Free Healthcare!

[C-Mart]

Depending on what you pay those employees (IE what subsidies they may are eligible for) it may be more cost effective to let them get their own insurance.

 

That being said you can't drop your plan and give raises to only those people. Because of that it is rarely beneficial to do so.

 

Fact is it sucks buying health insurance if you are a small business. Negotiation is non-existent because losing an 8 life group is nothing to them. The only advantage is you can more easily get creative with your network because it only affects 8 people.

[2highpsi]

They don't have any beneficial subsidies available to them due to pay. (We try to take care of our employees)

 

I think next year we are going to go high deductible, and help fund HSAs initially.

 

 

My originally post was pretty much a worthless rant. I agree that something needed changed in healthcare pre ACA, I'm just not happy with what we got.

[C-Mart]

I would love to see a study comparing insurance premiums from 1986-2013 vs 2013-2015

 

Here is 1999 - 2014

 

http://i.huffpost.com/gen/2039942/original.jpg

 

Kaiser family is a very reputable source for this type of info.

[C-Mart]

They don't have any beneficial subsidies available to them due to pay. (We try to take care of our employees)

 

I think next year we are going to go high deductible, and help fund HSAs initially.

 

 

My originally post was pretty much a worthless rant. I agree that something needed changed in healthcare pre ACA, I'm just not happy with what we got.

 

Subsidies cutoff dramatically at around 240% of the poverty line. We generally don't find it beneficial to drop the plan.

 

HDHPs are great with proper communication + HSAs. The problem you may run into is how many plans you can offer. Everyone may have to switch to the HDHP, but you should see a dramatic savings.

[2highpsi]

I wish our pricing chart looked like the one above.

 

 

Everyone I know with a small business experienced HUGE premium increases (assuming same coverage) in the past two years, yet none of these charts ever depict that. I would assume I was getting hosed, but I shopped it everywhere. Most recently I wasn't even able to re-create a plan like what we already have. Something about it not being "ACA approved" or something. All of the ACA plans had much less coverage.

[C-Mart]

We saw an average of 8% this year. Small business took a beating, but that doesn't show in the numbers because a 50% rise for 8 people waters down quickly with a 5% on a 3000 life group.

 

Now just wait for 2017 when they try to enact the Cadillac Tax. 40% additional if your healthcare is 'too good'.

[Mensan]

Here is 1999 - 2014

 

Kaiser family is a very reputable source for this type of info.

 

Looks accurate for my family coverage.

[Jewtoys]

I wish our pricing chart looked like the one above.

 

 

Everyone I know with a small business experienced HUGE premium increases (assuming same coverage) in the past two years, yet none of these charts ever depict that. I would assume I was getting hosed, but I shopped it everywhere. Most recently I wasn't even able to re-create a plan like what we already have. Something about it not being "ACA approved" or something. All of the ACA plans had much less coverage.

 

 

 

Same issue here.

 

 

Ended up with a plan that was nowhere near as solid as the previous years, but it was the best avaliable and at a 180k premium. Rough stuff, not sure how some places make it work.

[2highpsi]

Now just wait for 2017 when they try to enact the Cadillac Tax. 40% additional if your healthcare is 'too good'.

 

 

:fuuuu:

 

High deductible shit plan, HERE WE COME!

[C-Mart]

:fuuuu:

 

High deductible shit plan, HERE WE COME!

 

Nothing to :fuuuu: over. When funded (HSA) they are cheaper in the long run for the employer and employees.

[Draco-REX]

I can't wait to see if my insurance will hit 800/mo next year......

[BigOxley]

I can't wait to see if my insurance will hit 800/mo next year......

 

 

If it does, I could probably help take some of that CTSV-burden off your hands.

[gillbot]

We saw an average of 8% this year. Small business took a beating, but that doesn't show in the numbers because a 50% rise for 8 people waters down quickly with a 5% on a 3000 life group.

 

Now just wait for 2017 when they try to enact the Cadillac Tax. 40% additional if your healthcare is 'too good'.

 

fuck obamacare.

[everlight44]

I work in a sort of "patient navigator" type job at the hospital and deal with obtaining high cost medications. Say you are getting discharged on a medication that costs several thousand dollars and you have bad/no coverage, I have to get it for you somehow through a grant or assistance program.

