You can still get a nationwide PPO in Kansas, even though the marketplace sells only EPOs. Here is how owners leaving a job to run their company bridge the gap, starting with Kansas's continuation law.
Hi, I'm Sam Jaber. I'm licensed in 36 states and based in Tampa, and Kansans starting their own business, whether that's an electrical contractor in Lenexa, a bakery in Manhattan or a consulting LLC in Wichita, can work with me by phone.
This page follows one Kansas situation: the owner who is leaving a salaried job to run the company full time. The employer plan ends, the business hasn't proven its income yet, and the family still needs coverage on the first day. Kansas has a continuation law that can help bridge that gap.
Kansas's marketplace has 64 individual medical plans for this year, all EPOs; there's no PPO on HealthCare.gov here.
You can still get a nationwide PPO in Kansas, through me. Each family member answers health questions, the premium reflects the answers, and the network covers providers across the country. For a healthy family leaving a big employer's PPO, it's often the closest thing to what they had.
Kansas law lets people keep an insured group plan after leaving, under conditions. According to the statute, it applies to groups with at least two employees, you need three months of continuous coverage before it ends, and the premium is the same rate charged to members still in the group, so there's no added markup. You pay the full premium yourself, including the part your employer used to cover.
Larger employers usually offer federal COBRA instead. Either way, losing job coverage also opens a special enrollment period, usually 60 days, on HealthCare.gov. Electing COBRA and then dropping it on purpose later doesn't open another window.
Which wins depends on your family's health, your doctors, and how much the company will realistically pay you in its first year.
A few practical questions sharpen the comparison. How long will you realistically need a bridge before the business can carry a premium comfortably? Does your current plan cover a doctor or treatment you can't easily replace? Will your spouse's job offer coverage instead? And since every Kansas marketplace plan is an EPO, are your family's doctors inside any of the networks sold in your county? Answering those before your last day keeps you from making the decision in a rush.
If everyone is healthy, a nationwide PPO is worth pricing against continuation; the insurer reviews each person's answers and approves, declines, or approves with a stated exclusion. If your first-year income may be modest, the marketplace credit could make an EPO the most economical option instead.
Next step: A few weeks before your last day, call me and I'll price continuation, a marketplace EPO and a nationwide PPO for your family.
Keeping the same plan and doctors through continuation can be valuable mid-treatment. The marketplace is the other safe home, since its plans can't refuse anyone or charge more for health history. Underwritten coverage may not be the right fit for that family member.
Next step: Tell me what care is ongoing, and we'll work out how to keep it uninterrupted through the switch.
A thin first year needs planning in Kansas, because the state hasn't adopted the Medicaid expansion. If you later hire someone who isn't an owner or relative, SHOP may become an option for a group plan.
Next step: Before you enroll in a lean startup year, call me and we'll map out what the household can get.
Straight answers, no sales pitch.
Often. Kansas law allows continuation of insured group plans with at least two employees if you've had three months of continuous coverage, at the same premium rate as current members. Larger employers offer COBRA.
No. The statute sets the premium at the same rate charged to members remaining in the group.
No. All 64 individual medical plans are EPOs. A healthy family can get a nationwide PPO through me.
Losing job coverage opens a special enrollment period, usually 60 days.
Tell me your last day, the size of your employer, your county and who's on your plan. I'll lay out continuation, the marketplace and a nationwide PPO side by side.
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