Navigating health insurance as a solopreneur, with Mitchell Underwood
Navigating health insurance as a solopreneur, with Mitchell Underwood
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[00:00:00] Steve: Hello there, dear listener. I am Steve.
[00:00:08] Tyler: And I'm Tyler, and welcome to another episode of It's Not About The Money, the podcast where we help you gain the clarity you need to run a successful small business.
[00:00:17] Steve: Tyler has a financial coaching practice. I run a tax business and we are both small business owners like you. And this podcast is our exploration of entrepreneurship one episode at a time.
[00:00:29] Tyler: And this episode is another in our series of The Many Hats of an Entrepreneur, where we're covering business functions that every business has, but where you as the owner may not be an expert. So far, we've covered things like marketing, IT, sales, and finance. And today we're excited to welcome an expert in health insurance to the podcast.
[00:00:49] Steve: Mitchell Underwood is a health insurance broker located in Houston, Texas. He helps entrepreneurs, individuals, and families uncover and understand their health insurance [00:01:00] options and find the coverage they need right now. And this is, this one's my favorite. He's a decipherer of boring insurance jargon.
Welcome Mitch.
[00:01:08] Mitch: What's going on, man? Thanks for having me on.
[00:01:11] Steve: I heard you recently on, uh, Paul Ranieri's podcast, uh, Tax Strategy Digest, and thought that you would be a perfect fit for this series that we've been doing of somebody who has started a business, they're out on their own. What do they need to know to run the business successfully? And health insurance is a big piece of that for a lot of folks.
[00:01:31] Mitch: Yeah.
[00:01:32] Steve: So I'm excited to talk about this today.
Making the jump from an employer health plan to an individual health plan
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[00:01:34] Mitch: Cool, man. Yeah, no, definitely. I, like I said, I appreciate you listening to the podcast, Steve, and you know, for having me on here. I'm, you know, definitely happy to kind of share what I know. And you know, as far as that, you know, that goes, someone who is maybe thinking about leaving their job to become self employed you know, the biggest thing I kind of advise, just like with most things is you know, don't wait till the last minute.
Don't just say, Oh, I'll figure it out. Don't underestimate it [00:02:00] because that's really where I see the biggest issues coming up with people is they jump into something because they're excited about it. Right. And they're not really checking all the boxes. So that's kind of the biggest thing that I would advise someone in that situation is to pre plan it.
You know, look at your options in advance before you pull any triggers on anything because you know, there could be quite a bit, you know, quite a bit of blowback in that regard because I think the biggest thing I see is that people, they, they're used to their employer coverage, right? And they're used to it being simple.
It typically being good coverage and they may not have any idea just how different the world of individual health insurance is and it is significantly different. And it's oftentimes, unfortunately, a lot more difficult and troublesome in some regards. It's not clean cut. There's, it's a whole, whole different ballgame.
So anytime you're thinking about making a transition from an employer plan to an individual plan, you really do want to do your homework in advance. So if you have a timeline in [00:03:00] mind, like, hey, maybe I might make this jump in six months or, hey, if I could do this, you know, next month or the month after, I'll, I'll do it now.
You need to start doing your research, doing your homework and. I would always advise speaking to a professional that, you know, understands the industry and that can kind of give you some guidance on, you know, what you can expect. And also of course, trying to actually get a policy in place before that transition, because I see tons of entrepreneurs do this where they, they venture out and they, they're, they're, They don't even have anything set up.
You know, they, uh, they go ahead and get started and, you know, maybe they're uncovered, you know, they don't have any coverage for, you know, X amount of time. I mean, you don't even want to really theoretically go a day without health coverage. I mean, obviously it sounds hyper, you know, fearful in a sense, but I mean, you just never know what's going to happen on a daily basis.
So, I mean, you want to have something in place when you make that transition and do this, you know, do your planning in advance. So that's kind of my main tidbit there that I would say.
[00:03:59] Steve: Mm. [00:04:00] Yeah. Yeah. Yeah. Yeah. I'm glad you brought up the differences between, like, being on an employer plan as an employee and then jumping to individual coverage. Uh, I haven't made that leap myself yet, so I don't know what, what are all the dragons out there? Like, could you walk us through maybe what are the main differences there?
[00:04:17] Mitch: Yeah, so I mean, for one, I would say that your needs definitely come into play. So for instance, if you're, let's say you're on an employer plan and let's say you have some medical conditions, right? Let's say maybe you do take some expensive medications. You may not know they're expensive potentially because your employer plan is covering it really well.
