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Tell me again how my premiums won't go up?

Posted by rob333 (My Page) on
Thu, Oct 17, 13 at 8:06

Last year's medical insurance increase was 9%. This year's increase 28%. Sorry, but you're wrong. This isn't Canada or Europe or wherver else; it's land of the have-middle-class-foot-the-bill. Can't pull the wool over my eyes any more! I said I was waiting. Now I can say it 100% assured I know!!! The other shoe has dropped. No salary increases for years and now this type of deep into my pockets take away? I'm not an I told you so kind of person, but I told you so. Let's see how this plays out everywhere. Some employees around the US won't know their increases until January, but since I'm paid on the federal cycle, so I am in the October group.


Follow-Up Postings:

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RE: Tell me again how my premiums won't go up?

Rob, how is this tied to the ACA? Is this a raise in premium for the insurance you already have or is it a new plan through ACA that causes this difference? I'm sorry your premiums are going up but the link to the ACA is not clear as you state it.


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RE: Tell me again how my premiums won't go up?

Become self-employed. The whole system of collusion between insurers and care providers is built on employees. Really employers are part of the collusion as well, because they help coerce employees into accepting this massive scam.


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RE: Tell me again how my premiums won't go up?

My cobra costs well over a thousand a month the current plan I'm signing up for will be half that for the same benefits and a lower deductible! I checked out & called doctors who accept the plan as they were all listed on Zoc doc. Thats a major savings for me of about $7,000


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RE: Tell me again how my premiums won't go up?

Explain the entire groups' increase another way pidge. This group is 5 digits strong. Not 5 or 50 employees. Health didn't impact it. The premium is the same for every employee, whether 25 years old or 55 years old. This is raise in premium for each and every one of the 15,000+ on the group (I'm leaving off the top eschelon group as they're probably self insured). How is it not legislation? It also changed in that they're required to provide short term disability to everyone (I already had it for years now). Free of charge. Or I can buy up to have better protection. It also changed how our time off is being done. I lose 7 days a year out of my sick/vacation time. So far, I'm less than impressed. You might want to remember, I have an educated view of insurance. I know the inner workings and the aspects of the influences which might propel premiums. Other than health???? what is it that could kick it up triple over last year's increase? And they lost the upper tier healthcare provider. This is the "cheap" provider. Others lost the better benefits. Stripped down and kicked up premiums. MMM, my favorite!

I know you don't want to believe it, but try to be reasonable on that end of it. We'll have to see how it works nationwide, and there will be numbers and data coming in, so let's watch. But for Tennessee much higher premiums.

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Become self employed and slip under the radar? I'll take the penalty please! Or do without insurance? It's not cheap anywhere for anyone, but it's really not cheap to NOT have insurance.

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Whoopdeedo joe. I told you NY has had screwed insurance for years. Blame your state legislators. Also MI, AL, MA and others. Glad they got a kick in the A, but you'll be in the minority.

This post was edited by rob333 on Thu, Oct 17, 13 at 8:37


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RE: Tell me again how my premiums won't go up?

Waiting for open enrollment to see what next year's premium is, but for 2012 it was $204 per month for me and 2 child dependents (spouse has own plan). In 2013 it is $232 per month for same coverage, a 14% increase.

Edited to correct the monthly total; I was looking at a 2 week paycheck stub.

This post was edited by esh_ga on Thu, Oct 17, 13 at 8:46


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RE: Tell me again how my premiums won't go up?

I have Medicare now.

You youngin's can also add in the continuing, growing cost of us old people, too. Oh, to be young and carefree.

Stay healthy! Somebody's got to carry this burden.

Thanks.

Hay


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RE: Tell me again how my premiums won't go up?

Hay, I am honored to contribute to your Medicare coverage.


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RE: Tell me again how my premiums won't go up?

Is Medicare socialized medicine? I'm still trying to figure out what that is?


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RE: Tell me again how my premiums won't go up?

I just asked an HR person to confirm, YES it is an ACA related increase. Sorry! I hope everyone else fares better.

Hay, you're saying what I've been saying. Skyrocketting costs from the babyboomers won't help this matter. Glad to help you. Just wish I had the help of self employed and/or big businesses who would contribute to the pool.


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RE: Tell me again how my premiums won't go up?

"I just asked an HR person to confirm, YES it is an ACA related increase."

Seems to me that having to pay for "essential benefits" that are not essential to YOU is guaranteed to drive up costs. Why should non-parents who aren't capable of having children have to pay for maternity care? Even if a couple was going to adopt, why would they need pediatric care prior to adopting? Seems like the system is designed to force people to overpay. And that doesn't seem right to me.

Here is a link that might be useful: essential benefits


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RE: Tell me again how my premiums won't go up?

"Hay, I am honored to contribute to your Medicare coverage."

I guess it works out. Leaves me more money to spend on wild, young women.

Thanks.

Hay


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RE: Tell me again how my premiums won't go up?

Health care costs are going to plummet, followed by a rinsing out of the insurance game . One scam after another get will knocked out (with lots of desperate political battles involved), until we have "single-payer" or IOW a true socialist system.


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RE: Tell me again how my premiums won't go up?

Why should non-parents who aren't capable of having children have to pay for maternity care?

Because that's the way insurance works. It's also the way property tax works. You pay for stuff you don't use and others pay for you to use stuff that they don't use.


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RE: Tell me again how my premiums won't go up?

Why should people without children pay school taxes?

Why should people without teeth pay insurance that covers fillings?


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RE: Tell me again how my premiums won't go up?

"Because that's the way insurance works."

Not always. Unlikely in a free market.

In some cases you can actually buy insurance that reflects YOUR personal risks to the insurer.

I used to be able to do that with my health insurance.

Hay


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RE: Tell me again how my premiums won't go up?

I am glad to personally get two new benefits available as a result of ACA:

- cannot be denied for a pre-existing condition
- cannot be denied for reaching a "life-time maximum"

There are also 10 essential benefits available to everyone, but my plan already included them:

Ambulatory patient services
Emergency services
Hospitalization
Laboratory services
Maternity and newborn care
Mental health services and addiction treatment
Rehabilitative Services and devices
Pediatric Services
Prescription drugs
Preventive and wellness services and chronic disease treatment

Here is a link that might be useful: source


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RE: Tell me again how my premiums won't go up?

You already couldn't be denied for pre-existing. As long as you went from one carrier to the next. If you dropped coverage, then you were subject to pre-existing. If you married and you applied in time, within a month of the marriage, typically, you were covered without pre-existing. If you had a baby, automatcially waived pre-ex. If you adopt, automatically waived pre-ex. If you divorce, able to apply at your own place of employment and automatically waive pre-ex. And? There are so few instances of not having this.

So what does it matter? The majority of people already went from coverage to coverage. It's meaningless. It sounds good, so they're saying it. They're trying to attract those who have been out of the system. That's all.


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RE: Tell me again how my premiums won't go up?

The majority of people already went from coverage to coverage.

Yay for the majority. Screw everyone else?


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RE: Tell me again how my premiums won't go up?

You already couldn't be denied for pre-existing. As long as you went from one carrier to the next.

75% don't know that!


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RE: Tell me again how my premiums won't go up?

Sorry your premium went up so much. However, just because your employer is telling you the 28% increase is due to Obamacare doesn't mean it is.

First, if your company employs more than 15,000, it's most like self insured and the "insurer" you see is just acting as a third party administrator. Therefore 1) they already provided automatic coverage for any family member with a pre-existing condition; 2) they don't participate in the exchanges anyway; and 3) the only difference is they have to pick up the cost of one free physical per year and they're covering an additional 4 years of the country's healthiest demographic (adults between 21 and 26).

There is no way a 28% increase resulted from Obamacare. Just no way.


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RE: Tell me again how my premiums won't go up?

Posted by esh_ga z7 GA (My Page) on
Thu, Oct 17, 13 at 8:39

Waiting for open enrollment to see what next year's premium is, but for 2012 it was $204 per month for me and 2 child dependents (spouse has own plan). In 2013 it is $232 per month for same coverage, a 14% increase.

What is the $ amount of federal subsidy you will receive to keep your premium that low?

What is the total out of pocket per calendar year? $12,500? Higher?


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RE: Tell me again how my premiums won't go up?

I am a former HR Director. Premiums go up by 10% generally every year. This year, my Husband's employer is switching from Aetna (decent) to United Healthcare (horrible). Along the way, I have either been a member or negotiated with every major health and welfare carrier out there.

When you bid out your business, a new carrier will natch offer you a very competitive rate to earn your business. You can guess what happens in subsequent years. After about two or three years the rates go up and you bid it out again.


