My health insurance just got cancelled

Correct me if I am wrong,,,, but doesn't the congress have a different or separate Cadillac insurance plan that the tax payers pay for and not any form of obammmarcare???
 
No, some don't.




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Profound - some people break the law? You've made that discovery? We should alert the media!!! You're sidetracking again. . .

Again. You freely chose to pick up the tab. If you can't compete because of that, it's on you. Try to understand that a competitor who makes a perfectly legal business decision to not do so is not your moral inferior.

Again. The ACA is a transfer payment, carried on the backs of us in the middle of the curve. I do not have a moral imperative to pay for other people's health insurance.
 
Planned.




Smart consumers don't have that option. Smart consumers are employed and the employer chooses three or four plans that they'll subsidize, if they're lucky.

The vast majority of workers not working at entry level jobs, don't qualify for the tax credits nor do they shop the exchanges because that would be stupid. They'd be paying typically double what they'd get via the employer.

It's not a truly competitive market, so don't try to act like it is.




It's cheaper for their voter base. That's all it is.

There's no reason to be "on the road to single payer" if interstate competition and disconnection completely from the employer was to happen. Employer agrees to a dollar amount, insurers compete nationwide, fixes a whole lot of things.

Note that Jose had to ask for someone's zip code to figure their numbers.




There you go.



Cheapest way to buy 50% of the voter base and simultaneously make anyone who disagrees with covering it, evil. Wouldn't want to actually make a dent in the largest profit makers for the pharmacy company donors, in a nation where your chances of dying of heart disease are above 1 in 2.

Note you hear a lot of political fluff about how good single payer would be, but never private national pools. Doesn't make the insurance company money, and doesn't give the politicians more power. A total non-starter because of those two things. Also no talk of keeping employer matching dollars but removing the employer's forced choices of plans.


And there is no logical reason we insist on using employers to do the sorting and shopping for insurance for their employees.

The connection between employers and health insurance needs to be sent to the history bin.
 
Profound - some people break the law? You've made that discovery? We should alert the media!!! You're sidetracking again. . .



Again. You freely chose to pick up the tab. If you can't compete because of that, it's on you. Try to understand that a competitor who makes a perfectly legal business decision to not do so is not your moral inferior.



Again. The ACA is a transfer payment, carried on the backs of us in the middle of the curve. I do not have a moral imperative to pay for other people's health insurance.



I guess I just have higher morals than you.

It happens. Keep your chin-up, and keep trying each day.
 
I guess I just have higher morals than you.

It happens. Keep your chin-up, and keep trying each day.


The guy who wants to use purchased laws and lawmakers as a social engineering weapon, is claiming high morals. Man, I need some hip waders for that. The BS rose above my boot tops with that post.
 
Correct me if I am wrong,,,, but doesn't the congress have a different or separate Cadillac insurance plan that the tax payers pay for and not any form of obammmarcare???

Unless it's changed very recently, Congress itself has it's own plans. Congressional staffers have to use the exchange. And Federal employees have a pretty competitive set of options offered through various carriers and employee unions - all of which are generally less expensive than the plans available to the general public.

https://www.apwuhp.com/our-plans/see-premiums/
 
And there is no logical reason we insist on using employers to do the sorting and shopping for insurance for their employees.

The connection between employers and health insurance needs to be sent to the history bin.

You do realize that we got to the point of employers offering health care due to government price controls and tax breaks?
 
And there is no logical reason we insist on using employers to do the sorting and shopping for insurance for their employees.

The connection between employers and health insurance needs to be sent to the history bin.
Your very good at moving the goal posts and jumping off track. But I still don't think I've seen an answer to my question. For the last several years, my premiums have gone up, my deductibles have gone up, my copays have gone up, and my prescriptions have gone up. I don't get tax credits, and I can't choose my plan on the exchange because is offered by my employer. How am I better off?
 
You do realize that we got to the point of employers offering health care due to government price controls and tax breaks?

The government has overseen and regulated health insurance for at least 50 years. Any problems with health insurance are a direct result of government meddling. Only a liberal would think that more of the same will produce a different result.
 
Your very good at moving the goal posts and jumping off track. But I still don't think I've seen an answer to my question. For the last several years, my premiums have gone up, my deductibles have gone up, my copays have gone up, and my prescriptions have gone up. I don't get tax credits, and I can't choose my plan on the exchange because is offered by my employer. How am I better off?

