NFT: Health Insurance Open Enrollment

increase.

trying to switch to my wife's plan which hasn't announced their 2017 premiums yet.

It comes up on the tax return? Or the insurance company at the employer tacks on extra?

for declining coverage at my company in fact I get $30 a pay period if I decline coverage ADDED to my check.

$30 is nothing, but it's better than a penalty.

That penalty is not federally mandated as far as I know, that's purely a company thing I am guessing.

My company is huge. almost half a million people so we might have different policies than your company, not sure.

haven't seen the wife's yet.

for not taking their insurance, and instead going on your spouse's plan.

but my wife works for a healthcare company and I work for a fortune 50 company.

I can go on her plan or she can go on mine (who family in both cases) and neither of us pay a penalty either way for declining our coverage and going on the other's plan.

not sure why Uconn has penalties with his and his wifes plans.

For an employee turning down health insurance. If UConn is getting penalized, that's from the employer.

Seems a bit odd. Maybe it's about making sure healthy people don't opt out and screw up their rates.

In comment 13193376 NoPeanutz said:

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It comes up on the tax return? Or the insurance company at the employer tacks on extra?

The insurance company. They basically check to see if you are employed and will penalize you for it if you try and "cheat the system".

My wife's was like a $400 per month surcharge for adding me. My company was only $50 per month and since we have a wellness program that helps pay for almost half the deductible it was a no brainer to swtich.

If i refuse my own insurance and go to my wife's, her insurance would apply the surcharge.

Employee contribution remains unchanged. Company will absorb the increase. I think most economists would argue that higher benefits costs eventually constrain other employee comp, so the increase might hit staff indirectly.

I'm impressed: twenty minutes and this thread hasn't turned political yet. Probably just a matter of time.

We have 4 plans to choose from. Two tradition which are so expensive nobody is doing them. Then two high deductible plans, one is $1500/$3000 and the other is $4000/$8000. The company matches HSA contribution to $1500. One difference is after deductible the 1500 plan pays 90% and the 4000 plan covers 100%. With a total out of pocket amount of $6000 (1500 plan) and $8000 (4000 plan) The total difference in cost between the two plans per year is $1100. Preventive care I believe is covered 100% without having to reach the deductible. I could be wrong though.

In comment 13193403 Jim in Fairfax said:

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For an employee turning down health insurance. If UConn is getting penalized, that's from the employer. Seems a bit odd. Maybe it's about making sure healthy people don't opt out and screw up their rates.

That's probably 1 reason. Her company is small so I can see that. My company is global so my rates are competitive as is the penalty to add my wife.

but what really killed me was that I went from 250.00 deductible to 3500.00 deductible. In essence, "buy more expensive insurance, but unless you have major surgery, you'll never get to use it and will be responsible for all your medical bills out of pocket. Ridiculous

her dental + vision is better so i'm going on hers even with the accrued penalty.

of insurance premiums recently. You can see that if you compare premium increases by 5 year increments; 2011 to 2016 had the smallest premium increase in years.

Expect them to moderate next year, and as penalties are ramped up, getting some high deductible individuals into plans.

from having to reduce the risk pool by a decent size as people opt out.

In comment 13193418 UConn4523 said:

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In comment 13193376 NoPeanutz said: Quote: It comes up on the tax return? Or the insurance company at the employer tacks on extra? The insurance company. They basically check to see if you are employed and will penalize you for it if you try and "cheat the system". My wife's was like a $400 per month surcharge for adding me. My company was only $50 per month and since we have a wellness program that helps pay for almost half the deductible it was a no brainer to swtich.

Are you sure it's a surcharge not just the difference between individual premium and individual plus significant other premium?

My company healthcare premium options are individual, individual + 1 and family coverage. Each have different premiums.

They never even asked if my wife had coverage she declined. In our open enrollment the question isn't even asked.

In fact, and this is the only company I've worked for that does it this way, if I elect family coverage each kid (I have 3) increases the premium. If I had a 4th kid the premium no longer increases, but I only have 3.

The penalty isn't from the company from which you turn down the insurance. It's a penalty from the company that's going to bear higher premiums because they are now providing full coverage to a spouse who turned down coverage elsewhere.

yes, its the difference + the penalty.