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RE: Tell me again how my premiums won't go up?

You already couldn't be denied for pre-existing. As long as you went from one carrier to the next

That sure isn't the way things work here. You're covered as long as you maintain your current policy with the same insurer. You can get a worse policy with the same insurer, but you can't switch companies, they won't let you.

But given that insurance premiums have been going up every year, often double digit increases, for the past 15 years, why, suddenly, is this massive increase due to Obamacare? The only explanation I could think of is that your previous policy didn't cover much.


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RE: Tell me again how my premiums won't go up?

What is the $ amount of federal subsidy you will receive to keep your premium that low?

What is the total out of pocket per calendar year? $12,500? Higher?

I receive no federal subsidy, this is employer-provided insurance. I don't know what the total out of pocket is.


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RE: Tell me again how my premiums won't go up?

That's how pre-existing works nationally. With carriers who work nationally. Unless of course you live in an F'ed up state and the legislators ruined it for you. MI, CO, TX, AL, MA, NY, probably others which are escaping my recollection. Sorry the 75% don't know it. Blame their HR departments, they should've been telling them to sign on immediately. Oh, another example: when you sign up for the very first employer after the waiting period is complete, pre-ex waived.

Sorry hayden, but my HR department has no dog in the discussion going on here. HR has no reason to lie. Actually, they probably get in trouble for lying. Nice try!


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RE: Tell me again how my premiums won't go up?

Rob, then go back and ask them to explain to you exactly how the ACA is responsible for the increase. I don't think they are lying but perhaps they don't really understand the reasons for the increase either.

Its not OK to just say its because of the ACA ......you are entitled to the details of exactly why. Without all the information I don't know how your can just accept that it is.


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RE: Tell me again how my premiums won't go up?

Seems to me that having to pay for "essential benefits" that are not essential to YOU is guaranteed to drive up costs. Why should non-parents who aren't capable of having children have to pay for maternity care? Even if a couple was going to adopt, why would they need pediatric care prior to adopting?

And how is this in anyway related to the ACA? Or is just that some like to make it sound like that evil Obama is making you pay for coverage you don't need because he's a big meanie?


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RE: Tell me again how my premiums won't go up?

"There are also 10 essential benefits available to everyone, but my plan already included them."

The 10 essential benefits are not "available" to everyone under obamacare.

They are MANDATED for everyone whether they need them or not...except those with "grandfathered" policies.

Policies without the costly baggage Democrats alone decided to call "essential benefits" are being grandfathered in for now. So much for the nonsense claim that "essential benefits" are "how insurance works."

Even the BS language is part of our Brave New World. For example, there is no way maternity care is an "essential benefit" to men, boys, prepubescent girls, elderly or infertile women. The presence of a uterus, functioning or not, has no bearing on what progressives believe and will repeat all day long. Maternity care is an "essential benefit" for all. Sit back and watch, as they come forward to argue for mandated benefits people must buy, even though they have ZERO RISK of needing it. Ever.


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RE: Tell me again how my premiums won't go up?

Its simple math....below some excerpts from Dave Ramsey explaining the math behind ACA. For complete article and video: http://eaglerising.com/2254/dave-ramsey-destroys-obamacare/

“January 1st, 2014 every insurance company is required to take on anyone, no matter how sick they are, and they cannot charge them more than someone who is not ill…You're 500 lbs. you have diabetes, you’ve got cancer, you’ve had three heart attacks you’re going to pay the exact same premium as a perfectly healthy person.”

“I understand the motivation, and the nobility and the moral imperative behind that. I get that. But that doesn’t change the math, the math is that those people get sick more often and run up more medical bills than someone who is healthy. Duh.”

“If they now have to be covered by the same company that you’re covered by and they’re required to take them… then the math kicks in. Because the amount of money that that company was paying out to the medical community is going to go way up. They’re going to pay out to the medical community per person than they ever have before… what they pay out per person is how your premium is determined ��" plus profit.”

“Everyone is going to be charged the same. Translation you are going to pay higher premiums to keep the insurance company open, so they don’t go broke. Because they are now going to have to cover people that they didn’t have to cover before… sick people.”

Read more at http://eaglerising.com/2254/dave-ramsey-destroys-obamacare/#sRP8FgHgj2Qs74FS.99


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RE: Tell me again how my premiums won't go up?

Why do I pay school taxes when my kids have been out of school for years? Why do my cousin and husband pay them when they never had children? Because, that's the way it's structured. Same with health care policies. All of them.


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RE: Tell me again how my premiums won't go up?

So what does it matter? The majority of people already went from coverage to coverage. It's meaningless. It sounds good, so they're saying it. They're trying to attract those who have been out of the system.

During the Great Recession, it was not unusual for an unemployed person to be unable to afford COBRA premiums. Coming onto a new policy with a new employer with a gap in coverage -- they've fallen into the trap.

Premiums go up by 10% generally every year.

In my area I would say 10-15%.

When you bid out your business, a new carrier will natch offer you a very competitive rate to earn your business. You can guess what happens in subsequent years. After about two or three years the rates go up and you bid it out again.

Same in my experience with a small company.

Also some carriers will offer new plans that are very attractive only to steeply raise the premiums in subsequent years. While the overall increase for an entire company may be 10-15%, these once attractive plans can increase much more. HMOs typically have had the lowest increases.




Rob, I also suggest that you request clarification on how ACA has increased the premiums. You may find out something that will influence future health care insurance decisions.


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RE: Tell me again how my premiums won't go up?

chase, I listed the reasons for increases at the top. Changes in overall physical health, group size change, etc. There really are no other changes this go around. Insurance actuaries base the premiums on these things. It really is ACA. I'm sorry it bothers everyone, but it's truth. And like I said, we all can keep watching as the numbers roll in. We'll have more data later. I'll get over it, but it sure is a hard hit at a bad time. I still love you, but this is one thing I understand in great depth.


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RE: Tell me again how my premiums won't go up?

Rob , yes I hear you.... but how is it , specifically, that the ACA affects things like group size change and changes in overall physical health?

Rob I have no horse in the race but I don't understand the connection.....do you?


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RE: Tell me again how my premiums won't go up?

Changes in overall physical health

What exactly does this mean? Number of claims have risen?


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RE: Tell me again how my premiums won't go up?

Because they are now going to have to cover people that they didn’t have to cover before.

They will also have a bumper crop of new members since everyone is required to buy insurance.


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RE: Tell me again how my premiums won't go up?

My DH works for our state. Our premiums increased significantly in July (16%), the deductible more than doubled ($150 to $350) and the costs of non-generic drugs doubled with a $50 deductible now on those too.

My opinion is there were a few things that went into this. One, the current governor felt she could do it. She said that premiums had not increased in oh so long and insinuated state employees had been enjoying the largesse of tax payers for too long. She was partially right, premiums had not increased but the out of pocket costs have been ratched up significantly over the years.

I suspect some of the increase has also been due to changes in the law but, I suspect many are using ACA as an excuse for a portion of the increase as many are quite willing to accept that.


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RE: Tell me again how my premiums won't go up?

  • Posted by ohiomom 3rdrockfromthesun (My Page) on
    Thu, Oct 17, 13 at 15:15

you are going to pay higher premiums to keep the insurance company open, so they don’t go broke. Because they are now going to have to cover people that they didn’t have to cover before… sick people.”

....I remember several threads in the past about how insurance premiums were high because of all the uninsured who used ER's/hospitals. You are wrong, you were already paying for "those" people.

SMH


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RE: Tell me again how my premiums won't go up?

There were no significant changes in the group members' personal health. To differentiate it from the insurance term "health of the insurance"...

which is too much jargon. I'll have to think about how to break that one down. Hm....

When the majority of your a group is fairly young/middle aged, and they are fairly healthy, they are a sound (or healthy) insurance pool. The larger the pool and more concentrated on the "fairly"s the healthier it is. It doesn't have to be only "fairly" people, but the more there are, the better it is on on everyone who is involved in the pool. Utilization is lower so the price stays down. Does that make sense?

I've written and erased so many times! Am I still jargoning?

:)


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RE: Tell me again how my premiums won't go up?

Ohio, they changed how much medicare and medicaid will pay, I THINK. They've shifted the burden. I THINK. I could be wrong. But it seems like that is one of the changes that came about. Like not being subject to pre-existing. I could be wrong! So we are paying one way or the other, just paying differently? I'd be interested to know. I'll have to dig.


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RE: Tell me again how my premiums won't go up?

