For departing employees looking at COBRA, "part of it depends on the group that you're leaving behind, " says Leon. "If you're young and the group has many expensive older people, " meaning higher group premiums, "you may do better on your own. If you're one of the expensive older people and the group is younger, you may be better off staying with COBRA."
If you pick COBRA, you get more options once your 18 months runs out. State law requires the insurer to offer you a conversion to an individual policy.
That provision does not apply to workers who received COBRA through large employers that are self-insured, but they can still get conversion policies through other state and federal laws, says Edward Domansky of the Florida Office of Insurance Regulation.
Conversion policies can get expensive. The law allows that "rates can be 200 percent of a standard risk policy, " says Thomas. "So basically you're paying double for a conversion policy. That sounds outrageous, but carriers lose a lot of money on conversion business."
Sandra Foertsch, of South Florida Health Insurance, an insurance agency, says conversions don't need to be outrageously expensive. "It really depends on the insurance company. Neighborhood Health Partnership can be very competitive."
The problem is that in conversion policies, people don't get a choice: They have to go with the company that offered them COBRA.
The options can be stunning: High deductible, health savings accounts, basic coverage for doctor visits but not for hospitals, catastrophic coverage that kicks in only when you have hospital stays.
"The good news is there's tremendous flexibility these days, " says Valerie Rubin, a spokeswoman for Blue Cross Blue Shield of Florida. "The bad news is -- and we understand this -- is that flexibility makes it more confusing."
People seeking to purchase a plan on their own can spend hours, perhaps days, studying, comparing and getting quotes on the Internet, or they can find a broker to help.
Monthly charges are generally based on age and sex. The older and sicker you are, the tougher the search becomes. "You might think you're healthy. 'Hey, I go out and play tennis every day!' But that might not be the way an insurance company sees it, " says Foertsch.
"A perfect example is a 62-year-old couple I had recently. They were declined by three insurance companies. The husband was taking medications for high blood pressure and cholesterol. She was taking medications for a hiatal hernia and anxiety, " says Foertsch.
She was able to find policies for both, but the wife's included provisions excluding coverage for her preexisting conditions.
Maternity benefits often require an extra charge, and often don't kick in until a year or more after the policy is purchased. Dental is also usually an extra charge, but many want it. "Dental is the top benefit for young people, " says Thomas.
Health savings accounts -- which have high deductibles and tax-free dollars put in special bank accounts -- are a fairly new product, and still intensely debated within the industry.
"Nobody cares about HSA accounts after they've been laid off, " says Foertsch. "They're living hand to mouth. They don't have money to put into a health savings account."
Danny Saunders, a broker with Setnor Byer Insurance and Risk in Plantation, disagrees: "They're becoming more and more popular. I have one myself."
The premiums are lower and customers can put those extra dollars in a tax-free account. "It's better than half a plan, with a high deductible, or no