flogmad

Hello. I have a 3 year E1 Visa and my wife and I are moving to Tampa from the UK in February 2011. We have loads of questions and lots to learn.

One thing on my list is medical insurance.

We're in our 40s and pretty healthy and are used to living in the UK with our NHS although we do have some private cover as well.

My E1 Visa is sponsored by my company and I'll be the first US based employee so there's no existing medical plan we can join.

Would people recommend I setup a scheme for my company to provide medical cover for the two of us or would it be better to do it as individuals? Are there some well known companies people can recommend for company or private medical cover?

I'm going to start a US company as a wholly owned subsidiary of the parent UK company.

Thanks in advance for any suggestions.

Rete

Are you saying that the company's newly formed US Subsidiary of a UK company and there are no other employees except yourself? Will you be the one and only employee for a year or more? Will the company be hiring others? As a business it is cheaper for them to get a plan but they will need more than 1 employee to provide coverage for. If the above is the case, then get individual and make it contingent upon transfer that the company foot the entire cost of the premium as well as pay for the deductible. Not the co-pay, but the deductible.

Oops sorry see that your spouse is also employed by the very same company.

flogmad

Yep, I'm going to start a new US company which will be wholly owned by the UK company. The UK company has some employees in the UK which currently includes myself and my wife. The US company will hopefully hire more staff but probably not for a couple of years. I'll be full time and my wife will be part time. Are two employees (one part time) sufficient for a company to provide a medical insurance plan?

When you say deductible, is that the equivalent to what we would the 'excess' in the UK? Also, what do you mean by 'co-pay'? Sorry for all the questions but am keen to learn...

Bob

Depends on the insurance, it won't be a great cheap rate, but it'll be better than you getting it on your own.

Check out local town/county business association or trade commerce type groups and join them, you'll probably be able to get a group plan from them then and it'll help.

Co-pay is what you pay every time you go see a doctor, get a prescription, get on an ambulance. That's different to the deductible that you have to pay for treatment before insurance kicks in.

Have a read through the wiki and search over past threads, there are loads, even very recent threads going over recommendations and info on what to look out for.

MsElui

im no expert - but for me deductible is like an excess - except for its not on a per incident rate. ie you can pay the excess each time you have an accident. Here you have the deductible amount set once per year. Stuff that isnt covered by your medical insurance 100% is billed to you up to the limit of the deductible. ie a kids vaccination and annual checkup is covered by my insurance but a trip for any other reason can cost me. if one trip costs $100 then thats $150 left of my £250 deductible. If I go again and it costs say $200 then i would only have to pay the first $150. The $50 and any subsequent costs is covered. That said - some things are NOT covered at all by insurance or the insurance only pays 80% of or whatever and it must be in network so you could still have to pay.

my family of 5 has a deductible of $250 per person - up to $750 for the family - ie we dont have to pay more than $750 in total for the family per year - and no more than $250 for any one of us in that year.

As said by Bob - this is all in addition to the co-pay - which is for me - $10 per person per visit.

flogmad

Thanks for the responses. I know it's impossible to give a precise answer but in rough terms can anyone give me an idea of what we (a couple 45 and 48 in good health) might pay for a year of medical insurance? Are we talking perhaps $10K or $20K per annum. I really have absolutely no idea the amount to expect to have to pay. Also, is it the norm to pay monthly or is it all paid in advance?

Bob

You pay monthly....and it depends on what you fancy for level of cover and what you're prepared to pay for a deductible.

You could pay as little as $100 a month if you don't mind $10K per incidence deductible, a broken leg should take care of that.

Or for decent cover, you could be looking at $1500 a month, per person.

flogmad

Blimey, I'd not thought it would be as much as $36,000 per annum

Bob

Thing is, like I said, it all depends on the individual plan, it could be anything in between...also depends on what kind of group discount rate you can get from joining a local trade association or what not.

Employer usually gets the policy and then either contributes part of the rate or pays the whole thing, so the individual often doesn't realise how much is paid. As the employee, what you pay as a premium goes to reduce your taxable income though.

flogmad

Thanks. That makes good sense.

Rete

I can tell you that if I were to take my company's plan with my spouse included, my portion of the premium would be in excess of $600 a month and that does not include what the company kicks in on the premium. Even my portion is half of the total monthly premium you are talking $14,000 a year.

My daughter and her family of 5 have private insurance with a $5,000 deductible per year (total between all members of the family) and a co-pay of $25 per office visit. There is no prescription insurance nor any dental and they pay $10,000 a year.

PS as it is your spouse that is the part-time worker then you would only be looking at one employee who requires a family plan and not two employees with individual plans. Normally pt employees are not eligible for healthcare from a company.

Rete

Not clear to me if you are the owner of the UK company and in an effort to get residency status in the US are starting up a US Company. If that is the case, can you afford to have healthcare?

flogmad

Yes to the first question, I am the principal shareholder of the UK company.

As to the second part, my plan is to expand on our existing US trade so no, it's not just an effort to gain residency but a sound business prospect. We will be purchasing healthcare I'm just not familiar with the options open to us hence the questions tonight.

HarryTheSpider

Welcome!

My employer engages the services of a health insurance company to administer the plan, but essentially picks up the actual medical bills. There are various levels of plan, which simply determine the balance between what you pay out of each pay check, and the deductibles or 'excess' - the amount of cover is the same for all levels. This is a different way to tackling the annual challenge of paying 30-40% more than the previous year for a reduced level of cover, as seems to be the case for so many employer medical insurance schemes... Given that typically the bulk of employees need very little in the way of actual medical attention, this and a focus on prevention ultimately leads to significantly lower costs for everybody...

I work for a reasonably large company, big enough that it has established its own clinic for employees and families to use - think of it as a small GP surgery like back home - the upside is that there is no 'co-pay' - nothing to pay for a visit - getting referred elsewhere is when the medical insurance plan mentioned above kicks in.

I'm thinking that as the principle shareholder of the UK company you will have insight in to the strategic drivers for setting up a US operation - is $18K of annual medical insurance costs a big enough reason not to press ahead? You may be able to find a co-operative set up that operates a little more like the scheme my employer uses...

Good luck

Harry

scrubbedexpat099

Most large companies operate that way, the larger the number of participants the more the cost can be actuarially predicted.

I think some of numbers mentioned are a bit extreme both ways, certainly $1k a month should get you something. It varies by State.

Deductible and Excess are the same term. The Deductible is usually capped.

The big unknown is co-insurance, usually is 20%, so if you have a bill for $10,000 you pay $2,000.

The higher the premium the more frills you get, the more they pay, the less you do. Like anything else.