In comment 13193428 mavric said:

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but what really killed me was that I went from 250.00 deductible to 3500.00 deductible. In essence, "buy more expensive insurance, but unless you have major surgery, you'll never get to use it and will be responsible for all your medical bills out of pocket. Ridiculous

That's fucking nuts. I've got a $2,000 family deductible with 90% coverage after that. But I can earn $750 towards that deductible for free which isn't offered with my wife so its a no brainer for me this year.

In comment 13193450 UConn4523 said:

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yes, its the difference + the penalty.

That sucks. I complain about my plan, and my premiums went up for the family of 5 33%, but it's a great plan, low deductibles, low or no co-pay, can go to any doctor, low prescription costs (like literally .85 for antibiotics, .23 for pain meds after surgery), etc., but it was already expensive.

We priced it out and figured my wife's plan was more economical, so I declined coverage and we're switching to my wife's plan.

am self employed, and don't get a subsidy. I have the lowest Bronze Plan, an HMO. $259 to $406 a month, with a $6,550 deductible that I assume is also increasing. Ridiculous. I may drop it, and buy a non ACA policy for catastrophic coverage.

The penalty doesn't apply if the annual cost of the premiums of some type of Bronze plan is more than 8% of your income, although I'm not sure if that's gross or net. You file a specific form, and select "Code A," which tells the IRS that you are not subject to the penalty because the cost of the insurance is unaffordable.

The average premium increase for the benchmark silver plan in 2017 is a whopping 25%. Many states have much higher increases. In Minnesota, the increase is nearly 60%. In Arizona, it’s an astronomical 116%. Insurers are also abandoning the market. Six states only have one insurer. United Health and Aetna left the exchanges. Minnesota governor Mark Dayton, a supporter of Obamacare, recently said that the Affordable Care Act is no longer affordable, and that it was on the verge of collapse in his state: Former President Bill Clinton said Obamacare is a “crazy system.”

The increases will be especially damaging to the five to seven million people who do not receive insurance from their employer, and who make too much to qualify for a subsidy. For a single person, $47,520 is the maximum they can earn and still receive a subsidy. That typically includes the self-employed. Even those with subsidies have extremely high deductibles that effectively make their health insurance useless, except perhaps for catastrophic emergencies.

The tax penalty is also not encouraging people to obtain insured. Many people would rather pay the penalty. Wages are still essentially stagnant, six million people are involuntarily unemployed, rents have skyrocketed, and debt is a financial yoke and loadstone around the necks of millions. The average car payment is about $500, and the average 2016 college graduate has $37,000 in student loan debt. Most young people also think they're indestructible. Obamacare was based on the faulty premise that healthy young people would sign up to counterbalance all the sick people who flooded into the system.

I would consider scrapping most of Obamacare, and replacing it with a system that makes the government the insurer of last resort for catastrophic medical expenses. Health insurers would pay up to a certain amount for each insured every year. The government would pay everything above that amount. That amount would be at least $100,000, to protect the government and therefore the taxpayer for paying for very common procedures. Most people thankfully do not incur $100,000 in medical bills every year. The amount would reset to zero for each insured every January 1.

Premium is a function of risk. This arrangement should lower premiums because it would limit the risk of the insurers. HSAs, copays, and deductibles would still be allowed, and encouraged, so that people still pay for some of their health care.

Something similar already exists in the workers’ compensation system. Employers in some states can self-insure their workers’ compensation claims. But even many of these employers only self-insure up to a certain amount, and obtain insurance for anything above that number. They essentially impose an enormous deductible on themselves, which reduces their premium.

I would fund this by reclassifying “carried interest” from a capital gain to ordinary income, eliminating “stepped up” basis for stocks and bonds, imposing a financial transactions tax, and cutting or eliminating as many government programs as possible.

In comment 13193428 mavric said:

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but what really killed me was that I went from 250.00 deductible to 3500.00 deductible. In essence, "buy more expensive insurance, but unless you have major surgery, you'll never get to use it and will be responsible for all your medical bills out of pocket. Ridiculous

Effectively a catastrophic plan. While I sympathize with your stated frustration, that "catastrophic" part is far & away the most crucial part of health insurance. If I drive a 300k Maserati, even though my insurance has a 5k deductible and will cover zero necessary upkeep, if it gets stolen in at Lincoln Financial, I have the peace of mind to know it's covered. Small consolation, I suppose, but important.

It's also noteworthy that you'll receive the negotiated rates with your providers, so even though you're paying out of pocket (up to 3500 in your case), it's preferable to being a true cash patient.

