Finding affordable health insurance in Illinois can be a daunting task, but with the right strategies, you can significantly reduce your premiums. One effective approach is to leverage employer-sponsored plans, which often come with substantial cost-sharing benefits. For example, employers typically cover around 75% of the insurance cost for employees and 50% for dependents. Additionally, exploring medically underwritten plans from companies like Optimyl Benefits and Allstate Benefits can offer innovative solutions that may lower your overall expenses. These plans often include a claims fund account, where unused funds can reduce next year’s premiums.

Now, let’s get to the heart of today’s episode: how to find cheaper health insurance. If you’re purchasing health insurance through the marketplace and don’t qualify for premium credits or subsidies, it can be incredibly expensive. Here’s a practical example:

• Family of Four: This family has a $2,250 deductible, 50/50 coinsurance, and an out-of-pocket maximum of $9,450 per person. They pay about $3,100 per month for their policy.
• Employer-Sponsored Plan: In contrast, a comparable policy through an employer in the same area with a similar deductible but better coinsurance would cost about $1,900 per month.

The significant difference in cost is due to how individual policies and group policies are rated.

Understanding Individual vs. Group Policies

Individual policies rate each person separately, while group policies can use a tiered rating system based on employee demographics, such as single, employee plus spouse, employee plus children, and family rates. This tiered system often results in lower premiums for families compared to individual policies.

Leveraging Employer Benefits

Most employers cover about 75% of the insurance cost for employees and 50% for dependents. This substantial cost-sharing reduces the financial burden on employees compared to buying insurance independently through the marketplace.

Additionally, employers can implement an IRS Section 125 Premium Only Plan (POP). This plan allows employees to pay their premiums on a pre-tax basis, reducing taxable income and, consequently, payroll-related expenses.

Exploring Medically Underwritten Plans

There are also innovative insurance options like those offered by Optimal and Allstate Benefits. These companies provide medically underwritten plans with a claims fund account. If there is money left over in this account at the end of the year, it goes back to the employer, potentially reducing next year’s premiums.

Final Thoughts

The key takeaway is that there are various ways to reduce health insurance costs, whether through employer-sponsored plans, innovative medically underwritten policies, or simply by shopping around for the best options. While the Affordable Care Act provides essential protections, exploring all available options can help you find the most cost-effective solution for your needs.

At the MLD Agency, we continuously work to help our clients navigate the complex world of insurance. Last week, we assisted several clients with Medicare, dental policies, and converting groups to better plans. We’re also gearing up for the 2025 certification to ensure we’re ready to meet your insurance needs.

Rather Watch Mondays with Mark? Watch Below!