Two people who are (trying) to use individual insurance as a substitute for employer insurance:
I'm married with a kid on the way, and I'm cautiously optimistic about what my family's options will be next year. I started working for a healthcare company a few months ago, and my job transition happened during my wife's pregnancy. The new company has a somewhat generous health insurance policy, but steers employees to its own hospitals to the point that you basically don't have coverage anywhere else except for emergency room visits. Since my wife and I already had plans for delivery at another hospital, we decided to keep her on COBRA and I would shop for an individual policy. To my surprise, I was unable to get past underwriting, despite my good health, because my wife was pregnant and the insurance company would have been required to cover the new baby if they had issued me a policy, regardless of the baby's health after birth. I'm sucking it up this year on the new company's group plan, even though I don't much care for being told that I can't have surgery at the hospital of my choice. Hopefully the rates on the exchanges for a whole family will make it worth buying (although we wouldn't qualify for subsidies because we are eligible for a group plan).
One thing to keep in mind is that, at least in California, companies going into the exchanges are apparently keeping costs down by . . . restricting your choice of hospitals and doctors. Given that you'll be paying for that insurance with after tax dollars, I'd look carefully at the options on the exchange before you give up your employer sponsored insurance.
And then a reader from Nevada:
I live in Nevada and work for a small German company that was looking to expand to the US. We started discussing employment opportunities last winter and I joined the company (which technically is a Nevada corporation, wholly owned by a German parent, with a single employee, me) in January.
One of the challenging discussions that I had to have with my prospective employer was around health insurance. Because this is government-provided in Germany, they had no concept of how this worked in the US. Nobody would write a group policy with a group of one, so I went off and found an individual plan that covered myself, my wife, and my son with a $2500 deductible for $503 a month, which the company agreed to pay for.
Although this policy is less generous that the one I had with the company I left, it's among the most generous that I could find on an individual basis, and the the opportunity to start the US branch of a successful European firm was worth the tradeoff.
However, my insurance broker has warned me that next year, my premiums for the same plan will be somewhere in the range of $1000-$1100 a month due to changes in the required coverage, a difference in the way they are able to grade premiums by age (my wife and I are in our thirties and my son is 2), and several other factors. I hope that by the time this kicks in, we will have been successful enough in the US that we will have more than just one employee and we can start shopping in the small group market, because I dread going back to my bosses and telling them that the cost of employing me has just gone up by at least $6000 a year. They will probably pay it, but there goes any performance bonus or salary increase.
It's not clear that small group will be cheaper--indeed, as it has some additional restrictions, it may be more expensive. But if your group skews young, that may help.
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