Pre-existing?

[marc869]

Hello all,
I really hope I can find an answer to my question.

A little background; I have been wanting to start a business for years but my wife has liver problems and she may need a transplant sometime in the next 10 years or so. I have switched jobs several times and have always had no problem getting health insurance through my new company. The law is that they cannot deny me or her coverage as long as there is no interruption in coverage for approximately 60 days. I had insurance in place when she was diagnosed.

The question is whether private insurance I obtain on my own or through my small business would have the same rules. It is really keeping me from starting down the road to my own business. My wife is scared to death to start up anything because of this.

Has anyone had this experience or any first hand knowledge at all? I'm hoping I don't have to contact a lawyer on this. Thanks so much for any help ahead of time.

M

[Corey Bryant]

Usually private insurance will carry some type of clause on pre-existing conditions. Sometimes these clauses will state 6 months or 12 months.

For example - I had a hernia. I knew I had one and I just got private insurance in December. I had never been diagnosed by a doctor or anyone in the medical profession. So therefore, I did not have the hernia. (Note: the insurance company paid the $3,000 for the hernia surgery but actually denied my primary doctor when he diagnosed it for about three months. They finally paid him as well.)

My advice - get insurance (privately) now for her. And then that way she has it. Otherwise, you might get stuck with the bill. Talk to a few insurance brokers. It is free and that is what they are there for.

I used to deal with insurance a lot about eight years ago and so many things have changed, they have this thing called co-insurance. Basically, it is another deductible. So keep that in mind as well.

The other thing - how many people are going to be in this business? If there are two employees (usually you can get business insurance) - and your wife will still be covered, however, your premiums might be a bit more. Once again, an insurance broker will be able to help you out (at no charge) with a lot of these questions.

[marc869]

Thanks! My first thought with this is that I could set up an LLC and then become an employee. That way I should be able to get health insurance through the company, right?

My wife is a stay at home Mom and has always been covered under my insurance. I assume she could still be covered by my LLC. I will give a broker a call. Thanks for the advice.

[Corey Bryant]

Usually most insurance companies will require a minimum of two employees. And a lot of times you will have to provide proof -time sheets, payrool, etc. The reason being, anyone could claim they are an LLC of one and get the "better" benefits of a company's insurance policy.