
Ask HN: What do when your company has bad health insurance options? - nealrs
I&#x27;m in the middle of completing my open enrollment forms for this year and I gotta say - my health insurance options are kind of crap. And it was the same at the previous startup I worked at it.<p>In fact, the only time I had good health insurance options was when I was at Caterpillar (obviously much larger &#x2F; corporate).<p>What options do I have, living &amp; working in the US, to improve my situation -- short of changing employers?<p>I mean, can you even compare startup insurance plans without asking HR during an interview&#x2F;at the offer stage?<p>FYI - my insurance options are determined via a co-employer (common for startups with under 50 employees)
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dtnewman
This is a stinky situation. Even with the healthcare exchanges, it's usually
cheaper and much less of a hassle to get your health insurance through your
employer.

It seems to me that this is a hard thing to compare before the interview/offer
stage. However, it's all part of compensation as far as I'm concerned. In
other words, it usually makes sense to take a salary cut for better health
insurance or to ask for more salary (or equity, etc.) when health insurance
options are worse, though how much of a cut/raise is going to vary based on a
person's needs (i.e. healthy people are rarely visit the doctor aren't going
to value good health insurance as much).

The other option that might be possible in a small company is to ask for extra
cash in exchange for not going on the health insurance plan. For example, if
your company pays $5000/year towards your health insurance, they might be
willing to cut a deal with you where they pay you $4000 if you _don't_ take
the insurance (under Obamacare, they have to _offer_ a group policy, but it
seems like doing this is fair game [1] as long as you have the option to be on
the group policy). In practice, this option really only seems practical if you
have a spouse or someone else who can put you on their health insurance plan,
since individual plans are usually much pricier than negotiated group plans
offered by employers.

[1] [http://obamacarefacts.com/questions/can-pay-employee-not-
tak...](http://obamacarefacts.com/questions/can-pay-employee-not-taking-
health-insurance/)

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nealrs
Yeah, spouse plans are great, _if_ they are significantly better/cheaper. I'm
a single dude who doesn't have a ton of health problems, but I see middle age
on the horizon and I know I'm going to start going to the doctor more.

FSA is a good option for for reducing total costs -- if you're ok
preallocating / can predict your health care costs for a year. Which I don't
think most people can.

Perhaps there's an opportunity for someone to improve transparency here w/r/t
job hunting. I'm not sure I would have changed my decision about where I was
going to work -- but it would have been nice to know what my options were.

~~~
sfrailsdev
FSA is also tax advantaged, so you can pay out of pocket and invest for
retirement or whatever, when you are more likely to have health costs.

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Mz
I used to work in insurance and I still sometimes write insurance related
stuff as a freelance writer.

Obamacare allows children to be covered by their parents until age 26, even if
they do not live with the parents and even if they are married. This may not
apply to your situation, but it may be helpful to some of the younger people
on HN.

A little known "loophole" for Obamacare that is actually very effective is to
go with Direct Primary Care. I have blogged about that;

[http://micheleincalifornia.blogspot.com/2015/12/how-to-
fix-a...](http://micheleincalifornia.blogspot.com/2015/12/how-to-fix-americas-
financial.html)

Best.

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JSeymourATL
“Long gone are the days when you thought your insurance—even if you were
paying higher premiums—was going to cover you very well,” >
[http://www.wsj.com/articles/employers-shift-higher-health-
ca...](http://www.wsj.com/articles/employers-shift-higher-health-care-costs-
to-workers-1476194147)

