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I was given a referral for a guy that is a house painter (sole proprietor - no employees). Colorado does not require Workman's Comp. for owners. He is currently covered under a group policy (Great West) from his wife's job.
There is a clause in the policy that states he is not covered if he is injured while engaging in a "for profit" business. He will fax me the exact wording but for now, that is the way it was explained to me. He wants a HD plan that will cover him while working but they also want to keep the group plan = low deductible, benefit rich, better coverage for illness. I still need to find out how much they are paying for him to be on the group.
Anyway, I have never run into this before - is that a normal clause? I called Aetna and inquired as to how the coordination of benefits would work if he had both individual and group coverage - they did not know and will call me back. He would only need individual if he had an accident while at work - if he gets sick, they want the group benefits.
Obviously, I do not want to see someone have "double coverage". It seems to go against principle. I think the proper answer is for him to take out workman comp. ins - but I have been told that it is expensive and he would be better off on an individual plan. Thoughts???
There is a clause in the policy that states he is not covered if he is injured while engaging in a "for profit" business. He will fax me the exact wording but for now, that is the way it was explained to me. He wants a HD plan that will cover him while working but they also want to keep the group plan = low deductible, benefit rich, better coverage for illness. I still need to find out how much they are paying for him to be on the group.
Anyway, I have never run into this before - is that a normal clause? I called Aetna and inquired as to how the coordination of benefits would work if he had both individual and group coverage - they did not know and will call me back. He would only need individual if he had an accident while at work - if he gets sick, they want the group benefits.
Obviously, I do not want to see someone have "double coverage". It seems to go against principle. I think the proper answer is for him to take out workman comp. ins - but I have been told that it is expensive and he would be better off on an individual plan. Thoughts???
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