant and Lodging Association, Business and Industry Association, etc.

There is wide variety in the types of health insurance offered through associations, carriers, and cost (both for the annual membership fee and for premiums), so shop wisely.

For a quick summary of the options outines above, click here.