"When the majority of your a group is fairly young/middle aged, and they are fairly healthy, they are a sound (or healthy) insurance pool. The larger the pool and more concentrated on the "fairly"s the healthier it is. It doesn't have to be only "fairly" people, but the more there are, the better it is on on everyone who is involved in the pool. "

Yes it makes sense Rob but what the heck has that got to do with the ACA?


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RE: Tell me again how my premiums won't go up?

One thing that kinda ticks me off, here in the Land of the Free and Home of Disgustingly Exploitive Health Care, is how my son, 21 years old and a specimen of perfect health, pays the same exact insurance premium as some 60 yr old duffer of a professor wheezing away on a pipe, leather patches on his elbows since the only exercise he gets is eating, since they're in the same university insurance pool. Talk about exploiting the young.


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RE: Tell me again how my premiums won't go up?

So now he gets to pay for maternity care and birth control pills...isn't that wonderful?


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RE: Tell me again how my premiums won't go up?

At his age paying for birth control is a good thing!


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RE: Tell me again how my premiums won't go up?

The school policies have been long been paying for that kind of stuff. Its actually pretty good coverage, a $500 deductible for only $347 a month, just for himself.

Extra goodness? Unless you have similar coverage, they won't admit you to the school.

The difference being the old duffer professor can rather easily afford the $500 deductible, while my son can't.

Point being that there are an awful lot of mandatory health insurance policies out there that don't discriminate against pre-conditions and so on. Why everybody is howling about Obamacare now is purely political.


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RE: Tell me again how my premiums won't go up?

...... giving birth in the U.S. is more expensive than any other country in the world. Total costs average $18,329 for a vaginal delivery and $27,866 for a C-section, with the bulk of the bill going to insurers. However, families with insurance still have to pay about $3400 out of pocket.

Here is a link that might be useful: link


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RE: Tell me again how my premiums won't go up?

You already couldn't be denied for pre-existing.

That is not the way insurance worked. My daughter was on my insurance because she was in college. She graduated and went on to advanced degree at 21. When she was to old to be on my insurance she could not get insurance.

She had asthma. There were women denied because they could get pregnant. She had two strikes against her. As a reason to not be accepted for insurance. I am not saying we could not afford insurance I am talking about no insurance co would accept her on any of their policies.

I would like to know who I could blame when I was working and my insurance went up every year when I had company insurance. Did we blame out companies for not giving us insurance that did not go up every year?

I do not remember a year when years, and years of working that my insurance did not go up. Did people use to have cheap insurance with no increases every year or was it just in my city?


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RE: Tell me again how my premiums won't go up?

There was a time when we didn't have to pay anything except co-pays and deductibles for employer-provided health insurance. Both of us worked for AT&T until the year 2000 - never paid a premium. Got outsourced to another big company and the next year, 2001, that company decided to charge employees a premium after many years of also not charging employees. Oh, how we longed for the days at AT&T! Except two years later, AT&T followed suit. Now single person coverage at AT&T is $96 a month (for management employees).

Every year since 2001 our insurance has gone up a few dollars. The managing company has changed several times: Aetna, United Healthcare, Blue Cross Blue Shield. The prescription drug provider has changed twice: Medco, now Caremark (CVS). Each switch is no doubt an effort to control costs but still it goes up.

All in response to rising costs.


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RE: Tell me again how my premiums won't go up?

And then there are those who are stuck in the middle and don't qualify for ACA....they are either too poor for ACA or make too much for Medicaid.

What about those millions of people?

Here is a link that might be useful: The Gap


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RE: Tell me again how my premiums won't go up?

What about those millions of people?

It's awful. They need to vote out their Republican governors that are refusing to expand Medicaid so they can have coverage.


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RE: Tell me again how my premiums won't go up?

Yep those are the people that are supposed to be covered by state-level Medicaid expansion and some states are refusing to do that.

Well, I guess they can just pick up and move, right?


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RE: Tell me again how my premiums won't go up?

Single payer.....so simple, very fair, eliminates so much of the administrative carp that keeps health care costs so high.......

.....sorta like that socialistic thing you call Medicare without all the add ons.


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RE: Tell me again how my premiums won't go up?

I receive no federal subsidy, this is employer-provided insurance. I don't know what the total out of pocket is.

No doubt your employer is paying part of the cost of your insurance. What they take out of your check is your portion. My husband has done some HR stuff, and a few years ago he said that the company pays an average of $6000 per employee.

And don't forget, that insurance companies must spend at least 80 percent of premiums on actual medical care, not overhead, advertising or profits. If they do take in more in premiums than that, they have to refund policy holders the excess.

From the article linked below:
That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect-"85% for large group insurers-"on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

My daughter received a check last year because of this provision.

It's my feeling that part of the cost of premiums going up is because of the uncertainty of a new system. Better to take in too much money and send out refund checks than not take in enough.

Here is a link that might be useful: Forbes article on cap on insurance company profits


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RE: Tell me again how my premiums won't go up?

" Because the amount of money that that company was paying out to the medical community is going to go way up. They’re going to pay out to the medical community per person than they ever have before…"

Except that they won't. All of a sudden the medical "community" is going to be without its long-time colluder. It takes two to tango.


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RE: Tell me again how my premiums won't go up?

No doubt your employer is paying part of the cost of your insurance. What they take out of your check is your portion.

I have no doubt they are either paying a lot or it is likely that they are self-insured and just cover the rest themselves.


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RE: Tell me again how my premiums won't go up?

It's my feeling that part of the cost of premiums going up is because of the uncertainty of a new system. Better to take in too much money and send out refund checks than not take in enough.

Plus they get to keep the extra for a year. Collect interest, invest the money and what they return to the company and customers will be nothing and they get to keep the profits from holding the money.

But it is easy to blame Affordable Health Care, not insurance corporate greed that has been in place for years.


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RE: Tell me again how my premiums won't go up?

The percentage of uninsured young people (ages 19 to 25) fell accordingly, from 48% in 2010 to 21% in 2012. Thats because they were added to their parents Insurance thats ACA
If your making 400% above the poverty limit it will cost yuou little or nothing!

Again most of the people I have talked to who were self employed were paying through the nose for policies with high deductibles thats if these companies would take you at all.
You know rape is a pre existing condition?
You could be sober for 40 years but your alcoholism is a pre existing condition (if you tell them the truth)

I know decent number of free lancers whose premiums like mine will be laf of what they have now.

It's not perfect & won't be till we have a single payer system!
This opposition is total BS!


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RE: Tell me again how my premiums won't go up?

If your making 400% above the poverty limit it will cost you little or nothing!

I do not believe this is a true statement. As one's income approaches 400% of the poverty limit the percent of your income you are expected to pay for health care increases and the potential subsidy decreases. For someone with an income between 300% and 400% of the poverty level for their size family, they are expected to pay 9.5% of their income before they receive any subsidy.

I also believe that I heard in a class that everyone on not on Medicaid will have to pay a minimum of 3% for healthcare between their share of insurance premiums and copays.

The myth of free medical care lives on.


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RE: Tell me again how my premiums won't go up?

jlhug, who said there was going to be free insurance?


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RE: Tell me again how my premiums won't go up?

I quoted Labrea's post which is just above mine.


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RE: Tell me again how my premiums won't go up?

I don't believe the 400% figure is accurate, either. The medicaid expansion is 133% of poverty level (if the Governor of your state was kind enough to institute the expansion, ie not a Republican).

My understanding is after that you get subsidies to help with premiums, but you will pay something.

However, just because Labrea may have the wrong % doesn't mean he or anyone else thinks medical care will be free.


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RE: Tell me again how my premiums won't go up?

My answer about health was to Nancy, sorry Chase!

I'm highly disinteresting in asking my HR a quesiton that will soon be asked by millions of people. And answered by more qualified indivdiuals. I'll wait for the answer.

Marquest, how to solve your daughter's type of uninsurance was something that HIPAA and the Clinton administration claimed would be solved. I knew they wouldn't be since it was guaranteed issue for groups. All it did was kick up premiums (which I've explained in detail before. Insurance carriers didn't want to go out of business). But, in Tennessee, when one is a student, they may stay on their parent's plan. When you're hired, you get your own plan and pre-ex doesn't exist. In theory, she could've been ok? Sorry it didn't work for her. It can now. For the record, I don't hate ACA, but I have wondered from day 1 from where the funds would come. It's here.

Yes, being unemployed causes huge problems! Once you're hired, pre-ex is gone when you're on the plan. But if one is out work, why wouldn't Medicaid kick in? Isn't this exactly what it's for?

I am going back on vacation, so don't think I'm ignoring you! Very unplugged. Enjoy your weekend! I may get to check in some today, but really, I'm trying to get off work as early as possible.


