Official Luthiers Forum!

From a political pov I think we all need to be very careful here. Politics, like religion is one of those subjects where once begun everybody runs to their respective corners and a general melee breaks out.

I think Hesh's point that this can potentially pertain to all is valid.

However, let's not turn this into a discussion of one candidate vs. another, or socialized medicine vs. a "free" market, etc. That is just going to lead to a big fight and this thread being closed down. I think there is potential for good information to come out of this thread... so let's tread lightly on THAT ground.

I know a few things about the insurance trade. I have been a small business owner for years and I have dealt with the nightmare of insurance providers for longer than I care to remember. However, I think for the most part people have NO IDEA what heath insurance costs. My average employee's family coverage was $1,000 / mo. at the low end and $1,500 / mo at the high end. THAT IS $12 - $18k per year!!! PER PERSON!!

So to get personal policy quotes at $1k per month and think you are getting hammered... well... no worse than your employer likely is, they just aren't passing all the costs along to you. (Employers that have huge numbers of employees have better rates, but most people in the US work for businesses under 100 people).

Also, you better be very very careful that if you ever lose insurance you may find that you can't get a policy at any price. My wife has a touch of a rumitoid type of condition in her feet. It is no big deal, it is controlled by medication, but it is in the constellation of illnesses that immediatly disqualify applicants, and I cannot get her coverage under a personal policy. She can participate in "open enrollment" which is "Guaranteed Healthcare Coverage" (ever hear that term?) for $1,200 / month for JUST HER -- not the whole family. Or I need to get a corporate policy (which is impractical for other reasons).

Insurance is a big mess. Guard your policy well.

I would say stay on the Cobra as long as you can, and in the mean time be shopping for a new plan. It takes time... several months to find the best price and make sure you won't be without coverage. And DON'T go without... it makes getting a new policy that much harder.

... and just WAIT to find out you are a guitar maker.

I think if the associations wanted to ever do anything that would benefit us as an industry it would be creating an insurnace pool and offering us individual and family coverage through a common carrier. Not discounts, but actual policies. (Yes I realize that this benefit would not pertain to non-US residents... but still... it would be an enormous win for all of us.)

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

welcome to the old guys club. One nice thing about this is that when you mess up you can say " I am old , I forgot." As fir Insurance , there is no escape. I am going with a POP and using a higher decuctable. I have an 80/20 for the first $5000 . That make me in about $4500 a year in PA
Good luck
john hall
PS another option is some insurance companies offer group rates for businesses with just 2 people. It sounds dumb but you can get worthwhile discounts. Talk to a trusted insurance agent

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John Hall
blues creek guitars
Authorized CF Martin Repair
Co President of ASIA
You Don't know what you don't know until you know it

It seems reasonable to get an HSA along side your insurance program, and set it up to cover your deductable.

Mike

Brock buddy you just gave me a great idea!

Insurance by definition is spreading the risk and cost over a sizable group.

The problem that Luthiers face is that typically a Luthier is a Lone Ranger and a company or one or a few individuals. Brock's desire to see our associations work to aggregate our numbers and subsequently provide some form of coverage for association members is a great idea.

Short of this what is to prevent a number of independent Luthiers from banding together into one business entity. This business entity would of course have a legal structure but be for the sole purpose of permitting independent Luthiers to qualify as a group for group rate health insurance.

Of course the members would continue to operate as they wish, have their own customers, run their business as they see fit but for health insurance and perhaps other forms of insurance be a group that can be leveraged for better rates.

If you are self-employed with a registered business, you can often go through your local Chamber of Commerce to get in on their group rate. Check that out.

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"I want to know what kind of pickups Vince Gill uses in his Tele, because if I had those, as good of a player as I am, I'm sure I could make it sound like that.
Only badly."

Which then makes me wonder why GAL would not offer that with membership.

Administration costs are prolly the big reason.

Mike

One of the reasons there aren't large group rate packages is that each state controls the premiums to some extent, and approves the company plans. When they get it by the state auditors, then they go on a selling binge and sell the group at good premium levels, and guarantee a level premium for at least a year, sometimes two. Then all bets are off after the "we'll be good" period. the increases I have seen have all been in the 40 to 60% range per year, when they started to go up. The only thing that you do know is that they are treating everyone in the group the same. Some consolation, when you are bending over already!

