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  • 1.  Medical insurance for independent consultants

    Posted 11-27-2018 02:10 PM
    Edited by Tirza Austin 11-27-2018 02:10 PM
    Medical insurance is one of the major considerations when leaving a company and starting one on your own. I'm lucky to have insurance for the entire family through my husband's job. I'd be interested to hear about people's experiences. Without getting too personal or political - are people able to find an adequate coverage at satisfactory prices through various available insurance markets?

    Natalya Sokolovskaya P.E., M.ASCE
    Wynnewood PA

  • 2.  RE: Medical insurance for independent consultants

    Posted 11-28-2018 12:24 PM
    Edited by Tirza Austin 11-28-2018 12:23 PM
    For <g class="gr_ gr_1065 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="1065" data-gr-id="1065">me</g> this is a resounding "no." 

    I recently started my own company and went on my husband's plan also. I recognize that I am very fortunate that I did not need to stay as an employee in order to afford health insurance for myself and my family.

    I previously worked for a small firm (less than 18 people total split between 2 offices in 2 states). Even when working for an employer, affordable insurance is pretty much an oxymoron and the costs have gone up substantially since I started working (15 years ago). And, unless you live in a large city, in many places there is basically a monopoly of which health care company you can use in your area. High-deductible plans are now very common. It's also challenging in many cases to figure out what policies actually cover when doing comparisons. To that point - where I previously worked the cost of having a family on our plan was so high that households with sole breadwinners went to the ACA exchanges for health insurance instead of staying on the company plan. 

    I've noticed that ASCE has started offering things like dental insurance. I'm wondering if at some point medical might be offered also, and in my opinion, this would be a hugely valuable benefit to individuals as well as small businesses. ASCE's life insurance is actually the reason I became an ASCE member <g class="gr_ gr_8515 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="8515" data-gr-id="8515">to</g> begin with (my employer offered this benefit though ASCE only). I've often wondered how many more companies would be started and jobs created if more people had access to a larger number of reasonable insurance costs outside of their employers.

    Stephanie Slocum P.E., M.ASCE
    Engineers Rising LLC

  • 3.  RE: Medical insurance for independent consultants

    Posted 11-28-2018 03:28 PM
    Edited by Tirza Austin 11-28-2018 03:27 PM
    Stephanie, thank you for your reply!

    Health insurance is a pet peeve of mine, having a family member with cancer lose their job in early 2000's, and not being able to find any health care coverage at all (luckily she's found a job promptly). My husband's high-deductible plan is also far from acceptable.

    I have next-to-zero understanding of the health care system, but can imagine that navigating the various available plans, and not having anyone to advocate for you in case of a problem is a nightmare.  I didn't know that ASCE had a dental insurance. I'd be interested to see if any health plans become available. A large organization like this may actually be able to absorb the variability in people's health conditions.

    Natalya Sokolovskaya P.E., M.ASCE
    Wynnewood PA

  • 4.  RE: Medical insurance for independent consultants

    Posted 12-06-2018 12:53 PM
    Edited by Tirza Austin 12-06-2018 12:53 PM

    The Affordable Healthcare Act was enacted January 1, 2014. ASCE no longer offers healthcare as everyone that does not have healthcare through an employer must go through this.

    ASCE does however offer supplemental health products to our members found here:


    Terri Dove Aff.M.ASCE
    Senior Manager, Affinity Programs & eLearning Webinars
    Reston VA

  • 5.  RE: Medical insurance for independent consultants

    Posted 11-29-2018 04:17 PM
    Edited by Tirza Austin 11-29-2018 04:16 PM
    I have been an independent consultant for over three years and after a few months on a COBRA plan have had ACA plans on two exchanges. My answer is that it is a mixed bag depending on your state's demographics, provider availability and regulatory climate.

    Initially I had a plan on the District of Columbia, which saved me a lot of money over a COBRA plan and was not terrible in terms of out-of-pocket cost. But DC is a strong exchange with a large and diverse risk pool that includes members of Congress, their staffs and a lot of independent consultants in a variety of industries.

    After I moved to New Hampshire last year, I had the option of auto-enrolling in my DC exchange plan or switching to a NH exchange plan. I reluctantly selected the latter, but have seriously regretted it. NH is dominated by one, for-profit health insurer, which has effectively colluded a few large health systems to make it difficult for unaffiliated providers. State level regulation in NH is haphazard and seems to be primarily concerned with generating revenue, so there is nothing done about this anti-competitive behavior. Also, NH is one of the oldest states in the country, so the exchange is likely populated by a lot of middle-aged people and families. I have had some difficulty finding providers outside the hospitals and one I have to pay entirely out of pocket. I have been unable to get a couple of recommended prescriptions because the insurer refuses to cover them. My deductible is huge although it does not apply to most expenses. 

    I recall ASCE members having access to a private exchange with Pearl Insurance a few years ago. I think I checked it out before selecting a DC exchange plan a few years ago. It looks like that exchange is no longer available and Pearl is selling members supplemental plans only.

    I will also note that comparing the total cost of plans is essentially futile. My first time shopping for plans on the DC exchange, I talked myself into a 'gold' plan by setting up a spreadsheet and assessing the higher premium with the lower deductibles and copays and anticipated use compared to other plans. It turned out my assumptions about how the deductible would be applied was totally wrong; Instead of having to pay it fully before coverage kicked in, I never had to pay it. So I took on a higher premium for no reason. The exchange's estimate of total cost is probably the best estimate you are going to get.

    I hope some of this helps.

    Richard J. Driscoll P.E., M.ASCE
    Lebanon NH