Q: I am going to lose my job on Friday, and the company I work for is based in NJ, but has fewer than 20 employees. I understand that COBRA applies only to companies with more than 20 employees. What can I do about health insurance?
A. You can continue your health insurance benefits under the NJ Continuation Law for twelve months or until you are eligible for other group health insurance benefits, whichever comes first.
Q: My employer paid for 100% of my health insurance in the past, and has recently told us that they are going to need the employees to pay a portion of the premium. Can they do that? Is this normal?
A: Yes, the employer can ask the employee to pay a portion of the health insurance premium. Employee contributions towards health insurance went up 27% last year. There is no law that says the employer must provide health insurance at all. But if they do, and if it is a small company with fifty or fewer employees, the employer is obligated to pay a minimum of ten percent of the premium. Next to payroll, health insurance is the second largest expense for any business. We are already getting some calls from people who have said their employer canceled the health insurance for everyone in the company! Be thankful that you can still get health insurance through a group plan, even though you must pay part of the premium. It is still the cheapest way to buy coverage.
Q: I have the same health insurance plan that I have had for the past 15 years. My insurance agent is recommending that I change to a more current plan that would save me a significant amount of money in premium. I have a pre-existing condition though, and am afraid to make a change. I am also concerned that if that plan costs less, it must offer worse coverage.
A: If you are working with a good insurance agent, that person probably told you that you could safely change health insurance plans with no waiting period or penalty for pre-existing conditions as long as you do not have a gap in coverage. This is a law – and it is true. If you have had a plan for 15 years it is obviously a pre-reform plan and you may be able to get better coverage for less money with a more current plan. You should compare the cost, the benefits and the limitations of both plans thoroughly before making any changes.
Irene Card & Betsy Chandler share the responsibilities of running Medical Insurance Claims, Inc. a health insurance services company. If you have questions relative to this column or other related topics, we invite you to call (973) 492-2828, browse our past columns on our web site at www.micinsurance.com.
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