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RE: Tell me again how my premiums won't go up?

Medicaid when you become unemployed? First I ever heard that one. I'm pretty sure that most people that become unemployed would not qualify for Medicaid as they have too many assets.


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RE: Tell me again how my premiums won't go up?

I wouldn't. I know my sister wouldn't. I don't think that's a given jill. And if that is the case, they can do what I did, sell it all. Bankrupt and get cash flow. Work multiple jobs. I've done all of these. Whatever it takes. I'm not talking in theories here.


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RE: Tell me again how my premiums won't go up?

Jill, the 400% of poverty level is accurate. One may qualify for advanced premium credits aka subsidy if one's total household income is between 138% (not 133%) and 400% of the poverty level.

Medicaid expansion was up to 138% of federal poverty level, not 133%.


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RE: Tell me again how my premiums won't go up?

Thanks, jlhug for the clarification.

So, is it the case that subsidies end at 400%? After that you don't get a subsidy?

If so, I think that's what I was trying to say. Above the 138% you get subsidies. At 400% subsidies end. I didn't know what the cutoff was, but now know it's 400%. Is that correct?

Thanks for educating me!

Rob - you cannot just sell all your assets and then get Medicaid. If you sell your assets, you have cash and therefore cannot qualify for Medicaid. Honestly, for someone that professes to know so much about the insurance industry, I'm surprised you don't know this.


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RE: Tell me again how my premiums won't go up?

Yep EDD has to have nothing nada squat in order to get medicaid !
But there is that other part of the ACA that everyone neglects.

While public opinion polls have consistently shown a partisan divide in views of the health reform law, the survey finds that young adults who identified themselves as Republicans enrolled in their parents' policies in greater numbers than young adults who identified themselves as Democrats. In March 2013, 63 percent of Republican young adults had enrolled in a parent's policy in the past 12 months, compared with 45 percent of Democrats.
More young people than folks over 75 go to the emergency room in a year

About 15 percent of young adults have a chronic condition and know pretty well that they need health care.

Most young people don’t qualify for Medicaid right now even if they have very low incomes because most states just don’t give childless adults Medicaid. That’s one of the biggest changes under Obamacare. If every state expanded Medicaid, about 8 million would qualify for Medicaid. Another 9 million would qualify for subsidies because they make less than 400 percent of poverty.


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RE: Tell me again how my premiums won't go up?

"Talk about exploiting the young."

I agree with you, David. One of the assumptions about making obamacare "affordable" was the assumption that young, healthy people would sign up for benefits they do not expect to use. Have you seen any data on how that's going? I think the minimum number needs to be around 7 million. I'm not sure young people are going to be as compliant as the government expected them to be.


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RE: Tell me again how my premiums won't go up?

I think the point, Nik, is that this sort of thing is going on now, in spades, all over the country, where often mandatory, same-premium insurance with large institutions, state schools, etc. leads to young healthy people paying a huge subsidy for old, fat, sick people they work with.

So why isn't aren't the tpers up in arms about this?


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RE: Tell me again how my premiums won't go up?

How much is 400 percent of poverty level?


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RE: Tell me again how my premiums won't go up?

Anyone earning up to 400% of the poverty line will be eligible for a subsidy, which is up to $45,960 for an individual and $94,200 for a family of four.

Here is a link that might be useful: source


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RE: Tell me again how my premiums won't go up?

Here is a commercial source that might help you do the math for your own family size and income. Seems like there should be a federal website answering basic questions like that. Anyway, I hope this helps. More info at link, including a "poverty calculator."

From the link:
"I read that starting in 2014 tax credits will be available to help make health insurance affordable families with income between 100 and 400 percent of the poverty line. What does this mean?

First of all, the credits will only apply to only to those who are not eligible for other affordable coverage.

The poverty line joins the ranks of poverty level as yet another casual reference to the federal poverty guidelines. To calculate your percentage of poverty, divide your income by the poverty guideline for your household size. Carry the decimal two places in your result; add a percentage sign, and you have your answer. Again, you can click here for the 2013 poverty guidelines.

Income ÷ poverty guideline for household size = percentage of poverty guideline

Example 1 " You are a single individual with an income of $20,000. The 2013 poverty guideline for a one-person household is $11,490.

$20,000 ÷ $11,490 = 1.74
You are at 174 percent of the federal poverty guidelines. You would qualify for the tax credit.

Example 2 " You are married with 3 kids, and your household’s annual income is $150,000. The 2013 poverty guideline for a five-person family or household is $27,570.

$150,000 ÷ $27,570 = 5.44
You are at 544 percent of the federal poverty guidelines. You would not qualify for the tax credit.

Example 3 " Yours is a 10-person household with an annual income of $75,000. For the 2013 poverty guidelines, you add $4,020 per additional person after the eight-person guideline of $39,630.

Step 1: Determine the federal poverty guideline for your household size.

Step 2: Determine your percentage of poverty.

$75,000 ÷ $47,670 = 1.57
Your household is at 157 percent of the federal poverty guidelines. You would qualify for the tax credit.

Remember: Tax credit eligibility in 2014 will be determined by 2014 poverty guidelines."

Here is a link that might be useful: source


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RE: Tell me again how my premiums won't go up?

I believe the 400% cap on subsidies for a married couple is about $92K .

There are some unforeseen (or previously un-realized) factors here.

Some biggies will be playing out in 2014. One is the number of newly-covered, never previously treated, who will be seeking care. There will also be pent-up demand from people who put off spending for care during the recession. Insurance companies are trying to cover all bases.

Today's Chicago Tribune Business page has a story with graph outlining average local costs to large businesses for health care 2008 - 2014 (predicted). There's also a breakdown of premium costs per employee to the employer and to the employee.

This shows a 6.6% predicted cost increase 2013-2014. Cost per employee goes from $10,753 ($2566 employee portion) to $11,466 ($2782 employee portion). Costs are just for premiums. Add in the copays, and you have a nine percent jump in costs to employees, 2012-2013. Total costs to employees are predicted to rise another nine percent next year.

Businesses have been and are continuing to try to shed some of these zooming costs.. Some are dropping benefits that they used to include because they went beyond what the ACA requires. The businesses can't pass along all increases to employees due to the provision of the law that caps the portion of the premium charged to workers at 9.5% of their salaries.

Employers are pushing employees to take more responsibility for their overall health. Some have gone from offering incentives for participation in wellness programs to imposing penalties on workers who won't participate. (Not entirely new; I remember IBM paid for plans to aid smokers and alcoholics.)

The 'bottom line' is what we all knew, all along. Uncontrolled health care costs in the touted 'free market' have the potential to bankrupt all of us. People will pay attention to their own 'bottom lines' now -- and blame the ACA. (That's a good thing if it leads to single payer and reigns in obscene profit in health 'care'.)


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RE: Tell me again how my premiums won't go up?

Yep EDD has to have nothing nada squat in order to get medicaid !

Exactly. When my dad was very ill and dying back in May of this year, we started the process of applying for Medicaid to cover in-house hospice. We had him moved to temporary in-house hospice which we were allowed to do under Medicare. But, it would only allow him to stay there for 7 days. My brother (a doctor) started the process of applying for Medicaid, but since they had about $7,000 in the bank, he probably would not have qualified (I was told). We had no idea what we would do at the end of the 7 days. Paying for in house hospice was more than we could afford. We couldn't bring him home again. My mom, who is 90 years old, was not capable of taking care of him. He was there for a little over 24 hours when he passed away, so we never had to decide or follow through with Medicaid application.

That $7,000 was the total sum of their money. That was their entire savings. 94 and 90 years old and have $7,000 to their name, and they couldn't qualify for in-house hospice while dying.

Health care in this country sucks.


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RE: Tell me again how my premiums won't go up?

There are a lot of single, young people who just graduated from high school or college who have no assets, no jobs, and no insurance. The Medicaid expansion will at least give them some cover.

The alternative? Have a baby. The parents and kiddo are then eligible for Medicaid.


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RE: Tell me again how my premiums won't go up?

Marquest, how to solve your daughter's type of uninsurance was something that HIPAA and the Clinton administration claimed would be solved. I knew they wouldn't be since it was guaranteed issue for groups. All it did was kick up premiums (which I've explained in detail before. Insurance carriers didn't want to go out of business). But, in Tennessee, when one is a student, they may stay on their parent's plan. When you're hired, you get your own plan and pre-ex doesn't exist. In theory, she could've been ok? Sorry it didn't work for her. It can now. For the record, I don't hate ACA, but I have wondered from day 1 from where the funds would come. It's here.

No Rob it did not happen. Because insurance companies had a hold.

