<p>I don’t have a great understanding of the financials behind Obamacare; but from what I think I’ve heard, employees and companies both pay health benefits with pre-tax dollars. If that’s true, then there is some logic behind assessing some level of fee, since our taxes would be going to subsidize the Cadillac plans.</p>
<p>If a group plan has a cap of $10K (for eg) now - which is higher than required under ACA - it is going to stay at 10K for the next year. Ditto for any group prescription plan. This will keep the cost of group health insurance plans down as it is cheaper to have a high cap then a lower cap. Plans one buy on the exchange, which have all been approved by each state, have the lower cap. </p>
<p>I’m quite surprised at all the poutage since all I’ve heard from the get go is people wanting to keep their plans they have. This is one component that if changed to ACA standard increases the cost of your insurance.</p>
<p>Damned either way. Folks complained about all those union people with “Cadillac plans”. Now people complain about companies having to pay a fee to offer a Cadillac plan. </p>
<p>That they are passing it on to employees is a corporate decision, and has nothing per se to do with ACA. (They probably would have tried to cut their costs in other ways, ACA or not. It’s what capitalists do.)</p>
<p>About 55% of Americans have health insurance through an employer. About 16% are covered by Medicare. About 10% buy health insurance on the private market.</p>
<p>“but from what I think I’ve heard, employees and companies both pay health benefits with pre-tax dollars,”</p>
<p>This is true.</p>
<p>emilybee, we’re talking about a cap here, not a deductible. That is, these “insurance” plans won’t pay out more than $10K. If you spend two nights in the hospital, too bad for you, you’ve just gone over the cap and your health care is no longer covered.</p>
<p>busdriver, could you link to some government source that explains the 50 million dollar fee your company will have to pay? I find that number difficult to believe without a source and would be grateful if you would provide one.</p>
<p>“If that’s true, then there is some logic behind assessing some level of fee, since our taxes would be going to subsidize the Cadillac plans.”</p>
<p>In theory, that sounds reasonable. But in reality, for a specific example, our “Cadillac plan” just offers 90% coverage with low deductibles, for about 14-15K/yr total cost, which is probably very inexpensive compared to most plans that are worse. So the Cadillac plan fine in this case, is more based upon a philosophy than an actual cost. I’m completely for getting rid of tax breaks for health insurance, and seeing how it shakes out.</p>
<p>Cardinal Fang, does your 55% refer to the percentage of employees insured through their employers as a percentage of all employees; or the total number of covered lives insured through the employer of their family member?</p>
<p>Cardinal Fang, no, that is not what this is about. </p>
<p>“The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.”</p>
<p>Read the article from today’s NYT</p>
<p><a href=“A Limit on Consumer Costs Is Delayed in Health Care Law - The New York Times”>A Limit on Consumer Costs Is Delayed in Health Care Law - The New York Times;
<p>"Damned either way. Folks complained about all those union people with “Cadillac plans”. Now people complain about companies having to pay a fee to offer a Cadillac plan.</p>
<p>That they are passing it on to employees is a corporate decision, and has nothing per se to do with ACA. (They probably would have tried to cut their costs in other ways, ACA or not. It’s what capitalists do.)"</p>
<p>But here’s the deal. They can only pass it on to the employees who are non-union, and I do think some companies (including mine) are taking this opportunity to pass more onto the employees, whether it is to cover the fines or cut down on costs. The union employees keep their cadillac plans until it is negotiated otherwise.</p>
<p>hayden, the latter. Of all Americans, 55% are covered by insurance provided by someone’s employer.</p>
<p>busdriver - can you explain why self insured plans need to pay the tax you mention? It sounds like few of us here would like to see it explained. I just assumed it is the Cadillac tax.</p>
<p>CF, I can look for a link, but I got the data directly from a letter that my company sent me. And using your own data from your post #1358, if they are charging $1 per life for data gathering and $63 per life to cover high risk patients (which has nothing to do with self insuring companies), that doesn’t sound like much, does it?</p>
