Obamacare

[Ddrak]

Our minimum wage is too high ($16/hr + 401k full time or $20/hr casual, more if you fall into an "award" category). It results in companies hiring kids and firing them on their 17th birthday, or just not hiring at all. Significantly distorts the cost of living too, raising the base prices for services far above and beyond what I'd seen in the US.

http://www.fairwork.gov.au/pay/national ... fault.aspx

Dd

[Partha]

So, after many delays, I am finally able to compare plans where I'm at.

The cheapest Bronze plan with my piddly tax credit (I mean, seriously, it's almost worth it not to take the damned thing) is about $180/month.

The one I'm looking at right now is from Coventry. $212/mo. Yes, the deductible is $6300, which is also my out of pocket maximum. As long as I stay in network, no copays, no coinsurance after deductibles. Decent range of services. Hell of a lot better than not having insurance.

Meanwhile, the only Platinum policy available is $405/mo. $1000 ded/$1500 oop, typical service includes a 20% copay.

[Embar Angylwrath]

Is that through a state exchange or the federal one?

[Partha]

Federal. Illinois never got an exchange running, being too busy with pension grandstanding.

[Lurker]

http://getcoveredillinois.gov/

[Harlowe]

I just want to say YEA LURKER, nice to see you around. =)

[Lurker]

Thanks. I've been lurking.

[Embar Angylwrath]

So was it Federal or Illinois? I thought if the state had an exchange you had to get it from there, not the federal one.

That said, if I understand the bronze one correctly, you shell out $6300 out of pocket before the insurance kicks in. So it's really just catastrophic insurance coverage, AND its an HMO type plan since you have to stay in network for max benefit.

We just went through our annual insurance review in CA, and will likely change our plan mix. Our current base plan, which the company covers 100% for the primary, is a higher deductible plan, and I don't like it. The employee shells out $2500 in deductibles before the insurance kicks in. Then its shared coverage on most stuff at 50% until the employee shells out another $5K. So total out of pocket to an employee is $7500. After that, the insurance picks up 100%.

We are moving back to a traditional co-pay plan, and zero deductible. Pretty standard amounts on the co-pay. A $100 co-pay for emergency room, $100/day hospital stay, $40 co-pay doctor's visits and $75 co-pay for stuff like MRI's. I think there are 2 wellness visits included per year as well, no co-pay. The trade-off is it's an HMO plan instead of a PPO, so you have to stay with the doctors and hospitals in network, unless you are out of the coverage area, and then you can use anyone at network co-pay rates. Also, women can port their gyno if their gyno is not one of the listed doctors. Big plus for our female employees. I think that's a CA law though, not sure.

For a 50-ish male, the premium is around $240/month for this plan. I've never liked the high deductible plans, I thought it actually drove people away from using healthcare, so I'm glad we have this option this year. It wasn't available last year.

We've been counseled by benefits advisers to have the employee contribute some of the expense for their coverage, but so far, ownership has resisted that recommendation. The advisers have said it makes the health plan more valuable to the employee if they have skin in the game, but we disagree, at least for our employees. They are a bright bunch of people, and we don't think they need to see a deduction on a pay-stub to fully value a benefit.

[Embar Angylwrath]

I should add that as part of the Obamacare, employers are now prohibited from establishing programs that help employees offset insurance costs. We had a program where in the higher deductible plan, we could assist the employee in expenses, essentially covering the deductibles. Can't do that anymore, its now against the law to financially support health care expenses outside of the plans themselves and Sec 125 deferrals, which don't apply to our employees since we pay 100% of the primary.

The insurance person explained it to me, and if I recall correctly it had something to do with tax free help and taxed dollars to support ACA. Somehow, by helping the employee with deductibles we were somehow hurting Obamacare. I didn't quite follow the conversation that closely, since it was irrelevant to us considering our change in plans.

[Harlowe]

Show me where it is against the law to financially support health care expenses outside of the plans themselves. Our company does that now. The company provides a healthcare benefit that covers the out of pocket deductible over the course of a year.

Also the employer mandate doesn't even apply until 2015.

[Ddrak]

I could see it being illegal to support an employee with health care and not having it count as salary (and therefore taxable at the marginal rate). Other than that, it's effectively just paying a bonus for being sick. Kinda weird but *shouldn't* be illegal.

"Skin in the game" is complete bullshit by the way. Sounds like the consultant has done their research on how to convince employees to part with more of their salary.

Dd

[Arathena]

I could see it being illegal to support an employee with health care and not having it count as salary (and therefore taxable at the marginal rate). Other than that, it's effectively just paying a bonus for being sick. Kinda weird but *shouldn't* be illegal.