To add to the insurance madness. Her first job was with the State Attorney General Office. They like so many other employers do not insure their employees for 6 months. That was their waiting period.

So you have employment and still do not have insurance for another 6 months. It is sad because people say people seem to think losers are lazy people that do not want anything. You have college educated working people in the position of no health care and a heart beat away from having to be on the welfare rolls if they get sick because they do not have health care.

It is like shooting ourselves in the foot as a country because we have to now care for a person because of not having what other countries have that are progressing.

I think of the Health Care Law as the same process of SS. We worked and paid for the old. When we get old the young will pay for us.

The young will also pay for the people that felt they did not have to work and stay home and raise their children. They also did not contribute financially to the system but they still get an SS check.


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RE: Tell me again how my premiums won't go up?

When you're hired, you get your own plan and pre-ex doesn't exist.

That has not been my experience in California. Pre-ex was excluded from covered treatment for one year after enrollment with new employer's carrier, and then the period was reduced to six months. Maybe a change in CA law reduced the exclusion period.

Again, this was a problem for the unemployed with high COBRA premiums, especially during the Great Recession.


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RE: Tell me again how my premiums won't go up?

marquest: "The young will also pay for the people that felt they did not have to work and stay home and raise their children. They also did not contribute financially to the system but they still get an SS check."

Only if they qualify for spousal benefits.

"Which Social Security benefits am I eligible to receive?
To be eligible for a Social Security pension benefit, you must be at least 62 years old and have a minimum of 40 Social Security credits. A credit is equal to a designated amount of earnings that increases from year to year based on national earnings averages. For example, employees receive one credit for every $1,160 of earnings on which they paid Social Security taxes in 2013. Because an employee can earn a maximum of four credits per year, you must have worked in a job in which you paid Social Security taxes for at least 10 years or 40 quarters to meet Social Security eligibility requirements.

However, if your spouse is eligible for a Social Security pension, you might be eligible for a spousal benefit. Typically, spousal benefits are equal to 37-50 percent of the spouse?s Social Security benefit and are paid to the dependent spouse while the other spouse is still living. Widow/er benefits are usually equal to 71-100 percent of the spouse's benefit and are paid to the dependent spouse after the other spouse's death. Eligibility is based on age and the number of years married to a qualified spouse. Contact your local Social Security office for complete information on which benefits you are eligible to receive."

Here is a link that might be useful: SS Spousal Benefit


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RE: Tell me again how my premiums won't go up?

Elvis the person that has not worked and collecting Spousal benefits did not work and contribute to that fund. It is not something they paid.

So they are not getting back funds they contributed.


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RE: Tell me again how my premiums won't go up?

From the OP:

"This isn't Canada or Europe or wherever else"

This was not addressed. What do you mean by this, rob? I think you have perhaps unknowingly identified our actual problem. How do the Europeans manage to cover everyone, at least somewhat, with bankrupting anyone?

Just mull it over. It deserves a lot of attention.


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RE: Tell me again how my premiums won't go up?

I think of the Health Care Law as the same process of SS. We worked and paid for the old. When we get old the young will pay for us.

We pay for the young, inexperienced drivers who cause a high percentage of the accidents on the road and that price can often be worse than a raised premium.
In that sense we also pay for the drunks and the careless who are calling or texting while driving or are just bad drivers.
Nothing in life or amongst a pool of insured is entirely fair. At the end of the day the important thing is whether or not there is enough insurance reserves to pay claims and, in our capitalist system, to insure a big profit for insurance companies and their shareholders.

Similarly as others have pointed out, property owners pay real estate taxes which benefit younger people, whether students or young teachers or younger couples with children.

Another way to have mandated health insurance for young people (and the rest of us) would have been to tie health insurance in with auto insurance and driving privileges. You get it or you cannot drive a vehicle.



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RE: Tell me again how my premiums won't go up?

The young inexperienced drivers pay a stunningly high price for the privilege to drive. Of course, they would not pay for insurance if it were not law, they would simply drive. I believe it is still that way in a few states - VT, for example.


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RE: Tell me again how my premiums won't go up?

Come on. Everyone knows the only reason this health care act passed is because the ins. monopolies agreed to it. Did you really think they would have allowed this if they thought their profits would not increase?


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RE: Tell me again how my premiums won't go up?

My current self-paid policy (I've *never* had insurance through an employer) covers only hospitalization. It will cover a doctor appt, lab, or ER if such results in a hospitalization. It does not cover any follow-up appts after release from hospitalization.

I've had the policy with the same carrier for over 25 years.

Had the first claim in 2007, which cost me over $4,000 out-of-pocket.

Had another claim in June 2013, which cost me over $4,800 out-of-pocket. Premium at that point was $486/month. The next renewal period (Sept 2013) went up to $692/month. Just me, no kids or wife. $2,500 deductible.

You already couldn't be denied for pre-existing.
I checked with three local insurance outfits about a switching carriers/policies. Upon hearing that I had a claim 3 months earlier ... one never called back; one said he doesn't have any enrollments available; the other flat-out said he can't write a policy on me, check back in a year or so.

I've not yet checked what's available under the ACA but I *have* to switch policies since mine doesn't cover the minimum requirements. My income is below the 400%-poverty level for a single person so I assume I'll qualify for some sort of "subsidy" although I'm not clear on exactly how that works.


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RE: Tell me again how my premiums won't go up?

" Did you really think they would have allowed this if they thought their profits would not increase?"

Didn't "they" just fight a mad campaign in Congress to stop it? They aren't giving up their predatory monopoly easily, but it is being broken. Some high-ups in the industry must be smart enough to realize that.


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RE: Tell me again how my premiums won't go up?

The insurance companies fought the ACA tooth and nail....just so happened that they don't own as many Democrats as they do Republicans.

Wonder who owns the Dems...someone does.

Dadoes, good luck on your search for affordable health care. Please report back on your experience. Real life stories are a better barometer of the facts than the hype from the right.


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RE: Tell me again how my premiums won't go up?

Dadoes, it is my understanding that you should receive a subsidy if your income is less than 400% of the poverty level for your size family AND the cost of your health insurance is more than 9.5% of your total household income.

Of course, my understanding may be revised as I learn more about this law.

I think one of the reasons premiums have increased is the uncertainty due to the requirement to cover people with pre-existing conditions. Remember the insurance/fund that was created to cover people with pre-existing conditions between the passing of ACA and 2014? Remember that it ran out of money due to the high costs each insured person incurred? It takes a whole bunch of healthy young people paying premiums to cover the costs of one person on dialysis or with HIV.

DD has gotten hit hard with an increase in health care insurance. She is a healthy 30something single working person. First her contributions to a HSA were halved. Second her portion of her employer provided health care insurance leaped by 18%. Her coverage other than the HSA is about the same for 2014 that it was for 2013. She is in the age and income group that is getting hit very hard with increases in health insurance costs because she is the one who is paying for the coverage for people with pre-existing conditions. Yes, it is great that that people with preexisting conditions can now buy insurance at a reasonable rate, but that doesn't make it easier for DD to pay her mortgage and other bills when her take home income goes down because of an increase in insurance costs.

I saw a figure this morning that about 476,000 people have applied for insurance through the federally run and some of the state run exchanges. But they won't release any figures for people who have actually been able to purchase insurance. They also won't say which state run exchanges are included. Yeah for transparency!


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RE: Tell me again how my premiums won't go up?

I suspect the real reason for not releasing the data is that they are unsure of it's validity.

With the PR mess they have on their hands right now it would be foolish to release numbers and then have to go back and correct them.

These systems are huge. It will take at least a month to settle it all down, that's the way it is with huge roll-outs like this. A staggered implementation may have been a better choice but I know for sure they would have looked at that. They likely could not do it legally....but the reason is a guess on my part.


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RE: Tell me again how my premiums won't go up?

Chase, the systems are huge but many programmers have commented on how poorly they are set up. The information presented if you are able to create an account (why do you have to create an account if you just want to window shop?) is barebones at best. Much of the information necessary to make an informed decision just isn't there.

I've been the "victim" of new online registration programs from the IRS. So I know firsthand how it takes time for the bugs to get worked out.

I agree that a phased in roll out would have been better, but probably would have been illegal.

Does anyone know of someone who has actually purchased a policy? I think David may have gotten through the system but hasn't actually been enrolled as of his last post on the subject.


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RE: Tell me again how my premiums won't go up?

" many programmers have commented on how poorly they are set up"

Jhug, large system design, integration and implementation was my career for many years.

Unless these "programmers" worked on these systems, and I absolutely guarantee you they did not, they are offering uniformed opinions.

