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Health Insurance Issues for Start-ups and Entrepreneurs

Concerns about health insurance can cause many start-up companies and entrepreneurial ventures to become hesitant when preparing to embark on their ventures. While health care costs continue to escalate, there are many new options available for small businesses and the self employed.

Health Insurance for Self-Employed Entrepreneurs

If you will be working from your home, consulting, freelancing, or otherwise self-employed, there are several options at your disposal for attaining health insurance. Indemnity plans are too expensive for most people, but they provide you with the most control. Managed care programs like Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) are typically less expensive, but have greater choice restrictions.

Many self-employed individuals find affordable health insurance through memberships with a professional organization. Industry associations frequently use their collective numbers to get group rates on insurance products and pass this savings on to their members. National business associations, local chambers of commerce, college alumni associations, and some unions also offer health insurance. Look for a reasonably priced product that will best fit your medical situation, and keep in mind that as of 2003, all self-employed health insurance costs are 100% tax deductible.

Health Insurance for Start-Up Businesses

The size of your organization will play a deciding factor in the type of insurance you offer your employees. If you employ between 2 to 50 people, you should be able to get group rates on insurance. If you employ more than 50, you will receive additional discounts. Some municipalities are forming separate divisions to offer health insurance to small businesses, so depending upon your location you might be able to take advantage of such a plan.

Offer as many choices as you can to your employees. This will allow them to choose the right product for their needs and to take responsibility for their own health care decisions. Additional benefits, such as dental and vision plans, might be the difference in getting that all-star employee that will make business lucrative.

Medical Savings Plans (MSA)

MSAs are a great way to provide health insurance. They were specifically designed as a way to make health insurance more affordable for small businesses and the self-employed.

Medical Savings Accounts function by use of two linked components. The first is a high deductible catastrophic health insurance plan that has a low monthly premium. This provides coverage in case of an unfortunate event. The second component is a tax-free medical savings account which functions in a similar manner to an Individual Retirement Account (IRA) or 401(k). Funds may be contributed to the account by an employer, or in the case of the self-employed, they contribute funds themselves. If you are an employer, you must have fewer than 50 employees, and provide a qualified high deductible health plan to your employees.

The MSA can be used to pay for:

  • Deductibles

  • Co-payments

  • Doctor and lab fees

  • Eyeglasses

  • Dental work

  • Other qualified medical expenses.

The money in the account continues to grow and rolls over from year to year. The funds can be managed at the person’s discretion, and can be used to purchase financial products like stocks, bonds, mutual funds, etc. When the insured person reaches the age of 65, these funds can be withdrawn for any purpose without incurring penalty.

MSAs can save money for employers because they have a set premium for each employee, regardless of age. The MSA can be structured to cover the higher deductible amounts of the catastrophic coverage. Employees find these programs very enticing, because if left unused, they see these funds growing in their account, rather than being lost to monthly premiums.

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