And then when you go and you look at individual health insurance and you find out maybe you have to pay the full price of that medication and it's 500 bucks a pop, you're like, wait, hold on. Well, you know, so like that's one type of situation I would say because when it comes to health insurance, there's kind of two different ways you can go about it as an individual.
You can kind of go through what's called the marketplace which is kind of your government sponsored sort of health insurance options, or you [00:05:00] can go through the private side. The private sector, however, they do still have limitations on preexisting conditions even. You know, for instance, so if you have a pre existing condition and you sign up something you find online, you don't read the fine print, for all you know, you could be really, like, exposing yourself to some serious risk there or maybe even be declined from coverage.
So that's one big thing I would say is your needs. Your individual needs and your family's needs are very important. So you need to understand that just because you've had good coverage and X and Y has been covered before, it may not necessarily work out like that on the individual, you know, in the individual space.
So that's one big one. Another big one I would say is price. People, I think sometimes really take for granted the fact that their employer is paying the majority of their coverage. You know, they think of it as being inexpensive because maybe they only pay a couple hundred bucks a month or what have you, but they don't understand like the employer is probably paying between 50 to 75 percent of their premium.
That plan is [00:06:00] expensive. It's not cheap at all. This stuff is expensive and depending on your situation when you go out as an individual, you can definitely encounter some sticker shock as well. You know, you can go in with an idea of thinking, well, you know you know, maybe it'll be a little more expensive, but it won't be that bad.
And it may be vastly more expensive than what you're used to paying. Um, yeah. So those are kind of the two big kind of dragons, so to speak, that I would say are kind of out there. For the most part is kind of price and then also what your needs are and how, you know, how are they going to be covered or possibly, you know, not really well covered, you know, moving forward.
[00:06:36] Steve: Is it always, uh, more, well, I, I shouldn't ask always questions because the answer is going to be, it depends. How likely is it that, uh, as an individual, you're, you're able to get a similar amount of coverage for a similar price, like including the employer's portion of that is, does that ever happen? Or is it, uh, when you're on an individual plan versus a group plan, it's, it's tends to be more expensive or.
[00:06:59] Mitch: So, [00:07:00] as far as that goes, it can still work out really well. It's not always necessarily the case that you are going to be seeing some sort of sticker shock that's way more than what you're used to paying. Like, I will say, for instance, that the size of the company that you work for is also important. So, like, if you're on a really large, like, corporate employer plan, Yeah, it's probably the best coverage imaginable.
It's probably not that expensive, but if you work for a smaller company let's say under 50 employees, let's say even maybe just 10 employees. I've seen people on group plan coverages that really aren't that great. Actually, the coverage may be sometimes isn't that good. Number one. And then number two, sometimes it's actually expensive too.
So I've seen people on group plans where their family coverage might be 700 bucks a month. You know, or you know, what have you, right? So sometimes it's again, like you said, it does depend. It just, it simply depends on what the context is of what you're used to. But yes, no, I, I have seen sometimes where you do transition and maybe [00:08:00] it's for the better because maybe you were on one of these actually somewhat expensive group plans.
And then when you go private, maybe end up just paying a similar amount or less to what you ended up paying. Or potentially if you do qualify for like a subsidized health insurance plan, maybe you're not forecasting your income to be that high for the next year. Sometimes it can be, you know, again, less, you know, similar or less expensive.
How price is determined
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[00:08:23] Mitch: So again, it just really does depend on a number of different factors. Yeah. Mm hmm.
[00:08:31] Tyler: probably a midsize company. And I got, I volunteered to be on the HR committee or whatever that got together and had input about which insurance plans to choose and whatnot. And, uh, that was my first kind of exposure to thinking about insurance in a more detailed way than just, you know, paying the premiums of, of, and having an employer sponsored plan.
And one of the things that I remember is that it really depended on how much the insurance got used by people in the group. That impacted the price a lot. Right. So I'm curious, [00:09:00] uh, when you're on an individual plan, like, are there assessments and things like health assessments that you have to do, or how do they determine the price and does it change a lot year to year?
[00:09:09] Mitch: yeah, no, that's a, that's a really good question and a good point that you raised too, is with employer plans, those rates, a lot of times can go up quite a bit if people use the plan, like, especially if you're on, again, a small group plan and let's say, God forbid, someone that year gets cancer. Yeah, you can expect to see that group plan rate shoot up a good bit the next year.
