Problems Securing Health Insurance for the Self Employed

The small businesses that struggle the most with health insurance may be the smallest of all: those with only one employee.

In 11 states, self-employed people have some of the same legal rights as small companies when it comes to dealing with insurers: Colorado, Connecticut, Delaware, Florida, Maine, Massachusetts, Mississippi, New Hampshire, North Carolina, Rhode Island and Vermont.

But elsewhere, in dealing with insurance companies, the nation’s estimated 20 million self-employed are on their own.

 

In Virginia, a state with relatively few controls on insurance rates, Clay Williams, a 59-year-old self-employed real estate agent in Falls Church, said the cost of health insurance for himself, his wife and two sons, had tripled in six years. After it ballooned last year to $1,956 a month, he angrily refused to renew.

When he shopped for a new insurer, one company rejected his 20-year-old son, a student, because six months earlier he had had mononucleosis, a common disease on college campuses.

Another company would have set limits on the coverage Mr. Williams could buy. And it planned to raise the annual deductible because of his age and his noncancerous prostate problem.

Mr. Williams finally decided last May to go with an Aetna plan with a deductible of $8,250 and monthly premiums of $680. Last December, he said, he was notified that the monthly rate would jump 27 percent, to $864, on Feb. 1.

Then, a few weeks ago, he said, the company told him it had incorrectly recorded his wife’s application and was again raising the monthly premium, to $1,020.

Aetna confirmed Mr. Williams’s version of events.

“As an individual,” Mr. Williams said, “I have absolutely no clout. What’s my payment going to be in six years — $4,000 a month?”