"Does anyone know of someone who has actually purchased a policy"

My niece and her husband both have purchased insurance. They had difficulty logining on but found the help line excellent and the system, once they got in, easy to use.

All that aside their insurance premiums have been significantly reduced for similar coverage. I'm not sure what the differences are but they are happy with the price.

Mind you my niece, a Canadian, is less than impressed with the whole health insurance situation in the States.


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RE: Tell me again how my premiums won't go up?

Chase, you didn't happen to work for CGI, did you?

Here's one of the articles I found about the problems with the system.

Here is a link that might be useful: IT experts question the architecture

This post was edited by jlhug on Sun, Oct 20, 13 at 10:58


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RE: Tell me again how my premiums won't go up?

I don't know who managed the implementation of this code for them, but I wish some company like IBM would stand up and say - "let us help you fix this". IBM Global Services (not the equipment side but the consulting arm) has the resources and the expertise to dig in and get some problems solved.


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RE: Tell me again how my premiums won't go up?

No I didn't but I do know them very well and have done business with their Canadian Telecom group. My career was on the business side of system implementation and design. Defining the business requirements, designing the user interface, testing, implementation and roll out. In this case I would be on the 'Government side " of the project.

CGI Federal used to be AMS , an American SI that was purchased by CGI a few years back. CGI Federal aka AMS has done business with the Federal government for over 30 years. If I recall there was some sort of structural separation from CGI Canada required at the time of purchase in order to allow AMS /CGI to continue receiving federal contracts.

Don't get we wrong I am not saying the design was good, I haven't a clue, I'm saying that troubles with implementing systems this large, especially when the government is the one defining the business requirements, is a complicated bit of business. Much of the system design flows from the business requirements and the governments are notorious for changing the rules right up until implementation...may have done some of that myself if the truth be told!

I can't argue any facts, because I don't know them, I find the comments in that article suspect.

Unless you had privy to the business requirements and the system design you can't comment with any degree of certainty. You notice they use words like "I suspect" and "possibly".


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RE: Tell me again how my premiums won't go up?

esh, I bet that they are pulling in system and business consultants from IBM, Microsoft, CISCO and more, as well as whoever they bought the servers etc from .....the pressure to get this fixed will be enormous.....a don't envy any of them.


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RE: Tell me again how my premiums won't go up?

Here is some info on AMS and the subsequent purchase by CGI.

The structural separation I was thinking of was not between CGI and CGI federal but rather between the side of AMS that did systems development work for the Department of Defense vs the rest of the government.

These guys have been doing federal government work for many , many years....my bet is the relationship between the business developers and the system developers is too cozy.


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RE: Tell me again how my premiums won't go up?

Here is what I posted earlier:

Waiting for open enrollment to see what next year's premium is, but for 2012 it was $204 per month for me and 2 child dependents (spouse has own plan). In 2013 it is $232 per month for same coverage, a 14% increase.

For 2014 it will be $240 per month with increased benefits such as the elimination of any lifetime caps and other wellness improvements. A smaller increase than 2012-2013.


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RE: Tell me again how my premiums won't go up?

Yes, but what did they do extra for your spouse? Because, here, they made you waive them at least three times if they could apply for coverage under their employer's insurance. They're trying to get everyone situated where they belong. Not a bad thing, just procedural.

Increased benefits beyond elmination of the lifetime cap? What benefits are they? Mandatory Short Term Disability was one we had added, but they just took it away in sick/vacation/personal time here. Six of one, half dozen of another isn't better to me.

Are your changes truly an improvement?

I cannot agree that trading one benefit for an equal one is an improvement. Making sure your spouse gets on their employer's plan (if they can) isn't better. Making sure you are covered with some base sickness payments isn't better. Are you just trading one thing for another? Different isn't better when you end up with the same thing. I admit the cap loss is a good thing, but the rest seems like nothing noteable.

And, more importantly, there will be states where it is lower in cost, so far New York and California because they have crappy legislation states, and there will be some that stay consistent. Yours may be a consistent state. This is an equalization time. Let's wait until all of the numbers are out and there is an overall trend going on, before noting all the NY/CA anecdotal cases as being the "standard" for the nation. Two states a nation does not make.


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RE: Tell me again how my premiums won't go up?

Yes, but what did they do extra for your spouse?

I said before that my spouse is covered elsewhere, with another employer. I didn't have to do anything about that this year.

Removing the lifetime cap is a huge improvement for those that may need it - and we never know if we are one of the ones that will need it should something catastrophic strike. That's the whole point of most insurance - just in case.

My only point today was to come back and report 2014 cost changes since I didn't know them at the time of the original post.


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RE: Tell me again how my premiums won't go up?

Esh, So with a very minor increase you have a better benefit? Sounds like a win to me.

~Ann


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RE: Tell me again how my premiums won't go up?

I am glad you updated us. I'll be glad when everyone does. Why say I received "other wellness improvements" when you specifically listed the one benefit out? Being vague has me believing you don't know or you won't say? I'm glad you had a typical increase! That's good. I'll be glad when most everyone has typical increases or reductions.

I do remember those saying, why would you get increased premiums (I can name names, but why?), but let's see the reality. Still waiting.


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RE: Tell me again how my premiums won't go up?

You're right, I just listed the one thing. My intention was to refer to the general list of improvements that the ACA has caused all insurance to include and which are now reflected in my plan:

No annual or lifetime limits on healthcare.

Insurance companies can't drop you when you are sick or for making a mistake on your application.

You can't be denied coverage for pre-existing conditions.

Young Adults can stay on their parent's plan until 26. (I have two children between the ages of 19-22 so that is a real benefit to us/them.)

A large improvement to women's health services. (We have two females in the family including one that is eligible for free birth control prescriptions).

New preventative Services at no-out-of pocket costs.

So those things and more are now part of my plan. Some of the things required (e.g., Essential health benefits like emergency care, hospitalization, prescription drugs, and maternity and newborn care must be included on all non-grandfathered plans at no out-of-pocket limit) were already a part of my plan.

Here is a link that might be useful: source


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RE: Tell me again how my premiums won't go up?

Thanks for the clarification, esh. It’s important to keep the issues straight when there is so much hyperbole being promoted.


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RE: Tell me again how my premiums won't go up?

Thank you esh! That is convincing. I appreciate the clarification.

I hope we all keep improving coverage without sky rocketing costs. Higher maybe. Sky rocketing, no thanks. Time will tell.

:)


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RE: Tell me again how my premiums won't go up?

DD, a single woman, has health insurance through her employer. Her share of the cost went up 50% with no additional coverage or benefits. Her employer pays 50% of the cost of her health insurance, so his costs went up as well. Her co-pays went up $5 a visit. The letter from the insurance company did specifically refer to ACA as the reason for the majority of the increase in premiums.


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RE: Tell me again how my premiums won't go up?

I wonder how far I would trust the letter from the insurance company. I would suspect self-interest.


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RE: Tell me again how my premiums won't go up?

What about liebel? It'd be dang hard to disprove you've lied when mutliple insureds have the letter to provide. I would trust the letter.


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RE: Tell me again how my premiums won't go up?

rob, maybe but I do not doubt for a minute that insurance companies have legal departments that know how to guard against libel while still guarding the interests of the insurance companies--which is not whether their clients live or die but whether the bottom line remains in the black.


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RE: Tell me again how my premiums won't go up?

I'd like to know who the insurer is for that example.


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RE: Tell me again how my premiums won't go up?

Who would think that increased benefits would increase the premium? Surely you're smart enough to figure that out. Unfortunately,someone in Washington wasn't smart enough to realize it would happen, OR, was smart enough and has done what he promised the insurance companies. More business, more profits.


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RE: Tell me again how my premiums won't go up?

DD is one of the young healthy adults whose premiums have increased to cover the unhealthy who can no longer be charged a more in premiums because their medical expenses are higher and for the elderly whose premiums can not be more that three times her premiums. She makes too much for a subsidy. Someone has to pick up those costs and she just happens to be in that demographic.

Here's a link to a discussion of why her insurance went up so much.

Here is a link that might be useful: Obamacare costs young people more

This post was edited by jlhug on Fri, Nov 22, 13 at 19:49


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RE: Tell me again how my premiums won't go up?

Would someone please tell me just how "risk specific" the plans should be (I'm "talking" to those of you who are appalled that the young and healthy will have to subsidize the old and sick).

Maybe a separate risk category for twenty to forty year old males?

Another risk category for twenty to forty year old females? ("at risk" for pregnancy, afterall)

How about a risk category of fifty somethings who are healthy?

And another risk category for fifty somethings who have major illnesses or are at risk of a major illness - cancer, multiple sclerosis, heart trouble, etc.

