Helping Employees With Preexisting Conditions
Less than 60% of U.S. jobs now provide group health benefits, down from 80%. The sooner your employees get their own permanent coverage independent of their employment the better.
State-Guaranteed ("risk pool") Coverage is Now Available for Employees with Preexisting Medical Conditions, Regardless of Income
39 million Americans receive Medicaid (poverty), 47 million Americans receive Medicare (seniority), and now all states have state-guaranteed coverage for people with preexisting medical conditions—regardless of their level of income.
Coverage is typically the same BlueCross BlueShield type coverage your employees would purchase if they were healthy, except the state pays their health insurance carrier for any losses.
State-guaranteed coverage is not for poor people—it typically costs per person 100%-150% more than regular coverage, but only for the family member with the illness—so a typical family pays only 25%-40% more for all family members combined.
For obvious financial reasons, states don't spend money advertising their state-guaranteed coverage.
Helping an employee with a preexisting condition get state-guaranteed health insurance can be the gift of a lifetime—an annual premium of $3,600 a year can get $1,000,000 or more in health benefits, which could be priceless if their illness one day keeps them from being able to work (and getting employer group coverage).
In 40 states, the only qualification for employees to get state-guaranteed coverage is having been rejected or uprated (charged more) by a private insurance carrier, or in some states just having a letter from a licensed agent that this would occur if they applied.
If your employees with preexisting medical conditions had purchased individual/family policies before their family member had developed their preexisting condition, they wouldn't need expensive state-guaranteed coverage. That's why you should help your healthy employees get their own individual/family policies now before something happens to their health—individual high-deductible policies cost less than $90/month per employee (age 35) in most states.
Do not wait if you have employees that may require state-guaranteed coverage—virtually all states have a 12-month waiting period before covering preexisting conditions, unless your employees are HIPAA-eligible (i.e. less than 45 days since COBRA expiration or their existing plan was terminated through no fault of their own).
Where Can I Learn More?
Learn more about state-guaranteed coverage in your state, and who to contact in your state if you have a preexisting medical condition from New York Times bestselling author Paul Zane Pilzer's book, The New Health Insurance Solution. You can also search the online State By State Guide.