One Man Groups

Group of One Health insurance plans

 

One Man Group policies are legally enforced in states where there is no state high risk pool, or if the state has mandated that all health insurance companies offer it.  No company wants to do these health insurance policies because it is usually only bought by individuals with chronic conditions.

Many times, a business owner will be unable to qualify for health insurance and if he or she is just starting a new company and has a few assets this person might not be able to get approved for individual health insurance. If I had my choice, I suppose I would prefer a high risk pool to a one man group, as risk pools are often underwritten by states.

In any case, this our state by state guide for one man groups.  If your state is not here, then you should check either our risk pool page, or visit your state’s health insurance home page to see what plans are offered in your state for high risk health situations.




To get a one man group health insurance quote fill out our form on our group health insurance quote page.

Alaska

 

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

ACHIA. Alaska Comprehensive Health Insurance Association, the state-run insurance program for HIPAA eligible persons and for people with high health risks (called a high risk pool).

Alternative Trade Adjustment Assistance (ATAA). ATAA is a benefit for workers at least 50 years old who have obtained different, full-time employment within 26 weeks of the termination of adversely-affected employment. These workers may receive 50% of the wage differential (up to $10,000) during their 2 year eligibility period. To be eligible for the ATAA program, workers may not earn more than $50,000 per year in their new employment. Also, the firm where the workers worked must meet certain eligibility criteria.

 

Arizona

Usually, if you are self-employed with no other workers, you are not eligible to buy a group health plan on your own outside of the Healthcare Group of Arizona (HCG).  Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

If you are self-employed, your only guaranteed access to health insurance coverage is through the HCG plan (see below).  If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

The Healthcare Group of Arizona (HCG) is a state-run program that provides insurance to individuals who work for participating small employers.

· You also must meet minimum participation requirements.

· You cannot have offered health insurance coverage in the past 6 months.

 

California

If you are self-employed with no other workers, you are not eligible to buy a small employer group health plan on your own. Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health coverage is protected by the laws that apply to individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of your premium from your federal income tax.

Major Risk Medical Insurance Program (MRMIP). The state-run program that provides health coverage for people with high health risks (called a high risk pool).

 

Colorado

If you are self-employed with no other workers, you may be eligible to buy small group health plan coverage as a self-employed business group of one. To qualify, you must work in your business at least 24 hours per week on a regular basis. In addition, your business must have generated taxable income or you must have derived a substantial part of your income from the business. Substantial income is defined as an amount sufficient to pay your health insurance premium.

If you qualify as a self- employed business group of one, small group health insurers must offer you the choice of a standard or basic health plan on a guaranteed issue basis during open enrollment periods. You cannot be turned down because of your health status. You may be able to buy other, non-standardized policies insurers sell to other small employers, as well; however, insurers can turn you down for these non-standardized policies because of your health status.

You are only eligible to buy coverage as a self-employed business group of one during annual open enrollment periods. Your annual open enrollment period is the 31-day period following your birthday. Self-employed business groups of one are also entitled to coverage within 31 days of the following events: exhaustion of COBRA or state continuation coverage; the date you first meet the definition of a business group of one; or involuntary termination of other health insurance coverage. At all other times, your access to health insurance is protected by the laws that apply to individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Connecticut

If you are self-employed with no other workers, you are eligible to buy the Basic Small Employer Health Plan. For more information about the Basic Employer Health Plan, contact the Connecticut Insurance Department, Life and Health Division at (860) 297-3800.

Insurance companies are allowed to require proof that you are self-employed or a business group of one.

If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premium from your federal income tax.

Delaware

If you are self-employed with no other workers, you are eligible to buy a group health plan on your own. You are guaranteed access to all health insurance sold to small employers.

If you are self-employed and buy your own health coverage, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Washington DC

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals (see Chapter 3).

If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premium from your federal income tax.

 

FLORIDA

If you are self-employed with no other workers, you are considered to be a group of one. Insurers are required to accept your application for a standard health plan, a basic health plan and a high deductible plan in August of each year to make coverage effective on October 1, of that year. They can refuse to sell you other plans, however. Further, the rules for pre-existing condition exclusion periods are somewhat different.

For groups of one, pregnancy can be counted as a preexisting condition.

If you are a group of one and you have had no prior coverage, the group health plan can exclude coverage for your preexisting condition for up to 2 years. The plan can count as preexisting any condition for which you received, or – in your insurer’s judgment, for which you should have sought – a diagnosis, treatment or medical advice in the 2 years prior to enrolling in the plan. This is called the prudent person standard. If you had prior coverage, you will receive credit toward your preexisting condition exclusion period for any time you satisfied under your prior coverage provided there was no break in coverage greater than 63 days.

In order to show that you qualify as a self-employed person or a business group of one, insurance companies are allowed to require that you provide them with your tax forms.

If you are self-employed and buy your own health insurance, you may be eligible to deduct 100 % of the cost of your premium from your federal income tax.

