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sole practitioner health insurance

  • 1.  sole practitioner health insurance

    Posted 09-01-2018 12:54
    Any suggestions for getting affordable medical insurance for an individual too young for Medicare?  So I can't be the only one who can't find affordable health insurance for individuals/sole practitioner/business owner.
    So what is "affordable"...up until Jan 2018, I was paying about $325. Searched and even the marketplace indicate for my State of TN there is not an affordable healthcare carrier.  It was over $1200/mth for an individual.  4x my budget with high deductible is not affordable when I never go to the Doctor.

    I have been a sole practitioner since 2008 and had what I called "catastrophic" insurance.  Being a fairly healthy individual I was comfortable self-insuring but wanted to have coverage in case of a healthcare crisis. It seems I got grandfathered in after AHCA/obamacare took effect and was able to keep being covered with the same policy until 2018 when Humana decided or was forced to not carry non-compliant individual coverage.  Since discovering I no longer had a medical health care policy, I have been on a search for the holy grail of affordable insurance for a healthy individual who is too young for Medicare.

    Here are the facts and where I have looked so far without success
    -LIve in TN, just me no family, no spouse to be on their insurance plan, no employees, age 55+, female, non-smoker. Do not take meds and no pre-existing conditions.
    -My other insurance carriers do not carry medical insurance.
    -On the marketplace website....if I could not find affordable health insurance on their website they suggested
    -On the einsurance website I fill out a request for quotes. I will never again fill out a form online to get health insurance quotes.  I was harassed night and day every day of the week from "US health advisor" agents.  Agent claims to be CIgna but it is not.  It is Freedom. Reviews are mixed on US health advisor insurance.
    -I can't seem to find a broker to do a search for me.  They only do group plans.
    -I was surprised aia/aiatrust does not have something available to provide members a group rate.
    -I called Small Business Association and they laughed at me and basically said good luck finding insurance.
    -AARP only has supplement Medicare options
    -suggestions from friends lead me to more US Healthcare agents
    -Found State Farm has something that is AHCA non-compliant for less than $200.  This sounds too good to be true.  It requires a physical for my age to get the preferred rate.  It is not a known carrier.  I have some warning signs so I keep looking.
    -the non-complaint insurance like us healthcare advisors give me warning flags when I research reviews of their customer care and claim denials
    -I even saw a commercial for a health insurance helpline for healthy individuals who are not on Medicare.  When I called I got an "agent" was told the carrier was simple health insurance.  While the "agent", I could tell it was a call center, asked me some questions for a quote, I googled the name and found their BBB rating was a C-.  The complaints were being sold something then getting the policy it was not what they were told.  He gave me a quote and benefits.  I asked to be sent something in writing and he indicated they don't send out packages and brochures that is while the cost is low for their policies. I said I don't do anything without first reviewing something in writing.  He said if I gave him my credit card info he could send something.  I said no thanks and hung up.
    -I came to this forum and the search came up with the last discussion from 2011 where suggestions were things I had already tried with dead ends.  The original poster did not indicate what they finally found for coverage.

    Sorry for long post but wanted to indicate the journey so you knew what I had already tried.

    Elaine Bright, aia LEED AP
    Bright Ventures Architectural Consulting
    Nashville, TN
    Open: Call for submissions at - Financial support for non-profits working with architects

  • 2.  RE: sole practitioner health insurance

    Posted 09-03-2018 19:04
    Ms. Bright:  My sig. other and I used to have Blue Cross insurance.  WE got it by forming a "group" (WE have an LLC in which she is a 10% partner) and we paid $750 a month of $1000 deductible for a long time until we got Medicare. Now I am saving at least $700 plus a month..!!
    I used to pay for both of us and paid my first $18000 per year went to Health Insurance.  It was not good insurance because sometimes the doctors or hospitals charged more than Blue Cross would pay.  But, you cant get by without some insurance when you are over 40 or 50.
    Good luck.!  I have heard "Obama Care" was a good rate to people not making a great amount of money.

    Nelson B. Nave AIA
    Nelson Breech Nave, AIA Architect
    Kalamazoo MI

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 3.  RE: sole practitioner health insurance

    Posted 09-03-2018 22:53
    I have taken this issue up with the 2 nearby AIA Chapters a few years ago and all I the help I got was: "We can refer you to a broker." This really turned me off about the Institute.  In brief, having gone through a similar experience as you did, I found a local organization of AECs and discovered that they, as a group of around 75 persons consisting of small offices and sole practitioners, had a health plan and a benefits consultant.  I joined the organization and subscribed to their health plan.  It was not cheap, but compared to what I could get on my own it was less and better.  I think the Institute needs to step up to these and other challenges that small firms/sole practitioners deal with everyday.  

