When you leave or change your affiliation with a firm, its health insurance may no longer cover you. Here's how advisors operating their own practices are protecting their households while lowering insurance expenses.
Hi, I'm Sam. I'm based in Tampa as a licensed health insurance broker, and I work with financial advisors who own their practices or contract with firms rather than working as employees. I hold licenses in 36 states, and I handle consultations and enrollment entirely by phone.
As a financial advisor, you're comfortable reviewing contracts, evaluating costs and comparing financial choices. The confusing part of health insurance is often how eligibility works. If you switch your relationship with a firm, you can lose its coverage. And when you look for group insurance as the sole advisor in your practice, you'll discover there generally isn't a group plan available. I'll explain the alternatives I discuss with advisors and how we evaluate their costs.
Regardless of how successful your practice is, I begin with the same question: will your household's income for the coverage year make you eligible for marketplace premium assistance? Established advisors frequently exceed the limit, but we should verify that, particularly when you're changing firms or starting a new arrangement.
For advisors working for themselves, the relevant income is what the practice earns after business expenses. That includes costs such as compliance services, platform charges, licensing, employees and office overhead. Marketplace subsidy eligibility ends at four times the federal poverty level, slightly over $60,000 for one person, with the threshold increasing for larger households. Because advisory fees may be collected quarterly, annual earnings can fluctuate. We'll use your projected income for the specific year you need insurance.
This is where many established advisors find themselves. Without a subsidy, you pay the entire marketplace premium. For family coverage, that can become a significant expense, especially when you don't anticipate using much medical care.
For advisors in good health, private medically underwritten insurance offers another possibility. The insurer reviews health information submitted with your application and determines the price for applicants it approves. That premium can often be substantially lower than the marketplace's unsubsidized rate. These policies use nationwide PPO networks, allowing you to visit participating specialists without referrals and remain within the network when traveling for conferences or client meetings.
Before submitting an application, you need to understand how underwriting works. Your medical answers can result in approval, a declined application or approval that excludes a particular condition. Coverage terms also vary by policy, and I'll go through those details with you. Having a condition under treatment doesn't automatically tell us the outcome. The specifics matter, so bring it up when we talk and I'll explain how both options compare.
Next step: Give me a call and I'll compare a nationwide PPO quote directly with the full marketplace premium, letting you evaluate the numbers side by side.
If you were an employee receiving health benefits through your firm, that insurance generally stops when your employment ends. Losing the plan usually gives you a 60-day special enrollment period for marketplace coverage. You may also be offered COBRA. Just remember that voluntarily cancelling COBRA after enrolling doesn't create another enrollment window, so compare your choices before making that decision.
We can arrange for an underwritten policy to become effective when your employer coverage expires. However, the insurance company needs time to review and approve the application, so it's better to begin the process well before your final week.
Next step: Contact me once you know when your affiliation is changing. We'll coordinate the timing of your insurance so the transition doesn't leave you without coverage.
The options are different when your advisory practice employs other people. If you have at least one employee who is neither an owner nor a family member, you may qualify for group insurance through the small-business marketplace, or SHOP. Someone you pay as a contractor, such as a paraplanner receiving a 1099, doesn't count toward that employee requirement.
Whether group insurance actually offers better value than having everyone purchase their own coverage depends on your staff situation. I'd compare pricing for both arrangements before making a commitment.
Next step: Let me know your staff size and whether each person is an employee or contractor. We'll compare the available arrangements and determine what works for you and your advisory practice.
If you're leaving a firm that provided PPO insurance, you may assume you'll have to switch to an HMO or EPO. That's especially understandable where marketplace PPO plans are unavailable or priced too high. But I can offer nationwide PPO coverage throughout my 36 licensed states. If you're healthy, we can check the premium in a quick call.
There's no charge for my assistance. If you enroll in coverage, the insurance carrier pays me directly for helping you.
Straight answers, no sales pitch.
If you're the only person working in your practice, you'll generally purchase individual insurance through the marketplace or a private carrier. But if you employ at least one person who isn't an owner or family member, your business might qualify for SHOP small-business group coverage.
Generally, yes, when you're working for yourself. However, the self-employed health insurance deduction cannot exceed your practice's net profit, and you cannot claim it for months when employer-subsidized insurance was available to you. Your tax preparer can review how those restrictions apply to your circumstances.
When your firm employed you and provided your health benefits, leaving usually means that coverage ends. You generally receive a 60-day special enrollment period to choose marketplace insurance, and COBRA may also be offered. If you're healthy, you can consider medically underwritten private coverage as another alternative.
Yes. If you're a healthy financial advisor earning more than the subsidy threshold, I can compare private nationwide PPO plans for you in any of the 36 states where I'm licensed.
We can get started with your practice's net income, the type of affiliation you have, and the people who need insurance. I'll compare the available routes and explain the prices. If your existing coverage is already the better choice, I'll tell you that rather than recommend a change.
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