Now, tell me what you think the premium is going to be for someone who presently has cancer? (If your guess is under triple digits, you're too low.)

And if you can't afford your healthcare insurance when you actually need it, WHAT IS THE POINT OF PAYING FOR IT WHEN YOU DON'T NEED IT?

That's really the bottom line. You pay now so you can access it later. This is how it works in large corporations where the younger employees subsidize the healthcare of the older employees. And it is how the ACA is going to have to work.

Otherwise, what is the point?


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RE: Tell me again how my premiums won't go up?

I ran across this article this morning, a fairly candid - and far from flattering - assessment of trying to get insurance for employees if you're a small business.

I thought it was interesting - in some cases, its better to drop insurance because your workers are better off if they buy on the exchanges, in other cases, no.

The guy can see the light at the end tunnel, but says its likely better to wait a year.

Here is a link that might be useful: link


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RE: Tell me again how my premiums won't go up?

Thanks david, that was nice to read from a real person's point of view.


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RE: Tell me again how my premiums won't go up?

birdlover-
Well-stated. The whole idea that I shouldn't have to pay for anything I don't want is ridiculous in a democratic society, particularly with health care. I've been fortunate to have had access to health insurance my whole working life and now in retirement. When I was young, my premiums were huge in comparison to what I needed out of the health care system, but I didn't resent it, or decide that I should put off getting coverage until I was middle-aged so I wouldn't have to subsidize those old folks. I realized that one day I might be putting more demands on the system and it would all work out. Even today I'm still pretty healthy and really haven't gotten my money's worth out of the system by having some expensive, serious condition. But I guess that's ok!

For those who think that we should be able to pick and choose exactly what we want from our government programs, and not pay a cent for things we don't want for ourselves or others, I say fine. I'll start the list. Let's stop the following so I can pay lower taxes: optional foreign wars, the war on drugs, subsidies for the oil industry and corporate farming, tax breaks for banks and hedge fund managers, caps on Social Security at higher income levels, tax breaks for U.S companies that send jobs overseas and use accounting sleight-of-hand to vastly reduce their taxes, etc.


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RE: Tell me again how my premiums won't go up?

"caps on Social Security at higher income levels,"

How would stopping that lower taxes?


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RE: Tell me again how my premiums won't go up?

elvis-
In the future, the Social Security system will in time run out of money. In order to keep it going, more money needs to come into the system, either through raising the percentage of SocSec taxes taken out of wages -- which has been done many times -- or by raising/eliminating the caps on the amount of income subject to SocSec taxes, or both. It wouldn't be an immediate effect, but it would keep my taxes lower than they would be because high wage earners would be putting more in to the SocSec fund.

However, my list wasn't intended to be a comprehensive plan to lower my taxes, nor was it meant to be serious. My point was that people's complaints about having to contribute to a health system that may provide benefits they don't need (or need right now): 1) pales in comparison to all the things that are out of whack in our economy and tax system, and 2) ignores all the things we already accept when we live in this society and pay our taxes.

If we started a thread with lists of all the things people don't want to pay for, or want others to pay for, it would be quite interesting. I'm sure some people would include: welfare, unemployment insurance, food stamps, childhood nutrition, Medicare, Medicaid, and Social Security, to name a few. But the point is, we can't be selective about what we individually are allowed to support, and using this tactic to pick at the ACA is just so much whining as far as I'm concerned. It's sophistry that avoids acknowledging what is practical and how a democratic society functions.


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RE: Tell me again how my premiums won't go up?

Ah. Thank you, kudzu.


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RE: Tell me again how my premiums won't go up?

This seems like the best place to report the changes in our employer-based insurance. My employer offers 4 different plans (same carriers, plans, and conditions as this past year). After signing up for benefits renewal:

* PPO and EPO health insurance premiums increased by 40%.

* "Self-directed" plans (with high co-pays and higher deductibles) increased 20%.

The benefits analysts says that roughly half of the increase was due to medical inflation, and half of the increase was due to ACA requirements.


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RE: Tell me again how my premiums won't go up?

Lionheart, would you be willing to share exact amounts - the monthly premium for 2013 vs. the premium for 2014 on the PPO?


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RE: Tell me again how my premiums won't go up?

I grabbed the fixed rate that Anthem offered for 2014 and renewed early.

Lion, they need to make sure you know how to compute a 40% increase. *wink


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RE: Tell me again how my premiums won't go up?

We should remember that NY has the same rate for everyone, they don't take into account the age of the client.


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RE: Tell me again how my premiums won't go up?

For those of you that got better deals, how do feel about the fact that there are others who worked and planned to provide health insurance for themselves and their families, they liked it and were told they could keep it and it turns out Obama lied and they could not. These people are now faced with paying hundreds and hundreds of dollars more per month which they literally cannot afford--so that you now have insurance?

What do you think is going to happen to the economy when these people can't buy new clothes, can't buy the groceries they were accustomed to buying, can't go on trips because they can't afford the fuel, can't go out to eat, can't save?

We have many more adversely affected than those that benefit it seems to me.

It's be easier for individuals to just suck it up and adopt the people that didn't have health care than initiate this disaster.


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RE: Tell me again how my premiums won't go up?

Of course I would not be happy that anyone's premium or costs increased even one cent. However, I do see the change as a process towards a better future in terms of healthcare.

Think back to when Social Security was implemented - people had monies withheld from their check, less in their pocket. All with the promise that it would be better for them in the future. Now millions of people could not do without the Social Security payments they receive in retirement and in disability. Same with Medicare taxes and benefits.


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RE: Tell me again how my premiums won't go up?

Well, clearly we need to start blaming Obamacare for the rise in premiums.


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RE: Tell me again how my premiums won't go up?

Prior to 2001 my employer paid 100% of my healthcare premium; in 2001 we were asked to start paying (I think it was like $91 then, but it could have been less; I remember being shocked as I had changed employers in 2000 and felt like I had made a mistake but up til then my new employer had not required employees to pay anything). In 2002 my spouse's employer also changed from 0% contribution to being asked to pay part of it.

Both are very large companies. Increases have been going on for some time.


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RE: Tell me again how my premiums won't go up?

  • Posted by vgkg 7-Va Tidewater (My Page) on
    Tue, Nov 26, 13 at 10:48

There are at least two ways to feel sorry for these people (figures seem to indicate it's 0.6% of the population, present junk policy holders). Feel sorry for those who have to pay more for good coverage, or feel sorry for those who's junk plans get canceled or denied coverage when they need it for serious illnesses. Which do you feel sorry for the most?

The ones I feel sorry for the most are the marginal folks who live in red states that are being royally screwed for purely political reasons.


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RE: Tell me again how my premiums won't go up?

No. We shifted the sky rocketing costs to the working Middle America, asked to foot the bill, yet again. Finally, you're seeing me being fully my fiscally conservative self. Which is what I've been saying all along. I kept asking where were they going to get this funding from? No one could answer. The reality is, healthcare is sky rocketing because of an large aging population. The reality. So there you have it. It's not Obamacare by itself. Obamacare just pulled the rug out on Medicaid/Medicare relief to the healthcare system and pretended like the new plans would fill the gap. WRONG!

So I'll ask it again, why are premiums tied to employment? If they're tied to employment and nothing else, how exactly will everyone get coverage?

Now that so few have applied for the government plans, who will fill the gap?!!!!

Middle America. The group already crunched in the inflation ridden, stagnant wage earning status that we're stuck in. It's only going to get worse. Unless something changes. What is that change to be? Taxes. There. I said it. They'll call it a fee, or something else, but taxes. And it'll be another Middle American suck it up time.

_____________________________
Added this, or they can require proof from every person that they have coverage. I'd settle for that. Everyone should have to help. Since the new coverage is within reach to everyone. Supposedly.

This post was edited by rob333 on Tue, Nov 26, 13 at 11:48


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RE: Tell me again how my premiums won't go up?

If you're self employed, estimate your wages so that you'll qualify for subsidies and move the excess money earned to a MMF in the business name.


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RE: Tell me again how my premiums won't go up?

That sounds like you're cheating taxpayers, brush.


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RE: Tell me again how my premiums won't go up?

brushworks-
That sounds like an invitation to getting bitten in the butt once the IRS starts matching things up....


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RE: Tell me again how my premiums won't go up?

Actually, y'all are missing the bigger picture. brush is shoving the burden onto you and me. It's not about getting around or sticking it to the government, it's just plain short changing us.

I find that more offensive.

