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Mikado · 11-19-2004, 11:36 AM

I'm a group health broker in Houston, so maybe I can lend some insight into the situation. Notice though that things can change from state to state. Insurance is state regulated so law and provisions may be different where you live.

When I have a client in your situation I ALWAYS recommend staying with COBRA. Now the rules in Texas state that a company with 20+ employees falls under COBRA, and less than 20 falls under State Continuation. The difference? Under COBRA you can continue coverage for up to 18 months as long as you pay the full premium. State Continuation only provides 6 months of coverage. The reason I suggest people stay with COBRA is because in Texas, individual insurance DOES NOT cover maternity. So if your wife is pregnant, you'll be paying for insurance and the entire cost of the baby's birth. Not a very good deal, when you could have continued to pay your COBRA premium and had the entire thing covered. Of course the exception would be if you only have 6 months left out of 18, and the baby's not due for 8 months.

Now if your new boss were to look into some group health insurance, his rates would be 67% higher than standard issue because of your wife's pregnancy. So more than likely that is out of the question. If you can find an individual policy in your area that DOES cover maternity, then your rates will also be raised. How much depends on the state's regulations. Like the previous example, in Texas providers can only raise rates to a maximum of 67%. The other thing to take into consideration with individual plans that DO cover maternity, is that they will consider it a pre-existing condition and may decide to exclude it from coverage.

Unfortunately individual insurance (in Texas at least) doesn't cover everything that group insurance does. The rates aren't that much lower either, so if it all possible stick with a job that provides some group coverage. There are plans out there for small businesses to help them provide benefits. In Texas a group is only required to have 2 full time employees. However proper tax documentation has to be provided to show an employer/employee relationshiop. It's there to prevent a husband/wife getting group insurance.

If you have any other questions, let me know and I'll do my best to answer them. But again let me state that if you're outside of Texas, laws and regulations set by your state could be quite different. Good luck to you!

11-19-2004, 11:36 AM	#7 (permalink)
Mikado Crazy Location: Houston, Texas	I'm a group health broker in Houston, so maybe I can lend some insight into the situation. Notice though that things can change from state to state. Insurance is state regulated so law and provisions may be different where you live. When I have a client in your situation I ALWAYS recommend staying with COBRA. Now the rules in Texas state that a company with 20+ employees falls under COBRA, and less than 20 falls under State Continuation. The difference? Under COBRA you can continue coverage for up to 18 months as long as you pay the full premium. State Continuation only provides 6 months of coverage. The reason I suggest people stay with COBRA is because in Texas, individual insurance DOES NOT cover maternity. So if your wife is pregnant, you'll be paying for insurance and the entire cost of the baby's birth. Not a very good deal, when you could have continued to pay your COBRA premium and had the entire thing covered. Of course the exception would be if you only have 6 months left out of 18, and the baby's not due for 8 months. Now if your new boss were to look into some group health insurance, his rates would be 67% higher than standard issue because of your wife's pregnancy. So more than likely that is out of the question. If you can find an individual policy in your area that DOES cover maternity, then your rates will also be raised. How much depends on the state's regulations. Like the previous example, in Texas providers can only raise rates to a maximum of 67%. The other thing to take into consideration with individual plans that DO cover maternity, is that they will consider it a pre-existing condition and may decide to exclude it from coverage. Unfortunately individual insurance (in Texas at least) doesn't cover everything that group insurance does. The rates aren't that much lower either, so if it all possible stick with a job that provides some group coverage. There are plans out there for small businesses to help them provide benefits. In Texas a group is only required to have 2 full time employees. However proper tax documentation has to be provided to show an employer/employee relationshiop. It's there to prevent a husband/wife getting group insurance. If you have any other questions, let me know and I'll do my best to answer them. But again let me state that if you're outside of Texas, laws and regulations set by your state could be quite different. Good luck to you!