Napa's Health Insurance Guys: Can new business owner get health insurance?

Dear Kyle, Tom and Alan:

I'm 44 and been unemployed for several months. My unemployment benefits get me through, but I've decided to start my own business.

A friend told me that if I'm going to get my own health insurance, I'd better hurry because open enrollment ends Jan. 31.

First, can't I just apply directly to the insurance company? I'm in very good health. Second, if I start a business, can't I get coverage whenever?

Chris

Kyle: Let's start with the second one. If you start a business as a sole proprietor, you're going to need an employee (not spouse). The insurance company is going want a copy of your DE-9C, a quarterly report you're required to file with the state that will show you and your employee.

Small group health insurance is not cheaper than individual, and most prospective employees are going to want the owner to contribute at least half of the monthly premium as an inducement to work there.

To answer your question, yes, you can get it whenever, but it's whenever you get all your ducks in a row. Some companies would like to see your business up and running for at least six months.

Al: There are groups of one person, but that's usually when an employer signs up with an employee and shortly thereafter the employee drops off.

Tom: As of right now, open enrollment does extend to Jan. 31. In the past few years, that "drop dead" date has been extended due to pandemic, fires, drought, etc. —almost to the actual beginning date of Nov. 1. It would not surprise me at all to see the Jan. 31 date extended this year as well, and possibly including floods to the list of disasters.

Al: There are also Special Enrollment Periods (SEP) right now for FEMA-related problems in many California counties. These are specifically for Medicare plans, but I expect it to be available for individual/family plans too.

Kyle: Don't forget that in years past Covered California continues open enrollment for months, but the individual health insurance companies do not.

For example, you can go onto that very helpful "shop & compare" tab on the coveredca.com website, look up all available plans based on zip code, individual info, etc., and apply through Covered California.

However, if it's not in the Nov. 1 to Jan. 31 timeframe, you would not be able to go direct to the company to apply. The companies in our area are: Kaiser, Western Health Advantage, Anthem Blue Cross, and Blue Shield. Healthnet has decided to leave us for new enrollments.

Covered California has many allowances for applicants outside the Nov. 1 to Jan. 31 open enrollment time; individual insurance companies do not. In addition to the disaster SEPs that are becoming so frequent Covered California has a number of "qualifying events" that can guarantee coverage. These include: losing group or individual (including Medi-Cal) coverage; changing marital status; changing residence; becoming a citizen; getting out of jail; and others.

Remember, income is the key to how much you're going to pay for Covered California plans.