    Elmer Lin, Architect

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 4.  RE: sole practitioner health insurance

    Posted 09-04-2018 18:02

    Yes, I could never understand why the AIA could not interest a medical-care-insurance provider to provide a group coverage policy attractive to all.  Not enough members to make the actuarial numbers work?  There seems to be an attractive constituency for life insurance products.  Maybe not enough younger members? I would love to hear an answer from AIA.

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 5.  RE: sole practitioner health insurance

    Posted 09-05-2018 17:28
    As I understand it, the problem is that individual states have their own laws regarding health insurance and that makes providing a national association's group insurance difficult. I think at one point, AIA did have something for members but I couldn't access it because of Maine laws. I don't know if that is still the case.

    The system is ridiculously archaic and terribly unfair to small businesses and individuals.

    Carol De Tine AIA
    Maine Licensed Architect

    Carriage House Studio Architects LLC
    144 Vaughan Street
    Portland Maine 04102
    207 318 0731

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 6.  RE: sole practitioner health insurance

    Posted 09-07-2018 10:15

    When I first went out on my own, I looked at getting health insurance via the AIA Trust. It was the most expensive option and I ended up on a Blue Cross private plan. Luckily I am now on Medicare. It is the best coverage I have ever had, the least expensive and I have complete freedom in choosing heath providers and services. If this is what conservatives decry as government run insurance then I am all for it.


    Thad Broom



    Thad A. Broom, AIA

    Architects  & Designers P.C.

    220 Olivine Ave # 104

    Virginia Beach, VA 23462

    Tel: (757) 618 1125


    Beach Architect Logo_color copy


    Open: Call for submissions at - Financial support for non-profits working with architects

  • 7.  RE: sole practitioner health insurance

    Posted 09-05-2018 17:31
    I think the issue is the different requirements in each state.  Until you have portability across state lines, it is very hard to have a nationwide professional group manage a health plan.  Contact your representatives!

    Jane Kittner AIA
    Kittner & Pate Design Associates
    Waco TX

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 8.  RE: sole practitioner health insurance

    Posted 09-05-2018 19:46
    The AIA used to have a program, but it got more expensive every year until I finally gave it up and formed a "group" with my partner, who had other insurance but helped me out anyway. Now I'm grateful for Medicare.
    Medicare for all, I say!

    Bressack and Wasserman Architects
    751 Southampton Drive
    Palo Alto CA 94303 
    ph: 650 321-2871  
    fx:  650 321-1987

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 9.  RE: sole practitioner health insurance

    Posted 09-05-2018 20:49
    AIA would end up having to do any medical insurance on a state by state basis due to the variety of local laws and requirements (overall federal requirements not withstanding).  Even in states with a large AIA population, hard to sustain; larger firms likely already have a broker / carrier.

    Best bet may be to find a related group (builders, etc.) which offer plans to their members, and join.

    best regards,
    Joel Niemi
    - Architect

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 10.  RE: sole practitioner health insurance

    Posted 09-04-2018 09:30
    Without intending to get political here, BUT..... when a healthy professional cannot get access to affordable health insurance?!?  This pretty much indicates how broken the system is!  There is no reason this should be happening in the USA!  I suggest you share your story with your state and US reps & senators.  This is no small matter!

    Edward Shannon AIA
    Edward J. Shannon, Architect
    Des Moines IA

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 11.  RE: sole practitioner health insurance

    Posted 09-05-2018 17:33
    Yes, I'd really like to know why the AIA can't help us out with some sort of medical insurance for the sole practitioner/small practice.
    My husband is an IEEE member. They offer many benefits (including health and dental) and membership dues is about 1/4 what we pay as AIA members.

    Jennifer Kretschmer, AIA
    Principal Architect

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 12.  RE: sole practitioner health insurance

    Posted 09-06-2018 09:47
    Access to insurance is a touchy subject and does get into the realm of politics.  However, there is a lot more to it that most people are not aware of.  My wife works in medical insurance so I hear a lot about the difficulties with regulations, reporting, reimbursement from the ACA, medicare and medicaid, etc.  Unfortunately many insurance companies pulled out of the ACA because they were not getting reimbursed as promised.  There are a LOT of factors that make our current insurance system broken, and it has been years in the making.

