Health insurance options for startups

I wouldn't go a single day without good health insurance, and I wouldn't let any of my family be without this protection. Annual physicals and random checkups are one thing, but having insurance in case of a major emergency is absolutely essential.

I never had to think about health insurance while I was at Apple, but once I quit, I was on my own. Since our country doesn't give us health care, we have to do all the research on plans and rates.

Here are my findings, thoughts, and recommendations after setting up health care for Posterous. This isn't meant to be definitive in any way. I would love feedback and suggestions.

When I left Apple, I elected to go on Cobra so I wouldn't have to spend time researching

When we Posterous in June, 2008, I elected to continue my Apple health care through COBRA. I was paying over $400 per month, so it wasn't cheap, but it meant I didn't have to think about health care for a while.

When you are starting a company, you want to spend every waking moment coding and building. Trying to figure out which health plan to sign up for was not good use of my time. Instead, I paid the premium and knew I had great coverage.

If you can get it, Anthem Blue Cross Tonik is a great option for cheap health care

The requirements are strict, but Anthem Tonik plans are great if you can get one. These are meant for young, healthy people. You get a few doctor visits a year, a dental checkup, prescriptions, all the basics included. Anything after that falls into a high deductible.

Most startups go with high deductible plans, but these incentivize you to skip going to the doctor when you are sick

The most common health insurance plan I see people signing up for is Anthem Lumenos. This plan is designed for companies who want to keep costs low. It covers preventative care, but everything else falls under a high deductible.

What I didn't like about this plan is it disincentivizes you from seeing a doctor when you are sick. Do you have a cold? Do you need a prescription? If you know you'll be paying out of pocket for this, you might choose to skip it. I wouldn't want someone at Posterous to skip medical care they want.

For Posterous, I chose a high deductible plan that still gives you office visits and prescriptions

After doing a lot of research, I chose to go with the Anthem Solution plan. It's similar to Anthem Lumenos in that it's a high deductible PPO. But the main difference is normal office visits and prescriptions are covered, even before you satisfy the deductible.

The max out of pocket is higher for Solution than it is for Lumenos, but I think that's a fair tradeoff. I'd rather optimize for the common case (random doctor visits) than for the edge case (major medical emergency).

It's actually really unfortunate that we have to think about these issues at all. We shouldn't have to make sacrifices when it comes to health care.

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