<p>But it is for 3 years, $64 per life/per year. Guessing that each employee actually covers 3 lives in their family. Using a really big company, nice round number of 100K times X 3 years X 3 lives X $64. That equals a 54 million dollar fine in that example, unless I got my numbers messed up.</p>
<p>It may not sound like much (sounds like plenty to me), but that’s how it ends up, just based on the data that you gave me. I don’t think my company lied, too many people read the disclosures. Though now I have forgotten my original point.</p>
<p>emilybee, in message #1347, there was mention of how the ACA was affecting some colleges that had been offering inexpensive health insurance plans, and now could no longer offer those plans. Some of those college insurance plans cost around $150/year… but they had a payment cap of $10,000; that is, after paying $10K in medical costs, the “insurance” would stop paying. The ACA disallows yearly and lifetime caps.</p>
<p>This is separate from the out-of-pocket cost delay we have also been discussing.</p>
<p>“But here’s the deal. They can only pass it on to the employees who are non-union, and I do think some companies (including mine) are taking this opportunity to pass more onto the employees, whether it is to cover the fines or cut down on costs. The union employees keep their cadillac plans until it is negotiated otherwise.”</p>
<p>Gotta find a way to bleed the pig. They did this before ACA and will do so afterwards.</p>
<p>Without trivializing 50 million dollars, it sounds like 180 dollars/year per employee?</p>
<p>I found a tax on self-insured employers called the “Patient Centered Outcomes Research” tax. It assesses $1 per covered life for 2012 and $2 per life for 2013. Using your 100,000 number of covered lives, that’s no where near the $50mm number. I can’t find a reference to the high risk patient tax yet.</p>
<p>I have to say, though, that if your numbers are correct, I would call that a $19 mm tax. If you refer to 3-year numbers for tax, you have to refer to 3 years of revenue as well, to make it apples to apples. I wonder if your company’s letter mentioned 3 years of revenues.</p>
<p>texas, here is what I found online that explained the self insurance tax. I think my company is not even going to deal with the cadillac tax (though they may have to for the union employees whether they want to or not):</p>
<p>"The PCORI fee is assessed on self-insured and fully insured health plans to fund PCORI, which was established to conduct and promote clinical effectiveness research. The fee — paid by the health insurance carrier for fully insured plans and by the plan sponsor (typically employers) for self-insured plans — is $1 per covered life (employees, spouses, dependents). </p>
<p>The Transitional Reinsurance Fee, running through 2014-2016, will be assessed on self-insured and fully insured health plans to fund reinsurance payments to health insurance issuers that cover high-risk individuals in the individual market. Like the PCORI fee, the transitional reinsurance fee for fully insured plans is paid by the health insurance carrier, and the fee for self-insured health plans is paid by the plan sponsor (typically employers). The tax-deductible transitional reinsurance fee for 2014 will be $63 per covered life, with the amount decreasing thereafter through 2016. For a company with 300 covered lives, the fee would be $18,900</p>
<p>'Without trivializing 50 million dollars, it sounds like 180 dollars/year per employee?"</p>
<p>I know it doesn’t sound like much when it’s $180/yr per employee. But profit margins for companies are not always that high, and 50 million + bucks is substantial. I do think they will take it out of the employees, though, and whatever is left out of the customers. People always think these kind of things will come out of profits, but they generally don’t.</p>
<p>“emilybee, in message #1347, there was mention of how the ACA was affecting some colleges that had been offering inexpensive health insurance plans, and now could no longer offer those plans. Some of those college insurance plans cost around $150/year… but they had a payment cap of $10,000; that is, after paying $10K in medical costs, the “insurance” would stop paying. The ACA disallows yearly and lifetime caps.”</p>
<p>I wasn’t talking about that. I was commenting on today’s news mentioned in post 1338 and 1346.</p>