    Although I am a proponent of reaching out to our representatives, we should not just blindly ask the government to solve our problems.  We should get educated on the topic at hand, then offer specific suggestions to our representatives regarding what kinds of solutions make the most sense.  This is not just the case for insurance, but applies to other issues as well.  In many cases the answer is for the government to be less involved rather than doing more.

    Brad McKenzie, AIA
    Assistant Director of Business Operations
    Project Architect

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 13.  RE: sole practitioner health insurance

    Posted 09-06-2018 17:00

    Working with the AIA Trustees (who are AIA members), I know that they share your frustration with the challenges that individuals and small firms have with obtaining quality and affordable health insurance.

    As of today, there is not yet an association group plan nor customized health plans that the AIA Trust can offer to AIA members-but the AIA Trust is continuing to monitor the situation in the event that changes. The continuing Affordable Care Act (ACA) still defines only two ways in which someone can purchase private insurance: through their employer or as an individual. Currently membership associations cannot band together and purchase health insurance on behalf of their members, and until that changes, there are no immediate plans with association group pricing that the AIA Trust (or anyone) can offer to individual members. However, the Department of Labor (DOL) announced regulations on June 19, 2018, which expand the definition of Association Health Plans (AHPs). This expansion applies to firms and the self-employed (working owners).

    The Trustees are committed to finding a healthcare solution as soon as possible. We are working in conjunction with our independent consultant, the AIA Small Firm Exchange, and an insurance agency to explore the potential new options that are permissible for association plans under the new DOL guidance.

    However, a fully insured AHP option is dependent on the insurance companies obtaining approvals from the various states and offering such products in the marketplace. The DOL guidance clearly reaffirms the regulatory oversight authority of each state and the approval timelines vary greatly among the states. There is also a question of how many insurance companies will offer these products. To date, United HealthCare has expressed an interest and our team has ongoing discussions with their representatives.

    As we have updates on this topic, we will share them on our AIA Trust website: We also regularly update our page of healthcare resources found here:  In addition, you can sign up for the quarterly AIA Trust newsletter, Managing Your Risks, here: which will continue to publish healthcare coverage updates.

    Ann Casso Hon. AIA
    Executive Director, AIA Trust
    The American Institute of Architects
    Washington DC

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 14.  RE: sole practitioner health insurance

    Posted 09-06-2018 17:39
    I'll chime in at the risk of getting political.  Until we remove the profit motive from health insurance we'll continue to hear the stories of how difficult the solution is.  Obviously, sick people really hurt the bottom line of insurance companies' pro forma.  We must consider basic health care a human right and not a privilege.  Single-payer or universal health care is a reality and does happen in the majority of the developed world.  Voting is the root of a democratic society.  Voting in large numbers can create consensus, and lead to real change.  The AIA should acknowledge that the majority of its constituents are small firms. The AIA excels in many areas of protecting its members' professional reputation.  It should stand up to protecting its members' physical health and well-being with the same commitment.

    Gregory Holah, NCARB
    HOLAH Design + Architecture
    Portland, Oregon 97232

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 15.  RE: sole practitioner health insurance

    Posted 09-07-2018 17:54
    I have to agree with Gregory Holah here. I'm sure we all have stories about staying at a job we didn't like (or with a spouse we didn't like?) because we couldn't lose our healthcare coverage. Imagine all the lost talent, chances not taken, and unhappiness that's caused when you multiply that by millions of people. Removing profit motive and the massive overlap of bureaucracy that lots and lots of for-profit insurance companies creates would probably save a lot of money right off the top. And the benefit of increased mobility would be immense.

    If government-sponsored healthcare was so bad, then you wouldn't have seniors fighting to keep medicare, soldiers fighting to keep the VA, and congresspeople fighting to keep their system. Plus, somehow it's working for most of the developed world, and very few of those people seem to be traveling to the US to get care (much the opposite, in fact).

    Ian Toner AIA
    Toner Architects
    Philadelphia PA

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 16.  RE: sole practitioner health insurance

    Posted 09-08-2018 00:21
    Very well stated, Mr.Holah.

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 17.  RE: sole practitioner health insurance

    Posted 09-08-2018 05:31
    In the meantime, you may wish to look into CHRISTIAN HEALTHCARE MINISTRIES, My CPA advised me to enroll in order to avoid the non-insurance penalty and to have some type of $$$ assistance for major illnesses and/or accidents.

    I am hoping the AIA can develop a similar type of group coverage.

