<p>Ok, yes your post does read that way too.</p>
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<p>Sorry, I was unclear. </p>
<p>I was disagreeing with the premise of your post. If many of Walgreen’s employees are under 30, and still covered by their parent’s medical plan, then they have no need to ask Walgreens to cover them. Thus, the following point may be moot – there is no need (at least for this group of ee’s):</p>
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<p>Retail is the operative word, zoos. :)</p>
<p>More importantly (and for this thread), lets not forget that Walgreens is also a health care provider. With large pharmacies, they too will continue to take a huge revenue hit as companies – and Medicare Part D – continue to ratchet down pharm benefits. For Walgreens to pay its employees a so-called living wage+benies, they’d have to raise prices. Yet, they cannot on their pharm side.</p>
<p>I’ll second zoosermom’s post. H was a W manager for 15 years. Even at that time, they had far worse benefits than I would have predicted based on number of employees. Her other points are spot on regarding hours and expectations. IMO their retail model is not to invest in their employees.</p>
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<p>IMO, it has nothing to do with “their”; the retail model is the retail model. Since this thread is about health care, we need to recognize that a retail storefront, staffed 18+ hours a day, with credentialed pharmacists, is much, much more expensive than online/mail order pharmacies. Mail order is their competition.</p>
<p>There are always companies that hire better, treat people better. Two examples are Costco and Nordstrom. I mention them because they’re on somewhat opposite ends of the price spectrum. They pay better, train better, empower employees better and it shows in their financial results. </p>
<p>Another example is DeMoulas’ Market Basket, a supermarket chain in NE that is highly profitable, has great service and notably low prices. They have more employees per store than you would believe - outside of a Wegman’s maybe - and you can see each employee’s number of years on their badges. </p>
<p>Most larger companies, I think, don’t treat their employees very well because it’s harder to manage a company to that kind of standard; it demands more of managers and so they default to a lower quality management style. Small companies vary: some are selfish, some can’t see the forest for the trees, some have trouble competing for a bunch of other reasons, etc. </p>
<p>I remember sitting in meetings many years ago with small business owner after owner all trying to set up “money stuffer” pension plans that would never pay off for employees and all the proceeds would default, pro rata, to the remaining accounts so the owners would get more by turning over the staff, especially by getting rid of staff who had been there long enough to be valuable. The incentive then was money versus quality and money usually won. The rules have changed but the game is the same.</p>
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Why do you assume that the Walgreens will be reducing its subsidies to employees by outsourcing the insurance? It seems to me that they are still paying a subsidy, but now giving employees some more options. If the subsidy is straight percentage (example - employer pays 80% of premium) then it doesn’t make much difference – but if it is a dollar amount, then some employees may opt cheaper, higher deductible plans. Just as the person who gets an Obamacare subsidy keyed to the Silver plan has the option to increase their savings by opting for a Bronze plan instead, a worker who anticipates low out of pocket health care expenses can do the same. </p>
<p>I’m not saying that I am confident that Walgreens is going to step up to the plate on this – I just don’t see any evidence to the contrary. They are still subsidizing their employees - they are simply changing the mechanism for purchasing the insurance.</p>
<p>I confess that I haven’t read most of this thread (128 pages!), but got a piece of mail today that had me shaking my head. It was an apology letter from Anthem, which writes my individual policy. They were terribly sorry about a misleading earlier communication that suggested I wouldn’t be able to keep my current plan, since in fact I can. So here’s a bunch of theoretical pros who had the law and rules in front of them for quite some time–and they still can’t get it right. I actually don’t blame the law–as an attorney I’ve been exposed to much more complex legislation that companies somehow manage to cope with. I suspect Anthem–and maybe other insurers–just aren’t putting the necessary bodies and expertise into the task. And given their usual performance, we shouldn’t be surprised. (Shall I tell you about the time my hospital accidentally billed me for two C-sections on the same day, the insurance co. paid for both, and I had to move heaven and earth to convince them they shouldn’t have? Nah, you probably have your own stories of wild incompetence in the industry.)</p>