So that's one good example there of how group coverage actually does go up depending on usage. In the individual side, in terms of how like the rates are determined and whether or not there's going to be price increases and things of that nature I will say like if you do go through, like I mentioned, the marketplace, kind of your government sponsored option, that's all going to be, your rates are going to be based largely on your household, your total household income.
So that's the main kind of determining factor with those types of plans is what is your total household income for the coming [00:10:00] year. That's mostly what they're going to go off of. Now if you go private private health insurance options are primarily, those rates are more typically based on like your age and number of dependents that you have on the plan.
And then yes, some private health insurance plans do have what's called medical underwriting, where they do actually evaluate your, your, your situation as an individual or a family. They will possibly ask about like what type of medications you take. They might even look at your your medical history a little bit to kind of see like what kind of claims you filed.
If you had, you know, a major surgery, a condition that's been diagnosed and some plans, they may not even let you on the plan. You know, based on your, your medical history or they might rate you up, you know, like if you're a smoker, for instance, you know, that type of thing. So yeah, there is a lot that kind of goes into, kind of the private side in that regard.
But that would be the main kind of difference in terms of like what, What typically dictates your price is private is going to be more [00:11:00] focused on like your age and health. Whereas kind of your marketplace options, what I would call more like the public sector is really just looking at your total household income for the most part.
Yeah.
[00:11:10] Tyler: Oh, that's interesting. So two very different ways of looking
[00:11:14] Mitch: Yeah.
What Mitch does for his clients
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[00:11:15] Steve: This is really fascinating. I didn't realize it was so complicated, uh, behind the scenes.
All of, all of these different options.
[00:11:20] Tyler: Well, that's where my mind keeps going. Yeah. As this is, it sounds very complicated. I kind of want to learn more Mitchell about like what you do. Cause I mean, I'm hoping that what you do would help someone in the situation navigate this crazy landscape and kind of pick what's right for them. Is that
[00:11:35] Mitch: Absolutely. Yeah. So the business, you know, I, I've termed my business The Health Advocate, health insurance consulting services, because I really try to bring a consultative angle to this conversation where I'm trying to uncover what's going to be your best fit. Now, obviously what you want out of the plan has a lot to do with it.
I'm always going to try to be asking the best questions I can in terms of, you know, uncovering what is actually [00:12:00] important to you. Uh, you know, obviously what you can afford definitely comes into play as well. But trying to prescribe for each individual that I speak with, what is the best fit for them?
You know, because it just, there is no, there is no line in the sand. This is better than that. That's better than this. It just depends like with so many different industries. Right. So for me, I'm always going to do sort of an analysis first. I'm not really someone to just talk to you for a couple of minutes and go, okay, well, let's take a look at this real quick.
And, you know, I'll get you set up with something right now. You know, I, I'm going to have a full conversation with you first. You know, obviously as brief and concise as I can, but, you know, to really kind of uncover what you're used to you know, what your expectations are, you know, what your situation is and, and kind of determine what's going to be the best fit for you and then go from there.
In terms of prescribing maybe a couple of different options that I think will work best for your situation and, and really walking you [00:13:00] through that process too, in terms of how you get that set up. So that is definitely kind of my my strategy, my, my process, if you will, uh, of trying to help people in that situation.
[00:13:11] Tyler: Okay. Yeah. And so you mentioned a lot of different factors that would go into what an individual picks or what plan they end up going with. Could I, what, and let's see, you mentioned a few of them, what you can afford. So cost, what about like. Networks. Uh, is that still a thing in private insurance? I assume it is.
I just don't know. I've never been exposed to this market
[00:13:30] Mitch: No, you're fine. Yeah. So every, I mean, yeah, every plan is going to be built off of some sort of network of providers of doctors and hospitals. So that is super important to factor in as well. Like I'll tell you. Just to give you an idea of kind of the landscape out there, some, you know, some states, and this is another big factor again, that kind of can further complicate things is this stuff is different in literally every state.
So every state has a board of insurance that [00:14:00] kind of dictates what can be sold in that state and what can't be sold and how, even how it's structured. So, I mean, it literally depends even on the state that you live in. So with that being said, you know, network wise, like for instance, if you go through the marketplace in some states, like I'm here in Texas, in Texas, you cannot get a PPO plan on the marketplace.