You aren't.
 
The government has overseen and regulated health insurance for at least 50 years. Any problems with health insurance are a direct result of government meddling. Only a liberal would think that more of the same will produce a different result.

That's not entirely true, and it's a problem with using labels.

Regulation is necessary for smooth functioning of the economy. Most businesses want regulation that benefits them, and lobbies against regulation that doesn't benefit them (or hurts them). It is a form of creating barriers to entry. True, unfettered capitalism would be detrimental to most businesses (eliminate the patent and copyright systems, which are regulatory, and the market value of every tech company would plummet).

Regulation that improves information transparency (e.g. allows consumers to see the true prices of products they're using) tends to make the market more reasonable & allows informed comparisons & decisions. Opaque pricing hurts everyone.

And regulation needs to be coordinated with other regulations. Part of the issue here is conflicting regulations.

While I might agree that turning health care into a government business is not desirable, the current state of affairs is also not desirable.
 
And there is no logical reason we insist on using employers to do the sorting and shopping for insurance for their employees.

The connection between employers and health insurance needs to be sent to the history bin.
Used to be that employers offered health insurance as a benefit, it was voluntary. Now ACA makes it mandatory. I don't remember the details - isn't it full time employees for companies with 50 or more? Then companies started putting more and more people on part time? After all, why should the company put itself into a situation where it is required to raise expenses when the Government exchanges have made sure there is an alternative?
 
Smart consumers don't have that option. Smart consumers are employed and the employer chooses three or four plans that they'll subsidize, if they're lucky.

The vast majority of workers not working at entry level jobs, don't qualify for the tax credits nor do they shop the exchanges because that would be stupid. They'd be paying typically double what they'd get via the employer.

Even though I disagree with you about many things, I agree with this. But it has been that way ever since I had any kind of employer-sponsored plan. You have very little choice (I have a choice of two plans, at one time it was only one), but the employee share is much less than what I could get as an individual on the exchanges. It has always been that way, even when the market was less regulated. Even if the employer didn't subsidize, the plans are less expensive due to the fact they are a group policy. I have seen the total cost.
 
Even though I disagree with you about many things, I agree with this. But it has been that way ever since I had any kind of employer-sponsored plan. You have very little choice (I have a choice of two plans, at one time it was only one), but the employee share is much less than what I could get as an individual on the exchanges. It has always been that way, even when the market was less regulated. Even if the employer didn't subsidize, the plans are less expensive due to the fact they are a group policy. I have seen the total cost.

Much of the reason for those company group policies being cheaper is because they cover a smaller group - employees and families - that might be healthier than a general cross section of society. If you are with a small company, a couple of people having heart attacks or cancer treatments can cause premiums to rise the following year because of a higher than average claims history. People too sick to work get dropped from the group after a certain amount of time on disability coverage and no longer affect that group. The ACA exchange policies have to cover a larger group that includes those with pre-existing conditions.
 
Much of the reason for those company group policies being cheaper is because they cover a smaller group - employees and families - that might be healthier than a general cross section of society. If you are with a small company, a couple of people having heart attacks or cancer treatments can cause premiums to rise the following year because of a higher than average claims history. People too sick to work get dropped from the group after a certain amount of time on disability coverage and no longer affect that group. The ACA exchange policies have to cover a larger group that includes those with pre-existing conditions.
I'm guessing the company is 70-100 people. But I probably gave the average payout a big boost a couple years ago with a large claim. I would agree that the people being covered are probably healthier than the average for the general population, though.

But I will say that I had no trouble with the claims process. I didn't need to fight with the insurance company for anything. I even got a few un-asked-for refunds from providers when I mistakenly paid them and they also got paid by insurance. When I reached my out of pocket for the year, which I think was around $4000, they covered everything.

What was interesting to me was that the hospital plays the game of charging large amounts but the insurance company gets a huge discount. That in itself makes it worth having insurance, because even the out-of-pocket charges are negotiated way down.
 
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What was interesting to me was that the hospital plays the game of charging large amounts but the insurance company gets a huge discount. That in itself makes it worth having insurance, because even the out-of-pocket charges are negotiated way down.

Yes. Even with a high deductible plan, the discounted charges make a big difference.
 