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Waddy

Photobucket Build Album Library

Sound Clips of most of my guitars

Not true...

Well... not true in any that I have checked out. Most offer "discounts" but none that I could find offer a pool..

and trust me... I have searched.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

I don't think so. I think the insurance providers would be pretty happy to see a group with the potential size of a few thousand members join up.

This is complex to say the least, and my suspicion is that in our litigious world that few organizations would want to put themselves in harm's way. Imagine this scenario, the association researches and puts a plan together, you sign up and pay your monthly premiums, you get sick, insurance company (in typical insurance company fashion) is a huge PITA and makes noises about not paying, you get mad, you decide to sue, you can't sue your insurance provider in most states, so who does that leave? The association who you bought it through.

That would be my guess.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

I have looked into that too. No go.

Unless you are truly a legitimate company or have collected people into a recognized pool this would be considered insurance fraud. I know it sounds dumb when everyone is paying premiums based on their individual health profile, not on the actuarial risk profile of the group, but that is how they see it.

You could probably "get away with it" until somebody got seriously hurt or sick. Then the insurance companies would dig, find out this is just a loose association and not a legit company and all coverage would be denied and they would immediately demand all of their reimbursements back because they were defrauded.

I think the insurance industry has seriously rigged the game.

Here is what I "think" we might see in the future.

Companies stop insuring their workers day-to-day healthcare needs and replace it with a medical savings plan which they partially fund, then they buy catastrophic coverage policies for amounts above $25k a year or something like that. It costs them only a fraction to insure workers, and it is highly unlikely that anyone is going to go bankrupt from incurring a $25k healthcare debt (... our cars often cost more than that).

If all companies move to this model it makes consumers partially responsible for the cost of care and (as the theory goes) better consumers. It will give the companies a bit more breathing room in terms of cost -- which... in a good world could translate into wage growth or increased global competitiveness..

But I think it is simply a cost issue. Companies just can't afford to see a 10 - 30% annual increase in the cost of healthcare. Sooner or later something is going to give.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

Yep! Probably too late for some of us though.

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Waddy

Photobucket Build Album Library

Sound Clips of most of my guitars

Brock that's right - the Health Saving Accounts and more individual member choice in how your health care dollar is spent is the future.

In fact many hospital systems have been gearing up for this for several years anticipating this trend. What I see in my area is the two major health systems, one the largest in the world....., are redecorating the hospitals to provide private rooms, bringing in Starbucks, mall like shopping, broadband Internet access, and service providers such as people who will do your nails, style your hair, massage, etc....... The idea is that you will have so many dollars to spend to get well and you will be given the opportunity to spend it any irresponsible way that you wish.......

The end game is when you exhaust your account your provider has no duty to continue to perform or pay for you and pardon me..... you are SOL.

OTOH if you are an informed and cautious consumer of health care services you will have coverage when you need it.

So in a way it is a revolution because there will now be limits to the idea that what is collected from those who are healthy will be available to those that are sick. Only a set amount will be available to the sick which begs the question where will the excess go in the future - you don't have to be Federico Fellini to figure that one out....

The majority of Humana's business model is to help corporations make the shift from traditional single payer health plans to HSAs.

I guess that nothing is stopping any of us from creating our own HSA and trying as hard as possible to not get have anything catastrophic happen.

Interestingly my policy costs about the same as what a person would make working full time at minimum wage would earn(taxes not withstanding), at least for the moment. Or I guess you could look at it as comperable to a modest home morgage. No free lunch for sure.

Rich

I still think that companies will offer health benefits for catastrophic care (annual expenditures above $XX,XXX... you pick the amount). Catastrophic coverage on a group is "cheap" compared to day to day health care coverage. Companies can also partially fund the savings portion of each employee's account. While not a perfect solution, it helps companies bring the cost under control.

But none of this helps folks who are buying individual policies.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

Sorry duplicate.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

well I have my opinions about the mandated and legislated pyramid schem..... err sorry ... the health insurance industry.. all I can say is some states , like new york are offering a plan called " healthy new york " which is supposed to cover people at a discounted rate.. you might want to see if florida has a similar plan... some states also have companies forming groups of self employed individuals , for a group buy sort of thing ,personaly I am not buying into it , but if you feel it is a need ... good luck I hope it works out for you . Jody

I am at a loss here because I dont know what HSA is. Can you explain please?