You can't. There's like HMO and EPO, which is EPO is kind of similar to a PPO, just not as large of a network. But yeah, for instance, if you're used to like a really, you know, Blue Cross Blue Shield, UnitedHealthcare, whatever you know, group plan that has a really good PPO, And you go to sign up through healthcare. gov, you might find, you might only find HMO options. And just for, you know, anyone listening in HMO is like the most limited network of doctors and hospitals in the country. It's really only going to cover you really with, maybe within a zip code or two. And even then I come into contact with, you know, entrepreneurs sometimes that have done this, right.
They've signed up [00:15:00] for, uh, maybe an HMO plan and, you know, didn't really think anything of it. They go to try to use their insurance and they can't even use it. because they're struggling just to even find someone that's in network with the plan that they selected. So sometimes that's, that's, it's a huge component knowing that you have a good network of doctors and hospitals or that your preferred doctors and hospitals are in network because you go and try to use it and all of a sudden you can't even use your insurance.
I mean, you're almost paying for nothing, you know? So yeah, it's, it's network is very important in that regard and that, that is another piece of the conversation. Absolutely.
[00:15:36] Tyler: can understand why people get nervous about this topic. There's a lot, it's, it's complicated. Yeah. I
[00:15:42] Mitch: exactly, exactly,
[00:15:44] Steve: on top of the networks, uh, I'm assuming you have access to a lot of different, uh, insurance companies perhaps, and you don't need to name any of them, but like, is, is that sort of the model that you're working with where you can see lots of different plans at lots of different, [00:16:00] uh, insurance companies and kind of match up the one that best fits the client's needs?
[00:16:04] Mitch: Yeah, absolutely. So one thing that is good is that, you know, in my time of doing this, I have become familiar with, you know, you know, I'm not going to sit here and say, I know literally every single health insurance plan out there. But with that being said, I have a pretty good general idea of kind of what's available to someone based on where they're located and what their situation is.
So, yeah, that's kind of my process again, is I'm going to kind of try to filter out and, and find the best, you know, the best plan that's going to fit it. Their needs, their budget, and that is really going to, you know, best protect them at the end of the day, too. Because there's even, you know, there's different types of plans out there where, you know, again, pre existing conditions can come into play.
Even limitations of benefits where some plans may put a cap, put a policy year cap on the amount that they'll even cover. So I mean, again, yeah, I mean, it's, it's, it's intricate for sure. [00:17:00] So yeah, assessing kind of what the best type of plan is for someone's situation is, is definitely paramount in that regard, but absolutely.
I mean, at the end of the day, I'm going to try to make sure that someone is best protected no matter what they end up signing up for. Yeah, even if that's not a policy that I write that's, that's also kind of my brand mission as well is that, you know, I'm going to, I'm going to try to help these people the best I can, even if it's not something that I write, even if it's referring them to a partner of mine that I know can help them with a policy that maybe I can't write.
So yeah,
[00:17:33] Steve: hmm.
Open enrollment periods and qualifying events
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[00:17:34] Tyler: have a weirdly specific question. Maybe I, one of the things that comes to mind when I think about insurance is enrollment periods. Like, is that also a thing when you're doing an individual plan or, or is that something primarily characteristic of big group plans, I don't know.
[00:17:47] Mitch: no. And that's actually a really good question too, is as far as enrollment periods. Because I also know that sometimes I've talked to people who maybe left an employer plan and they think they can't sign up for health insurance until open [00:18:00] enrollment, right? So then they just like, well, I guess we'll just swing it the next three or four months.
And it's like, you know, you, you can sign up right now, actually, you know, you can. So, yeah, to kind of unpack that a little bit as far as the individual space goes, I'm sure everyone is familiar with open enrollment, even on the individual level, because every time, you know, October rolls around, you know, You might start seeing the commercials for healthcare. gov, you know, Hey, it's open enrollment. And typically those options do kind of open up in October through usually January 15th. It can depend a little bit actually on the state. Some states actually extend their open enrollment sometimes and, and things of that nature. But with that being said, there is also such a thing called a qualifying event.
So like if you move to a different state, for instance, that is also a qualifying event. If you lose your coverage, like you get laid off from your employer, or maybe you lose your health coverage because of like a divorce decree that is actually also a qualifying event where you can access the marketplace at [00:19:00] that time.
Um, now what I'll say for private health insurance options though, the one thing that is really good about private health insurance is that it can actually be accessed year round. So even if you did miss a window, like an open enrollment window for the marketplace, you do still have access to private health insurance options.