We are in the midst of a very messy adjustment period. When there's no real foundation (just a patchworked amalgamation by both the gov't & the private sector over decades), it's difficult to efficiently address problems since there's little sensible rhyme or reason to begin with. Deliberate sabotage is of course an added unhelpful consideration.

meant six million people are involuntarily working part time.

rolls are increasing, and with them we are seeing massive increases in HC expenditures, even with caps on reimbursement, because of their health levels.

It's also at a time when they severely mis-priced elderly premiums.

and picked up benefits, prior to that, I was getting my health insurance thru the Chamber of Commerce - Kid's had a plan through the exchange and we had another plan - all in I paid about 18,000.00 last year.

In comment 13193513 GiantsUA said:

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and picked up benefits, prior to that, I was getting my health insurance thru the Chamber of Commerce - Kid's had a plan through the exchange and we had another plan - all in I paid about 18,000.00 last year.

Disgusting.

In comment 13193535 NoPeanutz said:

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In comment 13193513 GiantsUA said: Quote: and picked up benefits, prior to that, I was getting my health insurance thru the Chamber of Commerce - Kid's had a plan through the exchange and we had another plan - all in I paid about 18,000.00 last year. Disgusting.

that's fucking criminal. How the fuck is a family supposed to live on $18k a year for insurance?

am very lucky. I work for an HMO and only pay 5 dollars for visits and rx.

In comment 13193553 UConn4523 said:

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In comment 13193535 NoPeanutz said: Quote: In comment 13193513 GiantsUA said: Quote: and picked up benefits, prior to that, I was getting my health insurance thru the Chamber of Commerce - Kid's had a plan through the exchange and we had another plan - all in I paid about 18,000.00 last year. Disgusting. that's fucking criminal. How the fuck is a family supposed to live on $18k a year for insurance?

My family plan costs more than 18k per year, and that doesn't include $210 per month for dental or the $21 per month for vision.

met a guy today at a networking event who said he's going to be paying about $2,300 a month next year for health insurance for himself, his wife, and his two children. He runs his own company.

pro's should be paid well, big Pharm, for profit companies that are making shareholders $ on peoples health problems seems very wrong on every level to me. Seems inhuman.

$2500, $3500, $5000 deductibles - sounds like major medical coverage, not health care coverage. WTF is that? If this is bringing healthcare to the poor, how exactly are the poor being helped. Whoopee, they get a subsidy, but they still have huge deductibles to pay before they get a dime back.

I love the idea and the spirit of it (health insurance is needed), but how can middle class and poor people afford it? It seems it is only useful for those with major health or chronic health issues.

Medicaid expansion.

The folks who use the exchanges are the folks who didn't have health insurance thru work and yet didn't qualify for the new medicaid limits. they didn't really have any options or subsidies at all before obamacare.

Obamacare is probably better than doing nothing but not quite all the way to being a good solution.

Would have been triple under the old system without the protections and subsidies.

Remember that.

In comment 13193600 Stan in LA said:

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Would have been triple under the old system without the protections and subsidies. Remember that.

Impossible to prove speculation, or please post your source.

Pre-ACA my costs and increases for the same coverage were much less. But yes they did increase each year. It was just never this level of increase and never did i have ridiculous deductibles.

Would something have to give and the premiums go up to today's levels, perhaps, but statements like yours are 100% speculative. And not proven, unless you have a source.

Because young, healthy people are opting out. They've decided it's more cost effective to pay the tax penalty than to buy insurance. Since insurers can't reject people with pre-existing conditions, healthy people can just buy insurance after they develop a serious problem.

The system is based on shared risk: the currently healthy people subsidize the sick. If the healthy don't opt in, insurers have nothing but people with high medical costs, and so they have to raise premiums.

Blue Cross Blue Shield and our costs actually went down 10%

In comment 13193577 GiantsUA said:

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pro's should be paid well, big Pharm, for profit companies that are making shareholders $ on peoples health problems seems very wrong on every level to me. Seems inhuman.

Ill choose my words carefully too. The people getting fat on this shit should all burn in hell. Fuck them all. The system is fubar.

And I am one of the lucky ones regarding health care. The industry should be shamed. But money and lies...all good.

Many politicians of all stripes feed - 14,000 lobbyist -

There's a chart floating around that looks at cumulative increases in premiums over time, and that since 2011 to 2016, they were very low.

Most of this is the considerable uncertainty surrounding the ACA, what would be allowed, the number of people entering, Medicaid expansion, etc.

