Finding small business health insurance

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Q. I’m thinking of starting my own business but I will need to buy health insurance. What should I do to find out the prices I should expect? I wouldn’t have employees but I’m married with three kids. Can Obamacare help?
— The research phase

A. Starting a business is a big decision and we wish you the best with your venture.

There are certainly many challenges you will face, and finding the right insurance is no exception.

There are many rules, regulations and variables to consider when establishing a company-sponsored health plan, said Ed Gaelick, a Chartered Life Underwriter and Chartered Financial Consultant with PSI Consultants in Glen Rock.

“Federal and state rules sometimes conflict and the various insurance companies interpret some aspects of the laws differently,” Gaelick said. “You have your mainstream carriers and those `outside the box,’ hence you’ll absolutely need a knowledgeable broker to help you navigate through the complication.”

Gaelick said the fact that you won’t have any employees to start will almost certainly rule out group-sponsored coverage, he said. Group plans would be more desirable as there are more choice and broader networks, he said.

While it seems moot at this time for you, he said, a company that meets the requirements for group coverage can start a plan anytime.

That is very different from getting individual — non-company sponsored — medical coverage, where there are only certain times when you can get coverage, he said. These times are called “open enrollment” opportunities.

“So assuming you have no other option than individual coverage at this time, you can enroll for a Jan. 1, 2017 effective date unless you have experienced a `triggering event’ that would open a `Special Open Enrollment’ period, Gaelick said.

A few examples would be getting married, having or adopting a child or losing other coverage involuntarily.

He said you can purchase coverage through a broker or go directly to healthcare.gov — the Obamacare Marketplace — and search for carriers, plans and rates yourself.

“The Marketplace is simply an online place to shop for individual coverage and the only way you’d be eligible for a `subsidy’ — which depends on household income,” Gaelick said. “It gets so complex and confusing. My strongest advise — seek the counsel of a good broker.”

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This post was first published in September 2016.

NJMoneyHelp.com presents certain general financial planning principles and advice, but should never be viewed as a substitute for obtaining advice from a personal professional advisor who understands your unique individual circumstances.