<p>I’ve had the opposite happen, though no apology letter yet. Two months ago Blue Shield CA told me that I would be able to keep my current, grandfathered HSA plan, with no change in premium in the short term. Now I find out that the plan is not grandfathered – the rep on the phone says there is no HSA eligible option any more, but the info on the web site suggests something a little different. They have promised me a letter with an explanation and rate sheet by the end of the month.</p>
<p>In my case I think it is that my plan (in theory) is “grandfathered”, but I’m not, because even though I have been with BS since 1994, I went onto this particular plan in Dec. 2010, and only plans in effect before March 2010 are grandfathered. (Of course I swapped plans overt the years trying to keep the costs of premiums under control). However, as if it were some sort of consolation, the agent told me that the rates for the plan that I can’t stay on would be going up anyway. </p>
<p>So I guess I will be shopping on the exchange after all. Apparently I have the choice of buying the same policy either directly from BS or on the exchange – but I think I have to use the exchange to be eligible for a subsidy. I’ll have to check to see if it is the same for a tax credit – because I am self-employed with a variable income, my plan is to pay the full cost and take the tax credit if I am eligible. Otherwise it is too unpredictable and I’d rather not be faced with any unpleasant surprises around tax time. </p>
<p>As to your other comment: " hospital accidentally billed me for two C-sections on the same day, the insurance co. paid for both" – I had a similar thing happen when my daughter was born. Only one delivery, but someone with the same last name as mine was in the hospital for a totally different condition and surgery - it all got billed and paid together. I did notify the insurance about their mistake.</p>
<p>Ok…question here. DS has an individual policy that says it will NEVER cover his preexisting condition (was issued about a year ago). This preexisting condition is fully controlled…and DS has had continuous health insurance coverage always. This plan has this exclusion.</p>
<p>So my question…when the provision for preexisting conditions goes into play, will his policy be re-written to cover this?</p>
<p>No. </p>
<p>See:
<a href=“https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/[/url]”>https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/</a></p>
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<p>No, I don’t see any evidence to the contrary either. But in general, big business makes major changes like this to benefit profit margins, not employee welfare. It sounds like the Walgreens plan will be revenue-neutral for the first year. But to the extent that future subsidies don’t keep pace with health care costs, that’s a cost Walgreens will be shifting to its workers.</p>
<p>But that is only one factor. Maybe the private exchange is more cost effective overall and ends up having lower premiums than Walgreens would pay if they continued to work directly with insurers for group coverage… Maybe, as I noted, Walgreens is able to offer prorated subsidies to part-time workers to purchase off that exchange, whereas before those employees would have been ineligible. Of course Walgreens is concerned about its bottom line, but part of that bottom line is the administrative costs it incurs via its HR department in having to negotiate health benefits each year and spend a significant portion of their job in the role of insurance agents for employees. </p>
<p>Does Walgreens want to save money? Of course they do. Will their employees by hurt by Walgreens shifting the responsibility for coordinating health benefits to a different entity – I don’t think we know the answer to that question yet.</p>
<p>No, we don’t know the answer to that, and won’t for a year or two. And it will vary from one company to the next. Undoubtedly some will contribute subsidies that enable their employees to keep pace with rising health costs. Others will not, and the employees will get an effective cut in pay. Others may go back to the employer-provided plans. There will be a lot of different approaches. It will be interesting to see what the prevailing model is 10 or 20 years from now. You’re right, there’s no way to tell right now.</p>
<p>I wonder why they created the private exchanges in the first place? Why not allow their employees to spend the subsidies on the public exchange?</p>