So you're never actually totally without options. It's just a matter, like I said, again, you want to try to do your planning and do your due diligence and not, you know, not be without coverage, not limit your options, that type of thing. So like if you do leave an employer, for instance. Again, that's going to open up your, your open enrollment through the marketplace if you need to go that route.
And typically what that window looks like is it's 60 days. So if you know you're going to lose your coverage, maybe you know you're going to leave your job a month from now, two months from now, it's a 60 day window. where you have to get that Marketplace option set up. Now, if you don't set up that Marketplace option within that 60 day window, though, now, yes, you do, you cannot access the Marketplace [00:20:00] until the actual official open enrollment period comes back open in October.
But again, you could still sign up for private health insurance. So you're not totally left out to dry. It's just, you know, ideally you want to have all your options on the table.
[00:20:13] Tyler: Interesting. Thank you. That, that, okay. So it was a weirdly specific question, but it turned out to be important. So glad I asked. Interesting.
[00:20:23] Steve: Yeah. This, this whole conversation so far has felt like discovering all these things that I didn't know I didn't know about health insurance. This has been really good.
[00:20:30] Mitch: Good, good.
[00:20:33] Tyler: Maybe for most of us. Okay. It's, it's best not to know. I'm just kidding. I don't, we just need people like Mitchell to help us out.
[00:20:39] Mitch: do what I can man, do what I can.
How do insurance brokers get paid?
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[00:20:41] Steve: yeah. I want to ask you, how you get paid as the broker, who's writing these policies or helping folks figure out which policy is right.
How does that work on your end?
[00:20:53] Mitch: I'm happy to answer that. And I'll tell you that it works the same across the board. At the end of the day, if the person you're [00:21:00] dealing with is writing the policy, if they're actually submitting, you know, the application for you they're getting paid on that. So yeah, if I actually write a policy, I, yes, I am going to get paid a commission on that.
Um, and that's, I mean, that's, like I said, that's insurance across the board for you. I mean, there's not really, uh, a, there's not an even on the term independent broker. Even that actually deserves a little bit of context. Now look, some brokers can write more plans than others. That is true. But there's not like a broker out there on the individual level that can literally write everything.
I mean, that does not exist. There's not someone out there who can literally write every single plan out there. So that's kind of what I was referring to earlier, even with like, you know, forming this, you know, kind of referral network partnerships that I have is that I can't write everything.
You know, there's not just, I mean, if I could, I mean, I guess I would, that'd be cool. Pretty cool. If I could literally write every single plan out there and never lose. Right. But you know, that's not how it works. At the end of the day, you know, every broker has access to [00:22:00] X amount of options. And now some brokers, you know, they might always try to You know, keep you in their wheelhouse no matter what, you know, maybe even if their options really aren't the best thing for you, they might, they might try and do that.
Now, I, I'd like to think that most people don't do that, but as I'm sure you all are well known, most people do not like health insurance and most people do not like salesmen and health insurance. And there is, I think a stigma kind of out there about. You know, people in health insurance that they're just trying to sell you something.
They don't care, you know, they don't care if it works out for you or not. They're just trying to, you know, kind of turn and burn. That's not how I do my business. At the end of the day, if I can help you with the perfect solution for you that's, you know, that's, that's my goal. That's my hope. It benefits you.
It benefits me. But if you're in a situation where, you know, I don't think I can help you, You know, I'm going to get you in touch with someone that can, or I'm going to make a recommendation, give you, you know, arm you with the information that you need to get your situation best rectified. So that's, you know, if that answers that question, that, that's, that's pretty much how it goes.[00:23:00]
[00:23:00] Steve: It does. Yeah, that makes a lot of sense. And I like that way of, of doing business where the, the client is the focus, really, if you can get them the right thing, uh, you know, the business will come back to you.
[00:23:11] Mitch: Exactly. Yeah. Pay it forward, man. I mean, at the end of the day, it's, it's good karma. It's just good business practice. It's, you know, it's your reputation. You know, I imagine that anyone out there that's kind of engaging in bad sales practices and things like that. I doubt they last long, you know, at the end of the day, that, that comes back to you.