One of the problems is of course the young "subsidizers". Another is the fact that many of the uninsured, who are now on Medicaid, are still not utilizing primary care, and still utilize the much more expensive ED and ER treatments. Couple that with under-estimates of how much care they would use, and you have higher premiums.

In comment 13193626 FatMan in Charlotte said:

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Blue Cross Blue Shield and our costs actually went down 10%

How 'bout that! Oh, and nobody is saying that until this year, rates have been LOWER than expected the last 4 years.

People don't want to hear that...

the role that uncertainty plays in pricing, and how the past 4 years of premium non-increases have been rolled into this year (and likely into next).

How about that...

The large sample size(5 years) shows a net Plus!

how 'bout that?

It really comes down to whether or not you think basic healthcare should be a human right or whether you think basic healthcare should be a for profit business. After you make that choice, the policy prescriptions are fairly obvious (if not the political prescriptions).

A net plus? Not sure how health insurance premium increases continuing to outpace wage growth show that, but what would you expect from someone who's accomplishment is knowing how to manipulate a joystick.

Let adults talk. We don't need the skidmarks of society contributing.

of ACA my premiums decreased too, we switched from Aetna to United healthcare for our carrier, but then year 2 under UHC (year 3 of ACA or something like that) our costs skyrocketed.

HR said it's not uncommon that the carriers intentionally underbid to win the contract and then make up for it year 2 when the company is less likely to switch again.

I'd be interested FMiC in seeing how your premiums look next year.

I have Blue Cross too, and I'm facing a 33% increase from last year for the same coverage.

My employer health insurance didn't go up. The max out of pocket on some PPO plans went up about $1000, but they actually sweetened the high deductible HSA plans. As for Obamacare, it looks like the top of the line PPO Platinum plan went up 20 % or so, the Bronze plans are about the same. Its important to note that health insurance was already highly regulated in California before Obamacare and its not easy to pull out of the largest state in the country.

In comment 13193655 Stan in LA said:

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The large sample size(5 years) shows a net Plus! how 'bout that?

So 1 guy has his go down and 38 have theirs go up, but that's a net win? Why did my wife's surge 25% after only 10% last year?

He's a moron.

In comment 13193577 GiantsUA said:

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pro's should be paid well, big Pharm, for profit companies that are making shareholders $ on peoples health problems seems very wrong on every level to me. Seems inhuman.

i guess I'd ask, if they are not allowed to make money, because it's inhuman, why should or would they do it at all? Should pharmas just close up shop?

The country is better off with the ACA, than without it. Otherwise, you'd be getting higher rates and zero protections and zero subsidies. Anyone who thinks different has an agenda like kicker.

Critical thinking skills?

AT LEAST. So those who don't like it, better get used to it...

In comment 13193714 Stan in LA said:

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The country is better off with the ACA, than without it. Otherwise, you'd be getting higher rates and zero protections and zero subsidies. Anyone who thinks different has an agenda like kicker.

I'm personally not better off. And I care more about that than I do if the country is better off (even if that's not PC or sounds selfish, so what, I feel like I paid enough before they passed ACA). They're just using more of my money to pay for more things for other people.

And in essence I simply had my taxes raised to provide more entitlements.

In comment 13193715 kicker said:

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Critical thinking skills?

You make me laugh, so my day is made...

In comment 13193723 pjcas18 said:

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In comment 13193714 Stan in LA said: Quote: The country is better off with the ACA, than without it. Otherwise, you'd be getting higher rates and zero protections and zero subsidies. Anyone who thinks different has an agenda like kicker. I'm personally not better off. And I care more about that than I do if the country is better off (even if that's not PC or sounds selfish, so what, I feel like I paid enough before they passed ACA). They're just using more of my money to pay for more things for other people. And in essence I simply had my taxes raised to provide more entitlements.

And without it, you'd be...?

Not a good place.

In comment 13193712 Bill L said:

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i guess I'd ask, if they are not allowed to make money, because it's inhuman, why should or would they do it at all? Should pharmas just close up shop?

Of course they should be allowed to make money. But they are making ridiculous profits and doing it by abusing the patent system. As an example, Pfizer - the world's biggest pharma - had a profit margin of 30% last year, and over 40% the year before.

In comment 13193724 Stan in LA said:

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In comment 13193715 kicker said: Quote: Critical thinking skills? You make me laugh, so my day is made...

And you make me cringe at the thought that you passed any form of our educational system.

Perhaps that needs to be revamped first...

eliminate some of the back end costs by incurring more "fixed costs" today.