 

If you make less than 16,000 per year (roughly) for a household of one in Ohio you can get expanded Medicaid coverage, which will pay for everything minus $3 copayments on high cost medications. I don't think that this act changed patient behavior a whole lot. Some patients adhere to their medication regimen and stay out of the hospital, but others are still getting readmitted over and over again for the same problems that they have for years. I run into a lot of patients who lost their medicaid because they missed renewals, didn't submit their proof of income, or did not go to their hearings. These people wind up in the ED / admitted because they did not take their blood pressure medications for 2 weeks (which a lot are $4 medications) and wind up with kidney injuries. And because they need a renewal, they have to apply for manufacturer programs to get their medications. Not many patients I know can afford Tikosyn even if they have coverage, and if you miss doses of that you have to be admitted.

 

The latest thing for me is the increase in "underinsured", which is what this thread is about. I've had trouble explaining to patients to drop their Caresource exchange insurance in order to qualify for expanded Medicaid. Yes, stop paying for bad coverage so you can get better coverage. Pretty crazy. It also is not uncommon for exchange plans to need financial assistance with their bills, as a lot of them are the equivalent of catastrophic coverage with the absolute minimum coverage. One plan I saw reportedly only paid $1000 per day inpatient... which doesn't even pay for your bed and food even at a negotiated rate.

 

tl;dr I don't think it is much if any better. The hospitals are getting paid more consistently, which is good, but the tax payers are paying for it and there is not much of an increase in positive outcomes. At least that is what I have seen.

[Draco-REX]

The fact that a healthy male non-smoker, non-drinker, with no health issues is expected to pay $400/mo out of pocket with a nearly $4000 deductible and ALSO pay for preventative checkups is proof enough that the system is broken beyond all reason. There is no argument that can justify that.

[smokin5s]

Personally, I'm a fan of High Deduct. plans. I've been on one since 2001 and find it great.

 

The key is to fund the account your first year in. Most employers at least partially fund it for you and if not, get it funded. Then if anything happens, depending on your plan, you're covered.

 

Case in point, if my son breaks his leg, wife a hip, etc. I'm responsible on our plan for the first $2,500. for the next 7,500 I pay 10%, once we're at $10k in bills I'm covered at 100%. Our family max out of pocket is $4,500 Thus for the first very bad incident, I'm going to pay $3,250 out of my pocket and then if another bad thing happens, I'll pay another $1,250 at which our plan is fully funded and we're all covered at 100%.

 

The rest is pure savings for time ahead including when the wife an I are old and gray. By "the rest" I mean the $453 +/- I put into my HSA each month that no one can take away. On the old style plans I paid that money and it was a pure waste. Money I would never see coming back to me.

5k then they cover 80%... before that didley squat... 15k is supposed to be 100% unless it's out of network, then you end up with 54k in debt in one year from a few surgeries that you knew the dr was in network, but the nurses, anestesiologist, etc... were not.... fuck high deductables.... it has put me in so much debt just trying to take care of my family, I don't think I'll ever be able to crawl out from under.

[Supplicium]

The fact that a healthy male non-smoker, non-drinker, with no health issues is expected to pay $400/mo out of pocket with a nearly $4000 deductible and ALSO pay for preventative checkups is proof enough that the system is broken beyond all reason. There is no argument that can justify that.

 

Thats how you make it "affordable" for others

[Cordell]

Thats how you make it "affordable" for others

 

Agreed, that's why it's socialist bullshit.

[RC K9]

My Rant:

 

The kids have had the same pediatrician since birth. My 9mo old daughter has something going on with her eye. There are 3 possibilities. 2 very serious, 1 not as serious. To nail down which it is, and MRI needs to be done. Yup, I have to pump my 9mo old full of ansethetic and stick her in a machine. The Doctor doesn't want to do it before she is a year old though because knocking a baby up like that is not good. She doesn't turn 1 until Jan 21. So guess what, I will be into a new ins plan by then; which, btw, won't be a PPO because NO Ins companies are offering PPO's for individual/family plans that are paid through out of pocket. You have to have an employer negotiated PPO to get one, and that is not an option for me. Our options are HMO or EPO (both suck IMHO), and its going to cost me a minimum of $4200/yr more than what I pay now for worse coverage, AND, my kids have to find a new Dr. Are the days of having a family Dr. that saw to you from childhood through adulthood gone? My Ins has gone up every year the last 4yrs. Not sure how this is affordable. I had tried to stay off the exchange in the past but I am going to have to try to go on in hopes of saving $300/mo. /rant for now.

[C-Mart]

I don't think the reporting has been brought up yet, but that is another whole fiasco to this situation. Employers are now mandated to show they are offering 'affordable' healthcare to their employees on a per month basis as of 1/1/2015. Kicker? the 'form' the government wants you to use was released.... 4/1/2015. They couldn't even come up with a simple form on time for the proactive minority who wanted to do to it.