Even with Kansas's marketplace offering EPOs exclusively, a nationwide PPO is still available through me. If you're leaving your employer to operate your own company, I'll explain how to keep your family covered during the transition, beginning with the continuation protections Kansas provides.
Hi, I'm Sam Jaber. I hold licenses in 36 states and help Kansas entrepreneurs by phone, whether they're opening an electrical contracting business in Lenexa, running a Manhattan bakery, or building a consulting LLC in Wichita.
We're looking at a specific situation Kansas business owners face: giving up a salaried position to devote all their time to their company. Their job-based insurance is coming to an end, the new business has no established income history, and their family needs protection without missing a day. Fortunately, Kansas's continuation law offers a possible way to maintain coverage while making that change.
This year, Kansas residents can choose among 64 individual medical plans on the marketplace, but every one is an EPO. HealthCare.gov offers no Kansas PPO option.
I can help your family secure a nationwide PPO in Kansas even without one on the marketplace. The insurer asks each family member about their health, uses those responses to determine premiums, and provides access to a network of providers throughout the country. For healthy households accustomed to a large employer's PPO, this can be one of the closest replacements for the coverage they're leaving behind.
Under Kansas law, you may be able to continue an insured group health plan after your employment ends. The statute requires a group of at least two employees and three consecutive months of coverage before termination. Your premium stays at the rate paid by people remaining on the group plan, without an additional markup. However, you'll be responsible for the entire amount, including what your employer previously contributed toward the premium.
With bigger employers, federal COBRA is generally the continuation route. Regardless of which applies, losing employer-sponsored insurance usually gives you a 60-day special enrollment opportunity through HealthCare.gov. Keep in mind that choosing COBRA and voluntarily canceling it afterward won't create a fresh enrollment period.
The right choice comes down to your family's medical situation, which doctors you want to keep, and what you reasonably expect your new company to pay you during year one.
Before deciding, let's get clear on a handful of practical details. How many months might pass before your company earns enough to handle premiums comfortably? Are you receiving treatment or seeing a doctor that your existing plan covers and you don't want to lose? Could you join health coverage offered through your spouse's employer? Since Kansas marketplace coverage consists entirely of EPOs, do any plans offered in your county include your family's providers? Sorting through these questions while you're still employed gives you time to make a thoughtful choice instead of scrambling on your final day.
When your household is healthy, comparing a nationwide PPO with continuation coverage makes sense. The carrier evaluates everyone's medical answers and may accept the application, reject it, or accept it with a specific exclusion. On the other hand, if you expect relatively little income during your first business year, a marketplace credit might make an EPO the more affordable choice for your family.
Next step: Reach out a few weeks before leaving your job, and I'll compare the cost of keeping your coverage, choosing a marketplace EPO, or getting a nationwide PPO for your household.
If you're already receiving treatment, continuation coverage may be particularly useful because it lets you stay with your existing doctors and plan. Your next move depends on the care involved. Explain your situation to me, and I'll compare marketplace coverage with a private policy for you.
Next step: Let me know which treatments or appointments are continuing, and we'll plan the coverage change around keeping that care from being interrupted.
When business income is tight during the first year, Kansas requires extra attention because it hasn't expanded Medicaid. Once you employ a person who is neither an owner nor a family member, you may also qualify to explore a SHOP group health plan.
Next step: If your startup year will be financially tight, give me a call before signing up, and we'll review which coverage your household can qualify for.
Straight answers, no sales pitch.
In many cases, yes. Kansas permits continuation for insured employer groups with at least two employees, provided you maintained coverage continuously for three months. You pay the rate charged to remaining group members. Bigger employers generally use COBRA.
No additional markup is allowed. Kansas's statute requires the same premium rate that people continuing in the group are charged.
No marketplace PPO is offered. All 64 individual medical options are EPOs, although I can help a healthy household obtain a nationwide PPO.
When employer-sponsored coverage ends, you generally qualify for a special enrollment window lasting 60 days.
Give me your final workday, employer size, county, and the people covered under your plan. I'll compare Kansas continuation coverage, marketplace options, and a nationwide PPO so you can see how they stack up.
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