"Skin in the game" is complete bullshit by the way. Sounds like the consultant has done their research on how to convince employees to part with more of their salary.

Dd

It depends on how you do it. We get direct deductible support as a part of our health plans - there is a health savings account directly attached to our health plan, administered by the insurance company that administers our plan. All direct deposits to this account - both from the company as a part of the plan and my self-selected contribution, up to a certain (reasonably high) limit, are deducted from my salary for tax purposes. Anything in the HSA rolls over year to year, and can be invested. This is, though, a part of the health care plan.

By Federal law, this requires that it count as a 'high deductible plan'. Low deductible plans - under about $1250 or $1500 have a different sort of very shitty account attached to them that wipes out at year end.

What they've done to us is slowly turn the PPO into an utterly useless piece of shit while leaving the high deductible plan, in a deliberate push to reduce the overall value of the benefits provided.

[Embar Angylwrath]

Show me where it is against the law to financially support health care expenses outside of the plans themselves. Our company does that now. The company provides a healthcare benefit that covers the out of pocket deductible over the course of a year.

Also the employer mandate doesn't even apply until 2015.

I've asked our insurance folks to point me to that part of the Obamacare regs. If they get back to me with something, I'll post it here.

Not sure what your point was about the employer mandate though.

[Embar Angylwrath]

Show me where it is against the law to financially support health care expenses outside of the plans themselves. Our company does that now. The company provides a healthcare benefit that covers the out of pocket deductible over the course of a year.

Also the employer mandate doesn't even apply until 2015.

Ok, so this is what I got from the insurance folks. Reimbursements aren't illegal per se, however, they are

restricting the use of reimbursement for deductibles to medical plans that have HRA deductibles.

Sounds like what Ara was commenting on.

[Harlowe]

Right, not illegal....I just don't think attempting to paint it as poorly as you can with scare-tactic terms does anyone any good.

[Embar Angylwrath]

If I was trying to do that Harlowe, I wouldn't have taken the time to go back and check with our insurance people.

And more specifically, reimbursement accounts ARE illegal, unless you set them up in specific way for a specific type of plan. Ara covered that pretty much. You'll have to let us know if the new Obamacare regs force your employer to modify or eliminate their support of your health costs.

[Embar Angylwrath]

What a debacle. Sebillius used the right word.

Obama outright lied to the American people to sell Obamacare. "If you like your plan, you can keep it. Period." That message never shifted. Not most plans, not most people. Everyone.

We also find out Sebillius knew how many people were enrolled through the site, even though she maintained she didn't have the information.

And to top it off, in an effort to be the most transparent administration, HHS still refuses to give out numbers.

Hope and Change people, Hope and Change.

[Embar Angylwrath]

Obama got the Distinguished "Lie of the Year" award from Politifact for his repeated statements about Obamacare that were patently false.

Well done BO, well done.

[Flunkie]

I work for an employer that has always had great coverage options for it's employees. Although my wife works, I carry her on my policy because it's a better and more cost effective plan for us. Anyway, I don't care much about Obamacare right now, but for the heck of it I went to Covered California to check out what it would be like for a 25 year old making $25,000/year. The results weren't particularly surprising for my zip code, a mediocre $145/month with a mid level deductible for a "Bronze" plan. Here's where the shock came in. I went back to the site about 6 hours later and input the same data, 25 year old, 25K/year, same zip code. The results the second time were totally different. I mean completely different plans shown and much higher prices across the board. The only plan close to the previous $145 plan was over $200! I don't understand if this is intended, or if this is a result of some kind of problem. Covered California has it's own system and web site that did not have serious launch problems like you hear in the news. But if plans can vary like this, it seems like something is wrong with the whole system.

I've heard that the penalty for the first year of no coverage is $75, the following year the penalty is a percentage of your income. I would have a hard time blaming any younger person for taking the $75 penalty and risking it. The system relies on healthy people paying for something they aren't going to use. The theory is that they will eventually get paid back when they get older. That was the theory behind Social Security which is collapsing at this point.

[Kliban Nimbledigits]

Well, we got hit with our first WTF Obama Care moment.

My g/f and I went in to get her MS medication and discovered that, due to Obama Care, it can no longer be dispensed as a "Preferred" drug of treatment as described by Kaiser Permanete. It now now labeled a "Non-prefered" and requires us to pay 50% of the cost. That's $3000.00 a month.

As a stab at Kaiser Perm, they never sent a notice that this was going to happen. Another rant for another day.