They are going to try to get more patients to utilize preventive care or engage in other healthy behaviors, even if it's more costly today, because it could save a ton of money on the back end.

Unfortunately, what they thought would help is making preventive care "free". That is going to have a very limited impact.

later. Expansion of coverage, largely to fund preventive care, was the prima facie (pretty much only) goal of the massive roll-out.

that can be covered elsewhere. Luckily my husband is self-employed so he can get coverage under my plan with no extra costs (beyond the normal premiums). I don't have the rates for this year yet, so I'm not sure if they've gone up or not.

In comment 13193725 Stan in LA said:

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In comment 13193723 pjcas18 said: Quote: In comment 13193714 Stan in LA said: Quote: The country is better off with the ACA, than without it. Otherwise, you'd be getting higher rates and zero protections and zero subsidies. Anyone who thinks different has an agenda like kicker. I'm personally not better off. And I care more about that than I do if the country is better off (even if that's not PC or sounds selfish, so what, I feel like I paid enough before they passed ACA). They're just using more of my money to pay for more things for other people. And in essence I simply had my taxes raised to provide more entitlements. And without it, you'd be...? Not a good place.

Why would you say that? Before it I felt like I was fine, after it I'm worse off.

I agree we probably needed healthcare reform, but I don't think it needed to result in higher costs for me.

Just because initial costs are high does not mean that lifetime costs will be higher.

If the system is successful in reducing cost growth, it could be a long-term boon for most people.

The goals of the law are generally on point. Its implementation is saliently messy largely because it’s inserting itself into a system in motion, one that has no overarching logic beyond perpetuating fee-for-service care and catering to the powerful.

So as the cherry-picking of the healthy by insurance Cos ended (I was once denied a CT plan no joke because I had recurring epididymitis; I had to use my Dad’s NY – which had guaranteed issue – address to get coverage), there are indeed seemingly “losers”. However, those “losers” could potentially soon or eventually become “winners” (this is important to keep in mind) if they lose their coverage or want to quit their job and start a business or if they get catastrophically ill and are not subject to lifetime cost caps.

There will be further “losers” in 2020 as the (fully justified) Cadillac tax is implemented. Something which may engender an evolution toward decoupling insurance from employers, which has demonstrable benefits for both our businesses and our workers.

The law’s struggles have also been exacerbated by, as I touched upon, a deliberate sabotage by a contingent whose opposition long ago reached comical proportions. A contingent which, recall, has a decorated past of hyperbolic hysteria. They’re lamentable but (largely due to gerrymandering) will be around for the foreseeable future.

One can hope as time passes and the individual named in the law’s sobriquet is well in the rearview mirror, that there can be somewhat of a good-faith effort to patch some of the holes. The degree of grandstanding we all must presently endure is tremendously unhelpful, but I suspect it will temper just as opposition to Medicare and to Social Security did. It’s possible, however, that I am underestimating the tenacity of their pettiness and consequently that we are doomed to a perpetual stamping of their feet.

of the fact that the law was created that did not solve many of the ills, and that some of its tenets will actually do quite a bit of disservice to existing populations.

1. Supply side ("quality" measures are pretty fucking awful).

2. Medicaid expansion with tremendously poor reimbursement rates and "measurements".

3. Trying to cram "behavioral change" on one margin (insurance plan choice) without recognizing that there are quite substantial behavioral changes that lawmakers did not expect (labor supply, ED usage, etc.).

Plenty of evidence on these points.

I've been (fingers crossed) using the 60 day retroactive Cobra and rolling without insurance. I am not currently a full time employee - I am a contract or PRN employee at 2 hospitals. I have been waiting on the Cobra letter from my previous employer (which hasn't come). I'll probably be seeking full time employment soon, largely due to health insurance.

went up 43%. $857 a month. $3500 deductible. My available plans have gone from 30 to 7 in two years. All the PPO plans are gone, only HMO plans remain. This year there is NO out of network coverage available on any plans. Affordable....

while the deductible has gone up 33%.

I work for a Fortune 500, not a mom and pop shop. It's scary.

In comment 13193646 Stan in LA said:

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In comment 13193626 FatMan in Charlotte said: Quote: Blue Cross Blue Shield and our costs actually went down 10% How 'bout that! Oh, and nobody is saying that until this year, rates have been LOWER than expected the last 4 years. People don't want to hear that...