And, you know, you, you get a bad name out there, a bad reputation. That's not good for business. That's not good for your clients. I don't, that's not something that I would think would be a conscionable, at least for me. So,
[00:23:38] Steve: Yeah. I am
familiar on the, on the life insurance side of, uh, you know, the, the sales tactics there, where if you, if you work for a single, uh, you know, Insurance house. Like that's, that's all you can sell. That's all you have, uh, where there are others that can, can sell products across, uh, a range of different, um, [00:24:00] what'd you call them?
Suppliers, I
guess.
[00:24:02] Mitch: Yeah.
[00:24:02] Steve: Uh, Carriers, carrier, carrier. Yeah, there you go. Uh, but I, I, I wasn't aware even of, uh, health insurance, uh, sales as a thing until a few months ago. So, so this is all new to me,
[00:24:14] Mitch: Yeah. Absolutely. Yeah. That's the thing.
[00:24:17] Tyler: Well, I think I saw one of your LinkedIn posts where you said something about clients telling you, thanks for being honest. And I think it was in reference to the, you know, times when you really don't have a plan, that's going to be the best for them. So, so, so that's where the referral network comes in.
I imagine you're, you're referring them to someone else at that point, or how does
[00:24:34] Mitch: Yeah, so either, you know, if I do think that there is a solution for what they're looking for, and it actually makes good sense for the, for their situation, then yes, I will. Absolutely. I'd be happy to put them in touch with someone that I know and trust that will take good care of them and can get that done for them.
Uh, and that post though. Yeah. In particular, what I was kind of voicing in that post is, you know, You know, at the end of the day, [00:25:00] sometimes the answer isn't the one that you want. You know, we all sometimes wish we could save more money. We wish we could get better coverage. And the reality is, is you just might not be able to.
You might be, you might already be in the best position that you can be. So I'll just tell it, give you like a quick example that I had in mind when I made that post on LinkedIn is I had someone reach out to me who said, you know, Hey, I want to talk to you about my health insurance options. It may not be for right now, maybe just for next year.
But. You know, I'm on an employer plan. I just wanted to see if I could save some money. Now, what she ended up telling me was that she's for her family plan, you know, for, uh, I think it was medical and dental, I think, you know, combining the two you know, by biweekly payments that she makes, I think they only, I think they pay under 400 a month for a family plan.
And, you know, I just had to tell her like, you know, I mean, could you save money? Yeah. I mean, there's, there are things out there you could sign up for, but it wouldn't be worth it. Uh, you'd be really, I think, exposing [00:26:00] yourself and your family if something were to happen because you'd be signing up for You know, far, you know, far less, you know, it would be very insignificant coverage to what you have through your employer.
So I mean, technically, yeah, you know, I could save you money, but I don't advise it. You know, I'm not gonna, you know, I'm not gonna recommend it. So, you know, that's, that's one of those types of situations where, yeah, I could have sold them something, but I mean, I'm not gonna put someone in a bad spot just to save a hundred bucks a month, you know, you know, just so they can save a hundred bucks a month.
Now, if they absolutely have to do it, I mean, that's maybe a different conversation. I mean, they literally say, I'm canceling my plan anyway. You know, you can't stop me. I'm canceling this plan. I can't afford it. What can you do? I mean, you know, okay. I mean, we can try to work with it, but at the end of the day, I'm going to give them the best advice.
And if, you know, if I can't help them and if I'm going to recommend that they just stay put, I'm just going to tell them to stay put. So yeah.
[00:26:52] Tyler: that's a great example. That's a great story. And that kind of resonates with me. I mean, I think, uh, my situation is a little bit different. What I offer [00:27:00] is coaching and I'm pretty firm believer that nobody needs coaching. It's like a very much, some people want it and can benefit a lot from it. Health insurance, I feel is a little bit different because I feel like, you know, people need health insurance, but at the same time, like I, I talked to a lot of prospects that I ended up really not trying to close a coaching program with them, right, because it's just not what they need
[00:27:20] Mitch: right
Right. Exactly. Exactly.
[00:27:23] Tyler: to that.
Mitch's ideal client
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[00:27:25] Steve: Mm hmm. So Mitch, who would you say is your ideal client? Who do you typically like to work with the most?
[00:27:32] Mitch: Yeah, so my ideal client is You know, definitely I would say someone who is like an entrepreneur, um, someone who's self employed, you know, maybe a small business owner, or, you know, it can even be someone that's just, you know, 1099, you know, like a contractor, like maybe someone that, you know is in construction or, you know, an electrician.
