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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.
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 A. Broom, AIA
Architects & Designers P.C.
220 Olivine Ave # 104
Virginia Beach, VA 23462
Tel: (757) 618 1125
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: http://www.theaiatrust.com/healthcare-coverage/. We also regularly update our page of healthcare resources found here: http://www.theaiatrust.com/healthcare-coverage/national-healthcare-reform/. In addition, you can sign up for the quarterly AIA Trust newsletter, Managing Your Risks, here: http://www.theaiatrust.com/news/ which will continue to publish healthcare coverage updates.
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
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.
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 www.healthcaresolutionteam.com Her email is email@example.com. 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