Insurance

<p>The discussion about loans and kids graduating and supporting themselves made me think of this topic. Our older D is graduating in another field, but with the economy what it is, may not be able to easily find a full-time job with benefits and certainly not in such a timely way that there is no gap from when our family coverage for her ends (at the end fo next month!). As she may be staying in Massachusetts, she at least has the option to get coverage through the state, but I believe very few if any other states have state-wide plans. So I was wondering in general what young actors do about health insurance, especially those in New York. Thanks for any insight!</p>

<p>Great question! I know that members of Actor’s Equity who work at least 20 weeks a year can buy pretty darn good health insurance through AEA at a decent cost. But that naturally is not going to be available to most kids just starting out. One mom of a recent grad told me that parents can cover their college grads for something like three years under COBRA.</p>

<p>It has been so long since I was in this position (30 years ago, moved to Las Vegas to pursue music), but if the option exists you might consider something like a major medical only. Its the catastrophic things you want to prevent, especially during what might be a relatively short gap in coverage. Most people can survive routine and infrequent medical expenses, if they are generally healthy. But having not explored this for years, don’t really know what is available.</p>

<p>My D is a member of Austin Circle of Theatres, and one benefit of her membership is that ACoT has a partnership with Fractured Atlas Open Arts Network of New York (a nonprofit organization) and ACoT members have access to Fractured Atlas’ member benefits. One of the benefits is some type of health insurance. My D is still in high school and she is covered by our policy so I don’t know much more than that. But it might be worth looking into to see if your community has something similar or if you are eligible directly through Fractured Atlas.</p>

<p>The solution to this dilemma will vary from state to state because each state has its own regulations concerning the types coverage that must be offered by insurers. It will also vary based on whether you have access to a group health plan or must rely on individual coverage.</p>

<p>In a nutshell, COBRA applies only to group health plans and provides that if someone on a group health plan loses coverage due to certain defined events, the person must be given the opportunity to continue their coverage on the group health plan by payment of the required premium to the plan or employer. This only applies to group health plans. So, for example, if a student is covered on a parent’s health plan as a dependant and the parent gets the coverage through his employer’s group plan, then if the student exceeds the permitted age for a dependant under the plan or graduates from school and is no longer covered as a dependant, the student must be given the opportunity to continue their coverge for up to 18 months by payment of the required premium. The premium is generally 102% of what single coverage costs under the group plan. If, however, the parent does not have group health coverage but has an individual policy that provides dependant coverage, COBRA does not apply and the student must apply for their own individual coverage. And that’s where state law kicks in; each state has different rules for what types of individual coverage must be offered.</p>

<p>NMR, I am not THAT well versed on this but since our D is in this situation graduating next month and will have to support herself…The issue of medical insurance has come up. The COBRA that you refer to, if I am not mistaken, or at least the way my husband explained it to me, is for 18 months after they graduate, not three years. Since we have a family health insurance plan (older D is still covered for a few years as she is a graduate student), if we drop D2 who is about to graduate college, we will not save one cent as the premium will be the same. However, she is allowed to be covered under the COBRA for 18 months past graduation. Therefore, she will not have to pay anything herself as we might as well cover her as it is not going to cost us extra to do so and there is no savings to us to drop her but she’ll only be able to be covered under that for 1 1/2 years. So, our hope is that in 1 1/2 years, she will be able to take over health insurance on her own as we are no longer supporting her after next month and she’ll be paying all her other expenses. Maybe by then, she’ll be Equity but that is a huge maybe, but that would make her able to get health insurance that way. Otherwise, she’ll have to purchase some at that point.</p>

<p>I cross posted with Michael. I think the reason our D is still covered for 18 months under COBRA, if I get this right…is because it is a family plan and I think that even though my husband is self employed, it may be called a group health plan that he purchased for his business.</p>

<p>soozie, if your husband has the plan for his business, it is most likely a group health plan and that is why COBRA would apply. With a student who is covered as a dependent, there are rules under the plan which define the criteria for being treated as a dependent. Normally, a child under the age of 18 is a dependent but if the child is a full time college student, the age cut off is increased to 23 and with some plans to 25. Once a child over 18 is either no longer a full time student or “ages out”, the child can not be treated as a dependent under the terms of the plan. Such a child must either exercise COBRA rights to remain on the group plan or get individual coverage on their own. In both situations, a premium must be paid. Once your daughter graduates, you will not be able to keep her as a dependent covered under your family coverage on your husband’s group plan at the existing premium for your family coverage. You will have to pay the COBRA premium to maintain her coverage on the group plan.</p>

<p>That’s the way it normally works. Vermont may have some laws and regs that impact on this but what I’ve described is the general rule found in most states and under federal law. You may want to look into this very carefully to avoid an unpleasant surprise!</p>