Also, I have been using the AARP cards as a squeegee like Hesh does. If they offer health insurance, I may be interested in joining them just to get the cheaper rates. Right now the $902/month is a BIG hit to my budget. I could buy a LOT of tonewood for that much money

Also, I appreciate the replies to this thread. I also assure you that I have no political reasons for posting this either. My reasons for posting it here, rather than the off-topic area is that I am sure that I am not the only self employed luthier who frequents this forum who is in need of health insurance. I am as serious about this need as I could possibly be. It would seem that luthier organizations such as ASIA and GAL would offer some sort of group health insurance for their members. If they do, I have no knowledge of it.

Any and all information and leads will be most appreciated! I am seriously in a bind here and need to get this straightened out as soon as I can.

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Reguards,

Ken H

Staying on topic, one thing that my wife and I have found out in the mid-west is that CostCo has the cheapest pharmacy hands down. You do not have to be a member to buy prescription items there.

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Jim Howell
Charlotte, NC

Ken buddy I cut and pasted this from the US Treasury site:


Health Savings Accounts (HSAs)
Mission

Health Savings Accounts (HSAs) were created by the Medicare bill signed by President Bush on December 8, 2003 and are designed to help individuals save for future qualified medical and retiree health expenses on a tax-free basis

So the idea is that a portion of your income can be designated as a HSA and that portion will not be taxed. There are restrictions, but of course....., on what expenses qualify as legitimate health related expenditures that the HSA funds can be used to pay for. I'm not up on that part but a Google search would provide answers I am sure.

If I recall correctly once funds are designated for an HSA they must remain in the HSA until qualifying health related expenses utilize these funds. So it's possible to over fund an account if one remains very healthy and had no chronic health related costs. I also recall that the percentage of income that can be earmarked for an HSA is capped but I don't know the cap - anyone know?

OK, I just ran a hypothetical 58 year old couple in Florida, on the AARP Health Care quick quote. Rates ranged from $670 per month ($5000 deductible) to $1100 per month ($1500 deductible, more benefits). They are using Aetna for these policies.

You can also check out ehealthinsurance.com for a quick take on other plans.

I have been self employed for many years and an HSA is what has worked well for me.I believe you can contribute up to about 7500.00 per year per couple,depending on your age which you can deduct from your taxes,I like that part.This can be used to pay for medical and dental expenses to offset your deductible if you chose.Also the premiums are much cheaper than other major medical plans.Plus any money that builds up in the account are yours,which can be withdrawn after a certain age if not used up on medical expenses.Of course that money would be taxed when withdrawn.I`m not sure if this was a Bush plan or what ,and I could care less about politics.I do know that it has worked out well for me and the misses.
James W B

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James W Bolan
Nashville Tennessee

Actually $902 doesn't sound too bad (relatively speaking of course) ... I would just stay with that program for now and explore your alternatives, but remember all healthcare plans are not equal, read the fine print (and the footnotes.)

The other solution would be for your wife to get another job. Not the plan I know, but it would do the trick.

... and with respect to the associations... that actually would be pretty rare for an association to create a pool. Most offer discounts on individual policies, but there are virtually no associations (that I could find) that offer a true group insurance plan that you can buy into. I think it is a GREAT idea, but it is so obvious that there must be some reason why it hasn't been done.

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com

Health insurance is a huge problem for everyone. That includes big and small employers and the self employed. I run a small business of 6 people and have supplied health insurance for the past 10 years. It has gone from approximately seven thousand dollars a year to six time that. I had to switch insurance companies every other year to try and keep the costs down. Last Monday, I announced that insurance would not be supplied by the company and help with individual policies was not going to happen.

I am 61 and my wife is 60. From 60 to 65 is the worst for health insurance. Too old to be considered healthy and too young for Medicare. I think your best bet is to get a policy with high deductible, benefits for living healthy (free physicals, etc.). Attached to that policy, an insurance policy to cover the deductible for catastrophic events is a good and pretty inexpensive safety net (car wreck, heart attack, etc. ). Also, you can add some sort of health savings account to the policy. The policy should include an advocate to get you insurance company rates for doctor visits, drugs, etc. If you go to the doctor and it cost you $130.00 uninsured, but a provider might pay only half that, you need to be given the lower rate.