Have used them for the last 14 years and have yet to experience any of these complaints I am reading about in here.

get better rates than others which is why some people may never feel it, or feel it very little. But its absolutely a problem. When you go from paying $250 a month in 2014 to $300 a month in 2015 to $400 a month in 2016, how can anyone say there isn't a problem? That's an example of my wife's company.

I work for a very large company so our rates are pretty good, thankfully. There was an increase last year but not much this year.

And see what premiums, overall expenditures and insurance rates would be.

To me, it all starts with a broken system based on requiring employers to offer insurance.

recently moved and am working a couple of per diem jobs thus I have to buy my own insurance. My experience the past week trying to get insurance under a 'qualifying event' on the exchange has been a total disaster. First, they couldn't verify my identity. Now that Open Enrollment opened the site is basically 'under construction.' And it seems damn near impossible to find a plan not on the exchange

Are those that pay for their own insurance and make a decent living. Not only are their rates ridiculous but you cant even deduct them from your taxes.

for one of the largest firms in the country, let me be 100% clear -

The vast majority of Obamacare is an utter disaster for both companies large and small, as well as consumers.

We (consultant industry) saw the exiting of the carriers from the exchanges coming a mile away, among many other things.

It's a complete clusterfuck.

I am repeating with the high deductible plan because A) I have never hit my deductible, B) it is the only option allows for a HSA, C) it is cheap. The deductible did go up $500 this year.

As opposed to the thoroughly harmonious structure to which it was affixed?

The fact is that it’s yet another suture upon a discordant and makeshift “system” that has been fashioned together over decades. It’s messy. It’s almost necessarily being absorbed in an ugly manner (for several reasons, one being the enduring petulance of many of its detractors). But its goal was/is laudable as it attempts to suture a patch upon the largest remaining hole, a profoundly immoral one with demonstrable economic drawbacks.

Just as Part D sutured on Prescription Drug coverage in 03.

Just as CHIP sutured on coverage for children in 97.

Just as HIPPA sutured on insurance protection when one changes jobs in 96.

Just as COBRA sutured on coverage post-employment in 85.

Just as Medicare/-caid sutured on coverage for the elderly & impoverished in 65. (Funny how some extol Socialism when it allows them to win Florida…)

Etc etc all the way back to the genesis of the present “system” in 1942 when FDR froze wages and consequently employers began offering health benefits in order to attract scarce labor. The IRS then amended the tax code and this dynamic was cemented in place.

To act as if Obamacare was some grand fundamental transformation is A) wrong and B) missing the point.

And remember, it wasn’t and isn’t the first or even the 2nd choice of those who nuclear bombed their political capital to pass it. That’s single payer (IMV an inadvisable course), then a public plan aside private ones (potentially workable). They settled for what we have now. Deeply flawed as I mentioned earlier, but given the aligning of the stars majority wise for pro Universal Coverage-ists in 2008 – something we won’t see again until maybe the 2030s – getting it done was advisable. Ideally a stab at improvements would now occur, just as it did after for instance Medicare Part D’s rocky roll-out when those who did not vote for it nonetheless helped make it work. Unfortunately a good faith partner, busy for one almost giddily refusing to expand Medicaid to their state’s poor, does not presently exist.

The history I listed above about the evolution of US insurance should be rather self-evident for someone with even a basic level of historical awareness. I’m not covering original territory. But as the Buckleys and Kemps and Doles and Bakers and HWs, even the Nixons, of the right - serious people who had real, workable ideas - have been replaced by pathetic charlatans who waste our time reading fucking Green Eggs & Ham in the US Capitol, it’s no wonder the self-evident turns elusive.

Nuance is a complication they do not want and one that, deeply regrettably, the American public by & large does not demand. Collectively, we ain’t too bright.

Do you not get co-insurance also?

I have BCBS through work with a $6K max out of pocket. Family deductible is $3K. Company matches $500 for HSA contribution. Premium went up $30 this year.

Now although the family is $3K deductible, I do not pay 100% of any medical bill until I reach the deductible. There is co-insurance that pays a usually very large percentage of every bill. My wife had a child last year, and I still didn't meet the $3K out of pocket deductible because of co-insurance.

Although my employer this year is pushing folks to increase their BSA contributions for wealth accumulation, I only ever contribute the difference between the $6K Max and what I currently have at open enrollment (with a small buffer). The minimum I ever contribute is $500/year of course because...free money...and since I got it up to the $6K, only this year am I contributing more than $1K to get there.