Everyone should have to have some sort of plan. Bare bones or full cover-everything-all-the-time (and you pay for whichever you pick), something! If it's just middle Americans and sick Americans who are paying/using it, we're all going down. All Americans.

Costs MUST be offset somehow. If you have a better plan how that pool of funds can get higher in a fair way, let's hear it.


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RE: Tell me again how my premiums won't go up?

Single payer.......get over it and get there.


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RE: Tell me again how my premiums won't go up?

How bout the government stay out of my business and my health.


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RE: Tell me again how my premiums won't go up?

Ah, but if they're not going to stay out of everyone's business and health, everyone's gotta be in the business of everyone's health.


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RE: Tell me again how my premiums won't go up?

demifloyd-
I'm fine with the government staying out of your health as long as you promise that you won't avail yourself of any form of program such as Medicare and Social Security.


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RE: Tell me again how my premiums won't go up?

Posted by kudzu9 Zone 8b (My Page) on
Tue, Nov 26, 13 at 15:29

demifloyd-
I'm fine with the government staying out of your health as long as you promise that you won't avail yourself of any form of program such as Medicare and Social Security.

*

That's fine by me, as long as I get back what was contributed.

You willing to do that?


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RE: Tell me again how my premiums won't go up?

demifloyd-
I'm happy to participate in the society I live in, and I support our social systems. I have never begrudged paying in to Social Security or paying for decent health care. So I would have no interest in seeking a refund of what I've contributed, if that were possible. I believe that a strong social support network is essential to a country that considers itself to be First World, and wish we had more if it...like moving further to single payer health insurance

Getting all your money back and opting out fully from our social systems seems appealing...until you need those services. It's like people who refuse to wear seat belts because it impinges on their freedom...and then go through the windshield. If they live after their expensive trip to the emergency room and followup treatment -- and without decent medical insurance -- they end up bankrupt and a burden to themselves and everyone else due to their need for lifetime care and support funded by other taxpayers. I don't want those people cut loose, but if the fantasy of rugged individualism were a little less rampant in this country, we would all be better off financially.


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RE: Tell me again how my premiums won't go up?

Even if I became bankrupt--which is highly unlikely, I would not expect my fellow citizens to pay for my health care or for my living expenses in old age.

We should be disciplined enough to live within our means and save for our own retirements and not expect others to supplement us.


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RE: Tell me again how my premiums won't go up?

demifloyd-
I agree with you about being disciplined and prudent and being responsible for one's own well-being. I have similar expectations for myself.

On the other hand, while I don't expect my house to burn down, it's a possibility, and, since the community won't build a new one for me if it does, I choose to have homeowners insurance. I haven't filed a claim in 40 years, so I haven't gotten anything back, but I do it because I appreciate the ability to participate in a risk pool for a reasonable amount of money. I've paid tens of thousands of dollars for this insurance over the years. Likewise, I've put untold amounts into health insurance premiums and needed far less back (thankfully) than I've put in.

I've been lucky, and maybe you have, too. But not everyone is as responsible or fortunate or lucky as we, perhaps, are. Your philosophy is fine for you, but it wouldn't work for a lot of people in this country. I don't want to start a debate about why that is, but the reality is that too many people have been shut out from decent health care and seek help only when their condition is grave and expensive. Others think they are invulnerable or don't want to (or can't) pay for decent health care until they find themselves in desperate circumstances. Whether through irresponsibility or shortsightedness, they become a contributing factor in out-of-control health care costs.

In my opinion, unless society can agree on a social contract that everyone contributes to so that everyone deserves support, we are dooming ourselves to a highly dysfunctional result. I would argue that -- totally apart from any humanitarian or fairness issues -- the economic damage of this situation is enough to cause us to work together to resolve it. That's why I support the Affordable Care Act...as imperfect as it is.

This post was edited by kudzu9 on Tue, Nov 26, 13 at 17:13


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RE: Tell me again how my premiums won't go up?

Good post, Kudzu.

I do not agree with you about supporting the ACA because I believe it will be the ruin of this country and our way of life.

However I do want everyone to have reasonably priced health care, supplementing those that are truly physically and mentally disabled where they literally cannot work at all.


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RE: Tell me again how my premiums won't go up?

Thanks, demifloyd. I am bothered about how rocky the ACA rollout has been, but I hope we can revisit this in a year and both be more optimistic about it.


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RE: Tell me again how my premiums won't go up?

because I believe it will be the ruin of this country and our way of life.

What part of it will cause that ruin?


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RE: Tell me again how my premiums won't go up?

"Lionheart, would you be willing to share exact amounts - the monthly premium for 2013 vs. the premium for 2014 on the PPO?"

For 2013, the employee contribution for the family plan was $351.08 per month. For individual coverage it was $120.20 per month.

For 2014, the employee cost for family coverage is $490.94 per month. For individual coverage it is now $168.06 per month.

This represents 30% of the premium cost. Employer pays the other 70%.

"Lion, they need to make sure you know how to compute a 40% increase. *wink"

:-)


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RE: Tell me again how my premiums won't go up?

Thanks. And no that wasn't the reason I wanted to know.


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RE: Tell me again how my premiums won't go up?

"Thanks. And no that wasn't the reason I wanted to know."

You're welcome. I know that it wasn't the reason you wanted to know. It's an honest question. People like to have information to compare (I know I do).

If I say something increases by 40%, it doesn't have much meaning unless you know the numbers. It's the actual numbers that give impact.

For example, if something costs $10 and increases by 40% to $14, it's not a big deal because very few people are going to be impoverished by a $4 difference (even though it's a significant percentage increase).

If something starts at hundreds or thousands of dollars and increases by 40%, people are going to really feel the effect. Hit folks in the wallet and it becomes personal. No one is very happy about this situation.

Btw, you asked that question just in time, because the enrollment period was ending yesterday and I didn't think that info would be available on our website any longer. So I snuck in last night and saved the numbers. :-)

Brush was being humorous (hence the wink at the end) and I acknowledged the humor and chuckled at it. That doesn't mean that I think you had ulterior motives in asking. I generally don't mind answering questions, unless it gives away too much personal information or can get me in trouble. :-)


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RE: Tell me again how my premiums won't go up?

If I say something increases by 40%, it doesn't have much meaning unless you know the numbers. It's the actual numbers that give impact.

Exactly. And thanks again.


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RE: Tell me again how my premiums won't go up?

"Posted by demifloyd 8 (My Page) on Tue, Nov 26, 13 at 14:48
How bout the government stay out of my business and my health."

Except when it comes to YOUR Social Security and Medicare, right, Demi? You have already made it quite clear that those are 2 entitlements that you'll be happy the government provide. I suggest that there is some real inconsistency in your arguments, particularly as it applies to ruin.

Our deductibles are going from $0 to $500 each next yr so this will become new cash out of pocket. Our premiums are also going up by about 25%....in the range of numbers lion mentioned.


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RE: Tell me again how my premiums won't go up?

But the government doesn't provide those jmc. We pay into SS and Medicare all of our working lives. And we continue paying premiums for Medicare for the rest of our lives.


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RE: Tell me again how my premiums won't go up?

But MrsK that is exactly how insurance works. You pay into it and later on you will expect to get to use it. Maybe even sooner than later. What's the dif?


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RE: Tell me again how my premiums won't go up?

Do you really think that the government doesn't contribute anything to what people receive in SS payments or Medicare?

Yes we pay into them but don't think the government doesn't put anything at all into it.


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RE: Tell me again how my premiums won't go up?

Posted by jmc01 (My Page) on
Wed, Nov 27, 13 at 9:09

"Posted by demifloyd 8 (My Page) on Tue, Nov 26, 13 at 14:48
How bout the government stay out of my business and my health."

Except when it comes to YOUR Social Security and Medicare, right, Demi? You have already made it quite clear that those are 2 entitlements that you'll be happy the government provide. I suggest that there is some real inconsistency in your arguments, particularly as it applies to ruin.

Our deductibles are going from $0 to $500 each next yr so this will become new cash out of pocket. Our premiums are also going up by about 25%....in the range of numbers lion mentioned.

*

Ummm, I don't think I've ever discussed that topic, specifically, as it relates to myself being "happy" to take two entitlements, MUCH LESS being "quite clear" about it.

I know that I have said on several occasions that I would be content to just take back what was paid in and be left alone, which I said again on this thread.

If you will be so kind as to post where I said that to refresh my
memory and back up your claims it would be appreciated.

Your sarcasm was noted, and I don't know why.

I have no idea what you are talking about inconsistency as to "ruin."

You can explain yourself on that too.

Sorry I have to call boo frickety hoo from going from a $0 to $500 deductible.

Mine is $5,500 and has been for 10 years.


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