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.