Georgia

If you are self-employed with no other workers, insurers may, but are not required to, treat you similarly to other small employers. While insurers can refuse to sell you the packages they make available to other small employers, they may choose to offer you a group health plan. If you are offered a small group health plan that is offered to other small groups, the limits on group health plan premiums will apply to your plan. If you are not offered a group plan, your access to health insurance is protected by the laws for individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Hawaii

If you are an unincorporated sole proprietor with no other workers you cannot buy a group health plan. However, you may be able to join a group health plan through a family member or a professional association that sells group health coverage to other small employers or self-employed persons. If not, you can seek coverage in the individual market. (See Chapter 3.)

If you are a sole proprietor with no other workers and you incorporate your business, becoming the sole employee of that corporation, the laws that protect workers access to group health insurance also apply to you. (See Chapter 2) Provided that you work at least 20 hours per week for 4 consecutive weeks and you earn a monthly salary of at least 86.67 times the minimum hourly wage, your corporation, as your employer, is required to offer health coverage to you. Health insurance companies must sell your corporation any small group health plan they sell to other small employers. To find out more information about how to incorporate your business contact the State of Hawaii Department of Labor and Industrial Relations at 1-808-586-8842 or visit them on the web at http://hawaii.gov/labor/.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% percentage of the cost of your premium from your federal income tax.

 

Idaho

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join a group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals (see Chapter 3).

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

Idaho residents are guaranteed the right to buy Individual High Risk Reinsurance Pool (HRP) plans under certain circumstances. You may be able to buy a HRP plan if an Idaho insurer turns you down due to health status or claims experience or offers to sell you coverage at a premium higher than that charged for HRP plans. You are also guaranteed the right to buy this coverage if you are HIPAA eligible or eligible for the Federal Heath Coverage Tax Credit (HCTC). This is called guaranteed issue (see page 18).

 

Maine

If you are self-employed with no other workers, you may be eligible to buy a group health plan on your own (or you may be able to join another group health plan through a family member). However, insurance companies that sell both individual and group coverage can choose to offer you an individual health insurance policy only. If you cannot find a carrier that sells group coverage to sole proprietors, you can buy an individual health insurance policy and be protected by the laws that apply to individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax   If you own a small business with 50 or fewer employees, you may be able to purchase health insurance coverage for yourself and your employees through the DirigoChoice.

Alabama

 

If you are self-employed with no other workers, you are not eligible to buy a group health insurance policy on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals. (See Chapter 3.)

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

Did not find a high risk pool plan particular to Alabama.

 

Arkansas

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals (see Chapter 3).

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Texas

  • · If you are self-employed with no other workers, you are not eligible to buy a small employer group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health coverage is protected by the laws that apply to individuals.

Louisiana

  • If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals. (See Chapter 3.)
  • If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of your premium from your federal income tax.

Mississippi

If you are self-employed with no other workers, you are eligible to buy a group health plan on your own. You are guaranteed access to all health insurance sold to small employers.

North Carolina

If you are self-employed with no other workers, you are treated similarly to other small employers. Insurers cannot refuse to sell you the standard plan or basic plan. However, insurers can refuse to sell you other plans.

If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Oklahoma

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

  • · If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

South Carolina

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

  • · If you are self-employed and your spouse is considered an employee, then you may be considered a small group for the purpose of purchasing health insurance. (See

above).

  • · If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Tennessee

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

  • · If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premiums from your federal income tax.

Virginia

  • · If you are self-employed with no other workers, you cannot buy a group health plan policy. Therefore, the laws that protect small employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.
  • · If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premium from your federal income tax.

West Virginia

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individual.

  • · If you are self-employed and buy your own health insurance, you may be eligible to deduct 100% of the cost of your premiums from your federal income tax.

Illinois

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

ILLINOIS COMPREHENSIVE HEALTH INSURANCE PLAN (CHIP)

Illinois has a high-risk pool program, called Illinois Comprehensive Health Insurance Plan (CHIP) that offers insurance for people with health conditions who are unable to buy private health insurance coverage and for people who are HIPAA eligible.  CHIP is also considered a qualified health plan for individuals eligible for the health coverage tax credit (HCTC).  (see Chapter 5) If you lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program then you may be eligible for a federal income tax credit to help pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and it is equal to 80% of the cost of qualified health coverage, including COBRA, and a specific policy offered through the Illinois Comprehensive Health Insurance Plan (CHIP).  (see Chapter 5)

 

Iowa

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plan do not apply to you. The laws that apply to individuals protect your access to health insurance.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

Iowa Comprehensive Health Association (HIP-IOWA).The state-run program for people with high health risks (called a high-risk pool). ICHA also sells coverage to those who are HIPAA eligible. See also HIPAA Eligible.

Indiana

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

• If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premium from your federal income tax.

 

Kansas

If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member). Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.

If you are self-employed and buy your own health insurance, you are eligible to deduct 100% of the cost of your premiums from your federal income tax.

KHIA. Kansas Health Insurance Association, the state-run program for people with high health risks (called a high risk pool). KHIA sells individual coverage to those who are federally eligible and to others with serious health conditions who cannot buy affordable coverage from private health insurance co