    Regina Konet AIA
    Konet Architecture
    Folsom CA

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 18.  RE: sole practitioner health insurance

    Posted 09-10-2018 19:50
    thanks so much for your suggestions.  I am not much for big government.  I was ambivalent about the ACA/obamacare when it came out but thought it would be nice for those who could not get health coverage due to illness or work situation.  Now, it seems reverse discrimination for a healthy entrepreneur.  After my struggle to find health insurance, I will be a watchdog on the healthcare insurance issue.  I also wanted to document for future members so those in the same situation can be aware of options.  I sure wish I could get the billable hours I have taken just to get to this point.
    rest of the journey...........

    1.  Chamber of Commerce and other business/trade organizations:  Seems, I am just speculating from my present experience, that since the ACA has gotten long in the tooth and grandfathered plans with major medical insurance companies are being dropped that the Business/trade organizations can no longer find affordable plans to offer their members.  My chamber no longer offers and other design and construction industry organizations that I have looked into locally are not offering group rates/plans to members as of this writing.  If you find any currently doing so let me know.
    2.   aiatrust is no longer offering health insurance as of this writing.  Ann thanks for your response to explain what is going on with that situation and I will keep a lookout for future changes.  As mentioned by other posters, state by state is probably the issue and now I am just discovering the significance.
    3.  US Health Advisors is offering a plan put it is not health insurance.  It may be an alternative but do your research.  I can't put my finger on it but I just don't get a good feeling about their business practice.  Something about where multiple agents across the country are forced to have to call and email you just as soon as you have filled out an online form.  The online forms do not disclose that it is US Health Advisors so you can avoid if you have already researched them.  Ask me how I know.  Again, this week, I filled out a form that offered to compare insurance and immediately got my phone ringing off the hook and canned emails.  There are many reviews that raised a flag.
    4.  Someone suggested going back to work long enough to get Cobra.  So this is where the government is squashing the small business/entrepreneur.  I like what I am doing and just to get health insurance I have to go back to work for someone else.  It was office politics that drove me out on my own and right now just don't have the stomach to go back to working for someone else unless it was an offer I could not refuse.  The businesses are being forced to make employees contribute and select high deductibles to get the insurance affordable for employees.  Watch out for Cobra, the insurance premiums can be high when you leave and elect to go on COBRA.  If you have a health event when on COBRA and period expires, you are stuck with little options.
    5.  BCBS of TN was suggested.  When you put in for a quote and indicate income that will not get a healthcare market subsidy you will be redirected to an off-market company that it seems similar to USHealthAdisors.  In my case, it was GoHealth who in the review seems to have a huge amount of limitations and may be similar to US health advisors. It seems all major medical carriers are redirecting to off-market if you can't get subsidies from Oh, also phone rang off the hook and my hiya phone ap identifying them as a telemarketer and they don't leave a message.

    6.  The solution I am researching now is the Health Share ministries mentioned in a couple of previous replies. It seems to work most like major medical insurance with affordable premiums.  (I have eliminated Liberty due to some red flags but mainly due to BBB NR rating because of a pattern of complaints and numerous complaints.  I eliminated Samaritan because they want you to send a check directly to someone who has a claim and I prefer a platform that all you do is send your premium in and then they send it out to who has a claim. I eliminated Solidarity as they seem to be only for Catholics) I am checking out Christian Ministries Medi-share, and Altrua.   I will let you know which I chose after I compare apples to apples.

    7.  One thing I did learn from a US Health Advisor that there is a Healthcare Blue Book similar to Kelly Blue Book for cars.  Check it out at
    Since my deductible will be so high, I will be using this to find fair prices on labwork and testing.  Maybe even procedures.  I learned my first lesson regarding the high cost of healthcare when a doctor sent me next door to the hospital lab to get an iron test of my blood.  Got a bill for $300.

    Fill free to contact me if you come across this thread looking for options and want to discuss.

    Elaine Bright, aia LEED AP
    Bright Ventures Architectural Consulting
    Nashville, TN

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 19.  RE: sole practitioner health insurance

    Posted 09-10-2018 21:39
    After being kicked off Blue Cross Blue Shield in TN even though my wife and I were healthy and willing to pay ever increasing premiums, we went down the same path many of you are sharing.