This isn't the best insurance in the world. But at my age, I save about 60% from a group policy and about 35% from an individual policy such as BCBS Advantage. I just need to stay healthy. And isn't that is what its all about anyhow?

Ken

I was for several years sort of part of the insurance field as a fraud investigator. Our independent company got on average 175 cases a month to look into. This was as adjusters, business owner and providers thought something not right going on. This is only a small percent of cases out there. I insisted as we did investigations that we assumed the person was not involved in fraud and had to prove the case with the same standard as other criminal activity. We did this and found over 95% of time fraud. The providers are going to make up this approx. Billion dollar a year problem somewhere. They do that in health, work comp, and home policies. I have heard over the years what is the problem it is only the insurance company, employer, State or provider and they are rich and won't miss it. That was and is the problem, they don't have endless pockets and they will make up the loss.

Working in 2 shops there were discussions on this issue a bunch. At Bill's we talked of it often. He looked into doing something in ASIA or having small business and in this case luthier shops into a pool. One problem with this, is well it is agains the law. There is a Fed Law that won't allow pools of small businesses to get policies across State lines. I have talked to folks in both parties in 2 States about this. One party is attempting to repeal this law and allow these small businesses to pool across the State lines. One party is fighting that tooth and nail. Reasons given mostly is the cost of policy from state to state may vary. True, however, as has been noted by the politicans is that this is a false issue and each State Insurance Commissions could make premiums level or set a percent that these companies would have to follow. Most insurance companys would welcome this and more folks and businesses they can get for a pool the better, and keep prices down. From my talks with politicans and insurance company folks, the problem with the one party attempting and stopping the repeal of this Fed Law is it would mess with their plans for universal or single payer insurance. They rail against the HMO's and say everyone should have same policy as they have. Funny, they have an HMO or PPO for most part. They also pay about $350 a month and employer (US) pay the matching funds. Just think if we paid for everyone the full price. Insurance companpies would stop or lower options as they couldn't or would not have Goverment lower premiums so everyone can be covered. If allowed to join pools small business like mine and others with say 3-20 employees could afford to pay half and half as it use to be. Trouble is these small businesses now don't have enough folks working for them, they have folks who may be older or pre conditions, so it isn't feasable to the insurer to make policies for these small businesses. I know we went through this. We had a great policy from national company, but there were not enough of us and most older and with issues. We had to get less coverage for more money and put more cost onto the employee. We finally got up to 25 folks working for me and younger so better coverage. If we could pools the cost would be better for company and insurer with better policy. Remember all policy's are not the same. I won't say which party is trying to get this done and which one is fighting it so can get universal or single payer laws. Bet you can figure it out though. Don't even want to go with other countries plans. Lot of them come here because can't get it there. Best thing is if this is important to you, find out the folks who are for pools and better private policys that would cost all less and one who isn't and contact the pol's and vote according to your findings and what works best for you. You may be on other side than me and that is fine, but have the knowledge of what is going on in this area of concern.

If legislation, not business complexity is what is preventing groups from pooling then it is time to change the law. I don't doubt what you are saying, but that is just wrong. .... I can't say too much more without violating the political rule... but suffice it to say, that I smell heavy lobby activity.

The problems go further than that though. I explored creating a loose affiliate of business owners that formed a corporation and "hired" all stock holders. The company would have no real purpose other than to provide health insurance and other corporate services (accounting, etc.) ... it essentially allowed several businesses to cost share and fix our mutual health insurance issues... The insurers flatly denied it, they said it was "insurance fraud"

Now don't misunderstand... each participant in the program would have to fill out a very detailed health profile and underwriting would have to determine a price for each participant. So there is no chance of slipping risky folks into the pool. .... so how exactly is this "fraud".

they are just a bunch of miserable b*****ds who have figured out how to get a lock on an industry.

I think the only thing that will realistically bring the cycle back around and loosen their grip of power will be when major employers stop proving day to day coverage and move to a hybrid plan like I discussed in an earlier post.

I get what Stan is saying about the pikers who are filing false claims. That is just wrong... But saying business owners who want to pool is fraud is just insulting, and infuriating.......

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Brock Poling
Columbus, Ohio
http://www.polingguitars.com