Yes. Even with a high deductible plan, the discounted charges make a big difference.
Yup, and I'm sure we'll hear from people who consider themselves great negotiators who are going to claim they could do better. But the insurance companies have more leverage, and do you really want to be doing that while you are sick? That is if you even have the ability.
 
Smart consumers don't have that option. Smart consumers are employed and the employer chooses three or four plans that they'll subsidize, if they're lucky.

That's not entirely true any more. There is a huge and growing segment of the population that are entrepreneurs or independent contractors. Those folks have no employer subsidized plans. And many companies use independent contractor to avoid the payroll taxes and benefits payments. Further. most smart companies today don't subsidize spouses/family - it's employee only. Heck, I know of one that won't even permit adding a spouse during Open Season unless the spouse has a "qualifying event"
The vast majority of workers not working at entry level jobs, don't qualify for the tax credits nor do they shop the exchanges because that would be stupid. They'd be paying typically double what they'd get via the employer.

It's not a truly competitive market, so don't try to act like it is.
Exactly.


What was interesting to me was that the hospital plays the game of charging large amounts but the insurance company gets a huge discount. That in itself makes it worth having insurance, because even the out-of-pocket charges are negotiated way down.

And that's a big part of the problem.
 
Further. most smart companies today don't subsidize spouses/family - it's employee only.

Then add the ever increasing deductibles and out of pockets. When I had my issue two years back, it happened in December such that I had the pleasure of satisfying two years of max deductibles and out of pocket. Damn, why couldn't I have had that problem mid-year? :(
 
Then add the ever increasing deductibles and out of pockets. When I had my issue two years back, it happened in December such that I had the pleasure of satisfying two years of max deductibles and out of pocket. Damn, why couldn't I have had that problem mid-year? :(
Same thing happened to a buddy, helping push his neighbor's car out of the snow on Christmas weekend. Ended up needing surgery and hit the deductibles for both years.
 
Unless it's changed very recently, Congress itself has it's own plans. Congressional staffers have to use the exchange. And Federal employees have a pretty competitive set of options offered through various carriers and employee unions - all of which are generally less expensive than the plans available to the general public.

https://www.apwuhp.com/our-plans/see-premiums/

Sometime in the mid 2000s, someone suggested that the cheapest way to achieve universal coverage would be to just put all the uninsured on FEP basic option.
 
Much of the reason for those company group policies being cheaper is because they cover a smaller group - employees and families - that might be healthier than a general cross section of society. If you are with a small company, a couple of people having heart attacks or cancer treatments can cause premiums to rise the following year because of a higher than average claims history. People too sick to work get dropped from the group after a certain amount of time on disability coverage and no longer affect that group. The ACA exchange policies have to cover a larger group that includes those with pre-existing conditions.

Often they are cheaper. In a 100 employee company, all it takes is one employee with liver cancer and someone else with a premature infant to wipe out much of those savings.
 
By the way, there's an excellent article on drug pricing in the WSJ today. Pretty clear that that the US is subsidizing the rest of the world. Including countries with lower labor costs that we import good from....


http://www.wsj.com/articles/why-the-u-s-pays-more-than-other-countries-for-drugs-1448939481
(note: subscription may be required)

And prepare now for the next benefits battle: https://www.washingtonpost.com/loca...7f8ade-979a-11e5-94f0-9eeaff906ef3_story.html


Note: To get around the WSJ wall, do a Google search on the article headline, then select the first search result.
 
Used to be that employers offered health insurance as a benefit, it was voluntary. Now ACA makes it mandatory. I don't remember the details - isn't it full time employees for companies with 50 or more? Then companies started putting more and more people on part time? After all, why should the company put itself into a situation where it is required to raise expenses when the Government exchanges have made sure there is an alternative?

You forgot that the definition of full time was established at more than 29 hours. This has served to create a new group of employees called the 29ers.
 
Even though I disagree with you about many things, I agree with this.


You might be surprised at what we agree on. Most conversations here are either aviation related (we don't argue much about THAT, you and me anyway -- the board in general is a different story... Ha!) and the political topics and ideas "approved" by the media.

Notice when we talk real turkey and ideas monolithic ham would touch with a ten foot pole because it doesn't further their cause, otherwise known as themselves, we tend to agree also?

The American public is so brainwashed into thinking the ideas and ideals pushed by politicians are actually important, they rarely step back from the never ending noise level created by DC to think about any of it much.

Nor demand their "representatives" think about any of it.