I mean, anyone you can think of that, uh, may not actually get, You know, health insurance through their employer, uh, whether because they're, [00:28:00] they're the sole proprietor or they're just worked for a really small company that does not offer health insurance or like I kind of outlined earlier, maybe they even work for a small company where it's really expensive to add their family to their health coverage.
Anyone that's in those types of situations I would say is, is definitely my ideal client. Just someone that really needs some guidance with individual options, because either they can't get it through their employer or what their employer is offering is is maybe kind of outrageous, you know, in terms of price or coverage or what have you.
So the main thing is, is knowing that there are other options out there. Uh, you're not necessarily chained to that employer plan. You're not necessarily chained to the marketplace or what you find on Google. You know, I mean, you know, at the end of the day though, yeah, my main client, my main ideal client is definitely going to be that, that sort of entrepreneur, that person that's in business or themselves that needs guidance on finding, you know, a proper health insurance plan.
[00:28:58] Steve: Okay, perfect. That's our, [00:29:00] that's the audience of this
[00:29:01] Mitch: Fantastic.
[00:29:01] Steve: to a T. So that's, that's great. Do you, do you do a group plans if there's like an employer that has a few employees as well? Or is it really just the individuals
[00:29:10] Mitch: No, yeah, so that's interesting. So I mean, I'll say right now, like I said, the main niche is definitely individuals, like, like, like I just kind of outlined. But I do have some small businesses that I work with. So especially like, you know, You know, technically speaking, I could go up to 50 employees. I don't think that'll ever happen.
I don't think I'll ever have a business that's that big that I'm working with because there's too many moving, moving pieces and it's, it's probably just too much. But let's say a company that's under 10 employees, I have a couple of companies that I work with that are under 10 employees where I can kind of do the same thing for that company.
As I would do for the entrepreneur, for the business owner, I would literally go down person by person and kind of. Sort out their options for them. Now whether the employer actually wants to contribute to that or not, that's up to them. You know, they have no [00:30:00] obligation necessarily to do that. You know, I even have a small business kind of more towards the northeast where they, sometimes they, they hire a new employee and they just say, Hey, give Mitch a call.
You know, he can kind of help you out. You know, they're not really paying anything on the plan. They don't really have. You know, there's no red tape involved, which is kind of what makes it potentially a little bit more advantageous is that, you know, a group plan, you're dealing with a lot of red tape, you know, participation requirements you know, this, that, and the other.
Whereas you just say, Hey, maybe I just give you, maybe I just reimburse you some money each month for, for your health insurance costs, you know? So there is, there is some flexibility of options there with the small business sector. It's just, it's a little bit less common that I deal with a small business than I do actually just an individual.
Yeah.
[00:30:44] Steve: okay. That's really interesting. Just for folks that, who might be solo right now, but intend to grow later on, that this is still an option, this kind of a, uh, an arrangement. That's good to
[00:30:55] Mitch: Yep. Mm-Hmm.
[00:30:56] Tyler: I kind of like that idea of them offering a stipend or something [00:31:00] for, to, for health insurance, then, then the individual employees can take their pick.
[00:31:04] Mitch: yeah. Exactly. Kind of puts it in their hands, you know? So,
[00:31:08] Steve: awesome. Well, I think we're going to wrap up pretty soon here. Is there anything that you wish we had asked you that we didn't?
[00:31:18] Mitch: no I will just kind of, one thing I guess I will elaborate on just for a second is I know, cause we, I briefly touched on it earlier, but again, kind of talking about how different this is in each individual state. I do just want to mention that, you know, it is a far more limited, your options are far more limited in some states than others.
Um, so for instance, what I, you know, as far as I'm familiar with, like the Northeast, we're talking like. New York, New Jersey, New Hampshire, Maine, uh, you know, the West coast, California, Washington, all those types of states, because those states are so highly regulated they do not have in my, you know, [00:32:00] from my, you know, from what I've seen, not nearly as many options on the individual side.
So typically people that live in those states are by and large, more or less funneled into the marketplace. They, they, Pretty much, there's not much you can do. If you're not on an employer plan, chances are you're probably just going to have to be on the marketplace. There's not as many private options available because of kind of the way you know, the board of insurance in those states has kind of dictated what's, what can be sold and what cannot.
So I do just want to at least mention that for any, any listeners that are perhaps in those regions of the country. I'm not saying don't reach out for help. Don't, you know, I'm always happy to have a conversation, but I'll
[00:32:39] Steve: you can still help them even with marketplace plans. It's just that there, there will be fewer options.