    We made the decision to go with Christian Healthcare Ministries. You need to profess your faith in Christ to be eligible so that may not bean option for all. We have been very happy with this decision and the fact that our "premiums" are about 1/3 of our previous BCBS policy is a nice aspect. Part of the way this type of program works is based on a bill share model which means we negotiate with our care providers to "self pay" and then submit our bills to our "carrier" who then reimburses our costs. My wife had a heart attack earlier this year and thankfully is recovering well now. I also made a trip to the emergency room for a minor mishap this year. We found that almost every health care provider we talked with discounted their fees at least 40% once they knew we were self pay. We are in the process of submitting our bills so will have to follow up in a few months on that aspect.

    In addition to all of this, One of our grown children who lives in AL and struggling to make ends meet got an Obama Care approved health provider and found out as soon as they found out they were pregnant with their 3rd child, that the provider would not cover maternity claims and then lost their accreditation and so they were suddenly without insurance.

    I don't have an answer to the problem, but maybe my experience will be helpful to some of you.....

    Scott Wilson AIA
    Scott Wilson Architect LLC
    Franklin TN

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 20.  RE: sole practitioner health insurance

    Posted 09-12-2018 11:01

    My wife and I have been on Samaritan's Ministry for 17 months after our Blue Cross premium doubled when our previous plan ended. We ended up going with that because I was able to speak with a couple of people who had used it and had very positive experiences, including someone who had all their children while they were on it. 

    If I can help with any specific questions I'd be happy to. As of today, we (thankfully!) haven't had to use it, but I really like that our money goes to an individual or family in need instead of a company. Also for most people now you can just send money through Paypal. 

    Best of Luck,

    Licensed Architect | Owner

    MANHATTAN, KS 66502

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 21.  RE: sole practitioner health insurance

    Posted 09-12-2018 16:49

    Oh, don't get me started.  I began self-insuring about 25 years ago, as a middle-aged architecture student, at $200-250 a month.  In my first job after graduation, I was covered by my employer.  Five years later, when I quit to work freelance, the premiums of my previous policy had quadrupled to over $1000/month.  Now I could afford only this insurer's HMO policy, at $600/month.  Over the next few years, this HMO premium ballooned to $15,000 a year

    That's when I got aggressive and discovered a shameful secret:  As a sole proprietor, I had been eligible all along for a business policy from this very insurer, at half the cost of my individual policy.  A broker referred by my local AIA chapter got this switch completed within two weeks. For the next couple of years my monthly premiums remained between $500 and $600 a month until >boom!< all of America's self-employed were "redefined" - dumped out of business policies and back into individual policies. In that first year of ACA/Obama Care my premiums dropped to $424 a month (without assistance, and I could even afford to upgrade the next year) but I was a martyr to ACA's teething problems; when I learned I could get identical coverage from my new insurer, at the same cost, by renewing directly - rather than through that hellish Exchange - I did.  I now had the benefits of ACA without its torture.

    I'd like to say that my new insurer and I lived happily ever after, but they went out of business last year, just as I graduated to Medicare.  Kiddies, you're on your own!

    Leslie Levy, Assoc. AIA


    Open: Call for submissions at - Financial support for non-profits working with architects

  • 22.  RE: sole practitioner health insurance

    Posted 09-12-2018 17:10
     A friend of mine is a high up in the food chain in one of Philadelphia's prominent centers for advanced medicine. I asked him his opinion of CHM from their perspective. His response was - "Christian Ministries is a cost-sharing plan. We do not accept it. Typically our patients who have these types of plans are self pay and get reimbursed through CHM or sometimes CHM will pay up front for specific services. We have had one or two rare instances where we accepted a single case agreement, but again very rare, and probably because case was clinically unique. 

    I think the self pay portion of this can be very daunting to pts.  For us it means that if you come for a service, we give you a discounted rate bc you are self pay and then as the pt you are expected to pay in total up front to have services.  Hope this helps."

    My early impression is that most of the negative reviews online are from folks who forgot that they forfeit the cost sharing if they cancel or change their plans the year following their treatment. It appears that diligently following the CHM guidelines is key for making it work.
    1. First confirming that the testing or procedure will qualify. 2. Getting the self pay discount (sounds like its commonly offered), 3. Having the healthy ability to promptly submit for reimbursement and  4. Getting a payment plan and patience in place, to wait 120 days for reimbursement.

    Thank you for sharing your research & insights insights.

    Frank Radey, AIA
    Radey Associates Architects
    Cherry Hill NJ

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 23.  RE: sole practitioner health insurance

    Posted 09-13-2018 20:56
    Isn't it peculiar that providers will give a self-payer a substantial discount [presumably factoring in collection-related costs on possible bounced checks, etc.] but are happy to charge the insurer the "usual and customary" rate?  Must cost a lot to keep the insurance companies going.

