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Health Insurance for Members

Health Insurance Alternatives In Connecticut

All of a sudden, it seems that there s a great deal of attention being paid to health insurance. The State of Connecticut is considering two proposals; the US Congress has at least two different bills moving forward. There's lots of attention, and lots of controversy. But what's not being explained is what someone can do today, here in Connecticut, to deal with the increasing costs of health insurance.

We can't solve the problem of expensive health insurance, but we may be able to explain to you what your alternatives are. And keep in mind that the Hamden Regional Chamber of Commerce provides you with access to high-quality health insurance carriers.

In Connecticut, there are many companies that sell health insurance. Health insurance in Connecticut comes in two types, group or individual insurance. Of course, there are many different products available, with a blinding array of acronyms: HMO, POS, PPO, HSA, HDHP, just to name a few. Today, we re not going to get into detail about the different plans available. Instead, we want to explain the difference between the two basic categories, group and individual.

Group health insurance is purchased by a business. Your employer, for example, may offer health insurance to the company's employees. That is group insurance. If you are self-employed, you can purchase group insurance, just for yourself (or yourself and your family); even though it is purchased for just one person, it is called group insurance.

The Connecticut Insurance Commissioners website lists nearly twenty different companies licensed to sell group health insurance in the State. Of course, not all of them would be appropriate for you, or for your company.

Group insurance comes with many more mandated benefits than individual insurance. And a group health insurance carrier cannot refuse coverage to an applicant, no matter what that persons health might be (although, under some circumstances, your choice might be limited to what's called the Connecticut Small Employer Health Reinsurance Plan). For this reason, among others, group health insurance is typically more expensive than individual insurance.

The premiums for group health insurance, for a small group" in Connecticut, that means fewer than 50 employees - are not based on the health of the group. That is good news for small employers; if one employee is seriously ill this year, the Company s insurer cannot raise the rates next year. On the other hand, many of our clients complain that they ve not had any claims at all, and yet their rates are still going up. Yes, that's true; because the insurance company cannot raise the premiums for a group that has a very ill employee, that cost is shared by all small companies.

Individual health insurance is just that, health insurance purchased by an individual (or an individual family). It is not purchased through an employer. The Connecticut Insurance Commissioner s website lists eight insurance companies that sell individual health insurance policies in the State.

Frequently, an individual health insurance policy can be half the cost of a group policy for the same person. Why? Well, there are a number of reasons:

-The individual health insurance company has the right to decline an applicant, based on that applicants health history. A group insurer cannot.

-The individual health insurance company can also impose an additional premium, a surcharge, on an applicant, because of that person s health history. Often that surcharge is a permanent part of the policy. Group insurance premiums, remember, cannot be changed because of the health of the group.

-The individual health insurance policy may have a lifetime limit on benefits, sometimes as low as $1,000,000. While that may seem like a lot of money, it isn't impossible to have costs that high, and then be left without any insurance. And some policies might have an annual limit, besides the lifetime limit.

-Some policies might have dollar limits on some benefits. For example, many policies have a calendar year limit on prescriptions, of $2,000 or $3,000. In fact, one policy offered in Connecticut has a $500 annual limit.

-Many individual policies won't cover maternity.

On the other hand, just like group insurance policies, once you've purchased an individual policy, the insurance company cannot raise your rates because of your personal health. They can only raise rates for everyone in your class - that is, everyone who is your age, your gender, living in your area in Connecticut.

So which type of policy is right for you? That is something you need to discuss with your agent. The good news is that, if you are a member of the Hamden Regional Chamber of Commerce, you can purchase either group or individual insurance with your Chamber membership. The Hamden Regional Chamber, through the Chamber Insurance Trust, offers group health insurance with ConnectiCare, and individual health insurance with Aetna.

If you are interested in more information, please contact:

-Patricia Pulisciano, True Care Insurance (203-230-0543) | www.truecareinsurance.com, or
-Joseph McDonagh (203-254-8400), jpmcdonagh@finsvcs.com.



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