I'm guessing the company is 70-100 people. But I probably gave the average payout a big boost a couple years ago with a large claim. I would agree that the people being covered are probably healthier than the average for the general population, though.



But I will say that I had no trouble with the claims process. I didn't need to fight with the insurance company for anything. I even got a few un-asked-for refunds from providers when I mistakenly paid them and they also got paid by insurance. When I reached my out of pocket for the year, which I think was around $4000, they covered everything.



What was interesting to me was that the hospital plays the game of charging large amounts but the insurance company gets a huge discount. That in itself makes it worth having insurance, because even the out-of-pocket charges are negotiated way down.


We are a similar sized company. One terminal cancer patient pushed everyone's rates up 20%. I hear he was a nice guy, he was dead before I got here. The insurance broker says next year we are allowed by those great "laws" Jose is so proud of to join a much larger pool which will help for further events but it won't change our rates in the near term at all. Company sucked it up and paid a significant portion of the rate difference for us, which was nice, but we'll see what it means to profitability and ultimately jobs here over the next one to two years. A lot is riding on new products that may or may not fly. Good products, it just remains to be seen if the sales and marketing folk can make the sales.

Having been an IT manager for a long time and knowing IT either has to make or save the company money or it's useless, but not with full access to the financials here since we are privately owned, made me prioritize projects that would lower monthly cash flow knowing those projects will directly affect whether or not I and/or others have a job next year.

This week alone I'll finish up three small projects that save the company $1200/month off the bottom line, and we've started one that will take considerable effort but will save the company $12,000/month. Have one other low hanging fruit one that has some significant business risk to do it right but if the vendor does what they're told, another $1200/mo gone. So by the end of Q1 for sure, and likely sooner, I'll have knocked $172,000 a year off of the bottom line and will have actually increased the IT resources and performance of existing systems in the process. It may save one job, whether that's mine or someone else's, I don't care.

This year is much more fun than last year when we were resource limited on time and had to spend money to get stuff stable and maintainable first before tackling the cost cutting. Always explained the order of operations to the upper management during this process so they wouldn't freak out that costs were going up, and that those were one-time costs, not recurring. Shooting these unnecessary recurring costs in the head will be way more fun this year.

That's not entirely true any more. There is a huge and growing segment of the population that are entrepreneurs or independent contractors. Those folks have no employer subsidized plans.


And those folks now do have the ability to shop, kinda, via the exchanges. My point was in response to Jose's lie that people should "just shop around", which was a falsehood when employer matching funds are involved.

It would be interesting to know if Jose allows his staff to shop the exchanges and not be on his group plans he chooses for them, and he will pay the same amount of money into those plans for them if they so choose to "shop" and leave his company group plans. I seriously doubt he would.

He's not really interested in competition in the medical plan market if he doesn't.

Then add the ever increasing deductibles and out of pockets. When I had my issue two years back, it happened in December such that I had the pleasure of satisfying two years of max deductibles and out of pocket. Damn, why couldn't I have had that problem mid-year? :(


That whole thing is also stupid. It should be a rolling 12 month window from the start of any particular diagnosis. But I have no confidence looking at the disasters that people design for medical billing systems that medical software developers could ever even get close to getting that right. So try to get sick in January, kids. Haha.
 
You forgot that the definition of full time was established at more than 29 hours. This has served to create a new group of employees called the 29ers.
Yes, I did forget.

Even local job fairs that crop up here and get advertised on local TV and radio are typically only hiring part-timers. I think a lot of places are using that for a couple of reasons: they can avoid a lot of regulations, and they use the 29ers as interns and decide later if they want to keep them as full-timers.

One of the problems is that those employees end up not having a good chance to moonlight at a second job. If part timers were anything less than 40, they might not need a second job. If they were half-timers, they might be able to work a morning and afternoon shift at two different places and end up with the equivalent of full time hours. But at 29 hours, they often don't get enough hours to pay the bills, but don't have enough time left for another job that could help out. Especially in a lot of those jobs where their shifts might change from day-to-day and not allow them to schedule a 2nd job.

It's tough out there for a lot of people.
 
Loss of half-a-billion on 540,000 people covered, or slightly less than $1000 per person. Not sure how many policies it covers, but it would work out be a loss of $85/month per person. The rest of their business is subsidizing the ACA exchanges business.

And god forbid, they would have to pay their CEO less than a 100 million next year :wink2: .
 
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