    After becoming self-employed, and using COBRA for nearly the full term, I/we were on a HSA (had been before, too) until this year, when the insurer we found more tolerable to work with stopped offering HSA plans.  At least my wife is now on Medicare, and I'll be there too after the new year.  However, for us that's essentially backup catastrophic coverage, as we prefer treatment by (in our opinion, more effective and healthy) 'alternative care' providers, not covered by the typical plans.

    best regards,
    Joel Niemi
    - Architect

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 24.  RE: sole practitioner health insurance

    Posted 09-14-2018 17:36

    Not sure if this will help anyone, but I have a contact who is in my professional network group and her company specializes in finding health insurance for independent workers, sole practitioners, entrepreneurs, etc.  She is licensed in 20 states and has worked in this industry for many years on both the healthcare side and the insurance side.  Her name is Stephanie Puryear and her company is Healthcare Solutions Team.  Website is   Her email is  I have not used her myself but spoke with her about the difficulty for architects  when finding insurance. Good luck!


    Suzie Van Cleave, AIA



    4421 N Oakland Ave #200                 O 414.204.8917 

    Milwaukee, WI 53211                        C 847.778.1625




    Open: Call for submissions at - Financial support for non-profits working with architects

  • 25.  RE: sole practitioner health insurance

    Posted 09-11-2018 14:47
    You might look at Farm Bureau - they had some individual plans that in the past were an option for me (Farm Bureau Health Plans - Individual and Family Plans in Tennessee
    Fbhealthplans remove preview
    Farm Bureau Health Plans - Individual and Family Plans in Tennessee
    Farm Bureau Health Plans offers affordable health coverage plans for individuals and families in Tennessee
    View this on Fbhealthplans >
    )  The costs were not inexpensive, but it was coverage.  It's not an easy market out there.  Best of luck!

    Van Gale Pond AIA
    Van Pond Architect, PLLC
    Nashville TN

    Open: Call for submissions at - Financial support for non-profits working with architects

  • 26.  RE: sole practitioner health insurance

    Posted 09-11-2018 19:07
    Hi Julia et. al,

    I am currently the chair of the Small Firm Exchange and we have been working with local components and the AIA Trust (ref Ann Casso commentary in Item #13) to gain coverage for small firms and sole practitioners, so your question and this discussion is quite timely.

    For reference, the Small Firm Exchange is a member group at the national level with a representative for each region of the AIA.  We began the conversation at one of our monthly meetings to discover how different regions handle health care because even though the ACA is a national issue, it is still dependent upon regional offerings.  As the initial inquiry summarized, coverage for a small firm with 1+ employees is exponentially easier to acquire than coverage for a sole practitioner.

    What follows is a lamens explanation of health care:

    As it stands, with the ACA in place, any health insurance carrier (BCBS, United, etc) is required to offer the same marketplace plans to an individual.  They will be the same cost.  These carriers can offer non-market place approved plans as well.  You should be able to call the carriers for your state without using a broker.

    Costco has an insurance line - it is primarily a broker service with United Health Care.  I've been told they can help with individual plans as well but I did not personally need to go this route.

    There are HR companies that essentially let you buy into their "group" plan as an individual.  This can be more costly, but if there are not ACA plans available - it can be an option but might require a lot of due diligence to find the right fit.

    Finally, there are a few locations, Portland and Knoxville that we know of, that have AIA local chapters who have partnered with brokers to provide health care options.  These group plans are still required to follow state law as it applies for sole practitioners.  There are not many states that allow for "group" or business coverage as a sole proprietor unfortunately.

    So, the Small Firm exchange is working to support our needs on two fronts.  First, we've been trying to connect with our components to find out which local chapters would be interested in offering coverage for their small firms and sole proprietors. Second, we've been working with the trust to understand if a national plan would be possible which does have a host of additional complications.

    If you would like to get more involved with this issue, I encourage you to find your regional representative of the small firm here: Small Firm Exchange Regional Representatives - SmallFirmExchange

    You can contact your rep to help us create a stronger network, you can sign up for the SFx newsletter and follow us on social media Facebook  or Twitter  Finally - continue to speak up and share your voice - the louder we are, the more we will be heard and take action!

    Thanks all for sharing on this topic - please don't hesitate to reach out to me too.

    Best wishes,

    Chyanne Husar AIA, LEED BD+C
    husARchitecture Inc
    Chicago IL

    Open: Call for submissions at - Financial support for non-profits working with architects