<p>My 22 yr old son was dropped from my husband’s federal insurance even though it was a famly plan. Check the laws of your state as well as your insurance policy. Here in Missosuri a law was passed January 2008 that says every child may stay on the parent’s insurance until the age of 25, evenif they do not live at home or are not in school. Unfortunately for us our insurance is federal and that supercedes state law. So, to COBRA my son in would have cost a ridicuolous $450 a month, 3 times what we pay for the other 3 of us!!! I did find a vey good individual BXBS(Anthem now) policy that we got him and we pay $141 a month. He is graduating in May but wih no job on the horizon ;‘( , along with most of the other 1.5 million graduating this year, we are paying his insurance for now. There are som good individual policies out there if you look around. I guess we will be facing the same obstacle in 1.5 years with my daughter as well. AHhhh. Breathe! ;’)</p>

<p>Illinois just passed a similar law last fall that is effective June, 2009, where dependents can stay the family insurance plan until they turn 26. That would have been great, but because my company health insurance plan is “self-insured” it is exempt from this new law! I had heard COBRa was very expensive so your info confirms that.</p>

<p>COBRA premiums, by law, are limited to 102% of the employer’s cost. If the employer has an insured plan with a multi-tiered premium structure (single, husband & wife, parent and children, family etc), you take the premium for the type of coverage you want and multiply it by 102%. Where it gets tricky is if the employer uses a composite premium structure where based on the demographics of the group a single premium is calculated that applies to all types of coverage from single to family. The composite premium is higher than what single coverage would be but lower than what family would be in a multi-tiered arrangement. With a composite structure, a person who wants single coverage on COBRA really gets banged. Under a self insured plan, an employer pays the claims that are incurred plus an administartive fee to a third party administrator. There are no “premiums” and as a result, a COBRA premium gets calculated based on an actuarial calculation of the plan’s claims experience - kind of what’s the average cost to the plan to provide he coverage. Depending on the claims wxperience of the group, the COBRA “premium” can be high, low or in between.</p>

<p>Michael, your post #8 is quite informative and now has me questioning if my husband is correct about my D’s coverage for the next 18 months under our plan. I am now going to have him look into it further as what he thought is not gelling with what you wrote entirely. So, thanks for the heads up and will investigate this further as this is upon us very soon.</p>

<p>soozie, the first place to look is under the plan itself. Your husband may have the master contract between his business and the insurer or you may have a plan booklet given to participants. Look for the definition of a “dependent”.</p>

<p>I just went through this with my son who turned 25 and “aged out” under my office’s group plan. The COBRA premium to put him on single coverage would have been over $6000/year - 12x the monthly premium charged by the insurer for single coverage. I ended up getting him an individual policy which, while not nearly as good as my office’s, will meet his needs and costs only $145/month. When he starts law school in September, he will be eligible for his school’s group plan which is better than his indivdual policy but costs about the same.</p>

<p>The cost of health insurance is down right scarey.</p>

<p>Michael, I will have him look into it for sure. And yes, the cost of health insurance is so high. Since we are self employed we have NO benefits and have to purchase health insurance for our family of four out of pocket and it is very expensive.</p>

<p>Costco is offering health insurance for small businesses and for families in some states. I don’t know what the quality is but in general everything else I buy at Costco is priced well and is a good product.</p>

<p>If I may make a suggestion for those of you who have a certian non profit insurance company for military families and their dependents, they offer an emergency health plan that covers only catastrophic events. My parents purchased this for each of us when we turned 23 and were no longer covered by my father’s insurance with the state. It was intended to protect us only for real serious illnesses or accidents. They paid for it and kept it for us until we obtained insurance from jobs we were working. I plan to do the same for my children. It doesn’t cover going to the doctor for the flu. But it will protect them if, god forbid, something serious should happen. It gave my parents, and me, some piece of mind. I’m fairly sure other insurance companies offer such catastrophic insurance.</p>

<p>Thanks, Michael, may as well check to see what COBRA would be for us as my company is a self-insured plan–perhaps I will be pleasantly surprised (but I won’t hold my breath). A better bet may be one of those single young-person’s plans that are under $200/month. I noted it was generally cheaper if you did not elect prescription coverage. For those of you with kids staying in New York I guess it is worth checking to see if the state offers anything (such as what my older D can get in Massachusetts–in fact, if you make under $31,000 or so per year there I believe there is no cost–but it may be about the only state that is like this. Soozie–perhaps there is some office at NYU that would have some info and recommendations–surely this affects a lot of kids.</p>

<p>ccsmom, first I have to have my husband look into this with our insurance company as now I am worried that his understanding of it may not be correct based on some things in MichaelNKat’s post. It so happens he has to call them tomorrow for some documentation for our older D who is working overseas this summer and hopefully will find answers to the stuff about my soon to be NYU graduate and her health insurance and then we’ll go from there.</p>

<p>I just called to check the COBRA price for my 21 year old D–$448/month so I’m with you ttsmom–ridiculous!! So my being part of a self-insured plan did not make any difference in the price. Hurry national health care!</p>