[00:32:45] Mitch: exactly. So yeah, that's the thing is I'm not closing off those doors.
I'm just letting people know in those areas of the country that it is a little bit tougher. Uh, so I, that's just one thing I did want to mention. Yeah. Yeah,[00:33:00]
[00:33:00] Steve: health insurance are also more complicated in the, in the states in the Northeast where we used to have a federally, uh, uh, individual insurance mandate with the Affordable Care Act. And that kind of went away, but a bunch of states still have it, uh, on your state tax return. And so that's something to consider if you have like a gap in coverage that you could, uh, be subject to some fines there, but anyway,
[00:33:24] Mitch: Absolutely.
[00:33:24] Steve: interesting. Oh, and the premium tax credit was, was maybe another one we could mention where, uh, you, you briefly mentioned, um, if you get your insurance on the marketplace, but you, you have to estimate your income for the year.
And if you get that number wrong one way or the other, that can have an impact on your taxes at
[00:33:46] Mitch: Yeah, yeah, no, that is actually a really, I'm glad you did bring that back up because that is important. I have run into self employed individuals that said they ended up owing like 20 grand in back taxes because they, they [00:34:00] estimated their income wrong. Now it sounds, when I hear that type of number, it sounds to me like they estimated wrong on purpose maybe.
So they would get a, uh, a, uh, a full subsidy. And thought, well, hey, you know, they're not going to know or whatever. I'll just put in whatever. And, you know, they get off, they take this full subsidy, not knowing like, hey, it's, it's the government they do have access to your tax returns. They are going to match that at the end of the year.
And if you told them you were going to make 60 K and you made 150 K you're in some hot water, uh, in terms of, you know, financially speaking with when it, when it comes to those taxes. So, yeah, when I tell people what I always tell people with that is, you know, You know, it's better to estimate higher than lower.
So if you estimate maybe a little bit high and you make under that number, you actually might get a tax credit at the end of the year, uh, for, you know, you're based on your premium that you got. Um, so it's, it's definitely better to estimate higher than lower. But with that being said, you can also update it throughout the year.
Um, so even if you were to estimate, uh, You know again, maybe you estimate 60 [00:35:00] grand for the year, but hey, maybe your business is really taking off You know, it's it's doing much better than you expected And you think you know, you're gonna definitely surpass that number You can still call up the marketplace update your income and kind of get that rate adjusted So that you don't get you know have that tax hit at the end of the year So yeah It is important to kind of know your numbers and and navigate that correctly as well or else that it can definitely bite you Yeah
[00:35:26] Steve: Yeah. If somebody gets a premium tax credit at any time during the year and I'm doing their taxes, I can't even submit it unless that form is on there and the numbers have been calculated that the e file will reject it right out of the gate.
[00:35:37] Mitch: Right. There you go.
[00:35:40] Steve: Yeah. Fascinating stuff. Well, thank you, Mitch. This has been really interesting.
[00:35:44] Mitch: Oh, great. Yeah. Well, hey, thanks for having me on, man. I mean, I'm glad, glad to be here and, uh, you know, share, share what I know. And it's, it's been a really fun conversation.
[00:35:54] Steve: If, uh, if, uh, folks want to get in touch with you, if they have health insurance questions or [00:36:00] need help finding a plan or exploring their options, what would you recommend? Where can they get in touch?
[00:36:05] Mitch: Well, I will say LinkedIn is actually the best spot right now. I'm working on the website right now. So that is something I'll hopefully have kind of you know, taken care of here in due time. I, uh, it was supposed to be done earlier this year and kind of hit a snag on that. But, uh, yeah, LinkedIn is actually a good way to get ahold of me.
And, uh, you know, I'm always, I'm always there. I'm always available. So yeah, absolutely. Just kind of check me out. And I, I do, as you guys alluded to earlier, I always do post a lot of helpful information. There's even some pinned posts on my profile. It's kind of like a template for if you're going self employed, sort of how to navigate your options there too.
So there's all kinds of information you know, client testimonials and so forth. So, uh, all that good stuff. But yeah, website is a work in progress right now, but yeah, LinkedIn is a good, good way to get ahold of me for now. Yeah.
[00:36:49] Steve: Okay, excellent. We'll put that link down in the show notes.
[00:36:51] Tyler: All right. Thanks again for joining us and you can catch us again on another episode of It's Not About The Money.
