Open Enrollment: Freelancer’s Health Insurance

Open enrollment for 2015 Affordable Care Act health insurance began on November 15.  Individuals who earn maximum $46, 680 and families of four (couples with two dependent children) that generate a maximum total income of $95, 400 are potentially eligible for a tax credit that will help defray the cost of insurance premiums. In tax year 2015,  the penalty for not carrying insurance will rise from $95 to $325,  or 2% of household income,  whichever is greater.

Business entities of 50 or fewer employees and located in Delaware,  Illinois,  Missouri,  New Jersey or Ohio can set up a Small Business Health Options Program (SHOP) account by completing an application that determines eligibility and if accepted,  investigate plans and prices and contract with an insurance company.  A 2014 University of Chicago study found that 2013 insurance prices offered through SHOP exchanges in 26 states were on average 7 % lower (about $220) than comparable insurance bought outside of the SHOP exchanges marketplace.

Freelancers and small business owners who did not buy health insurance in 2014 will need information to guide decision-making about the upcoming year.  The Freelancers Union  http://freelancersunion.org,  a New York City-based nonprofit organization that advocates for the interests of self-employed workers,   plans to help its 233,000 members purchase medical and/or dental insurance in all 50 states.

Freelance Union members also have access to retirement plans and disability,  liability and life insurance.  Additionally,  the Union operates two health and wellness centers in New York City,  where members can obtain primary care services at no charge and also participate in classes such as tai chi and yoga.  Membership in the Freelancers Union is free.

I went to the Union website and found that medical insurance is not offered in my state,  but dental coverage is available for $60.77 /month  ($112.32 /married couple and $164.89 /family).  The twice-yearly cleanings are 100% covered as are annual x-rays.  Services such as crowns,  fillings and anesthesia are covered at 80% after a $50 deductible and root canals,  endodontic and periodontal services are covered only after a 12 month waiting period and then at 50 % after the $50 deductible.  The yearly maximum benefit is $1250.

An individual pays about $730 for the year.  I might spend that amount in a year paying out-of-pocket for two cleanings with bi-annual x-rays averaged in.  My gums are not great and I must very soon see a periodontist.  Heaven knows what he will charge but the visits will not be covered,  since only two are allowed in 12 months.  Periodontal work would only be half covered and the maximum annual benefit is only $1250 for a premium that costs $730/year.  In sum,  health insurance is all too often not an advantage,  unfortunately.  Maybe the medical plans are better?  An individual Bronze level plan in New York City will cost $393/month in 2015.

Still,  it appears that Freelancers can benefit in other ways from Union membership (I am not a member).  There are plans over the next five years to open 15 primary care clinics across the country,  including Los Angeles and Austin, TX.  The clinics will not charge co-pays for office visits and will be open to all who purchase health insurance through the Freelancers Union.  There are numerous professional benefits as well.  Maybe I will join before too long.

More good information on health insurance prices is available at the Consumer Reports Health Law Helper,  which walks you through questions to help you understand your options for buying health plans,  with links to marketplace sites   http://healthlawhelper.org.  The American Association of Retired People AARP sponsors the Health Law Answers site,  which provides information for health insurance seekers of any age  http://healthlawanswers.aarp.org/en.  The Kaiser Family Foundation provides the Insurance Marketplace Calculator,  which helps you estimate the cost of health insurance based on your location,  age and income,  along with pricing for various level plans  http://kff.org/interactive/subsidy-calculator/.

Thanks for reading,

Kim

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