<p>No matter which type of “exchange”, it’s going to end up being the same dozen or so private insurance companies writing all the policies. So there must be an economic benefit to the companies to market policies via the private, corporate sponsored exchange. I don’t know what it is, but it could be related to back end, administrative costs. In the end, with the ACA, every insurer has to offer plans that meet the new ACA standards – so the benefits are going to be roughly equivalent no matter which plan you opt for. </p>
<p>I’m starting to get a little concerned about a techy problem: how are the computer systems for the public exchanges going to handle the load on Oct. 1. (I know that there’s no benefit to being first in line to sign up, but I’m still trying to figure out the bottom line on the actual rate I will be charged and specific plans that will be available to me … I imagine there are many others with the same degree of curiosity.) So I figure the next ACA stumbling block is probably going to be some serious computer downtime in early October.</p>
<p>On the other hand, maybe I don’t have to wait until October. </p>
<p>I just checked the Covered California web site and found the plans plus rates. For my age (59), base premium is about $650 for a Bronze PPO and (contrary to what I was told on the phone yesterday by the Blue Shield rep), Blue Shield will be offering an HSA-eligible Bronze plan. If I qualified for a subsidy (based on $45K annual income), I’d be looking at a monthly premium of $220. I’m currently paying $402/month for an HSA with a $3500 deductible, maximum $5000/year annual payout, but that rate would have gone up early in the year when I turn 60 in any event-- well above $600 under last year’s rate schedule. The HSA-eligible Bronze plan will have a $4500 deductible, $6250 maximum annual payout. </p>
<p>So basically I’m looking at maybe an 8% increase in premium level over what I would have been paying without ACA, plus a small paper loss in benefits. (“Paper” because I’ve never come near to meeting my plan deductible - the big benefit of ACA to me was the preventive care provisions, which means that the only stuff I ever use is mostly free, with or without the deductible).</p>
<p>If I qualified for a subsidy, my premium would plunge to around $220 a month. I kind of like the idea of making more money rather than less, but being self employed means that if I ever did get seriously injured or ill, I’d likely see a loss of income. So that’s a cushion I never had before, and no small benefit, given the high correlation between my physical health and my earning capacity. </p>
<p>I’m sharing this way-to-detailed information just to provide a picture of what this means to one person. I won’t personally be better off in the short run under ACA – I had a better, more affordable policy already – but I sure will be better off if I actually incur the type of medical expenses that the insurance is designed to cover. In other words, I’m worse off until the day that I actually need the insurance – and on that day, I will probably be very grateful for Obamacare. </p>
<p>By the way – the Covered California web site is wonderful. Very easy to use and navigate, and it makes specific recommendations for coverage depending on income level. I like that the back button works on its cost navigation system – it makes it easy to explore different scenarios at different age and income levels.</p>
<p>Thank you for sharing that. As a fellow self-employed person, getting too sick to work and the prospective financial/medical impact has been a major concern for me, since H and I both work together, and he’s 10 yrs older than me. I am so loaded up on keyman insurance (great for death but not so much for illness) disability, accident ins. etc. it’s crazy.</p>
<p>I don’t think ACA will necessarily mean I don’t need the kinds of contingency coverage I’ve gone in for, but I do feel I might be a little less stressed to know there is some kind of safety net should we fall that far.</p>
<p>My h’s father is a retired pastor at 85 who happened to marry a dramatically younger woman after he was widowed. It pains me to see them paying $800 a month for her insurance, and we’ve all been counting the days til she’s finally eligible for Medicare. Had ACA been in place 10 or 20 years ago, I think they’re an example of a couple who would have benefitted…and I wouldn’t have begrudged one iota of tax dollar that subsidized them considering what they’ve given.</p>
<p>I am also hopeful, though perhaps naively, that ACA could directly or indirectly correct an age imbalance in our workforce. Understandably, many have been reluctant to retire and are working well past their “passion-for-position” expiration date 
It’s painful to see so many smart, savvy youths unemployed or underemployed when some if them have a lot to give. Perhaps somehow this can be evened out if we’re all not terrified of “no affordable coverage.”</p>
<p>In my case, since I eat what I kill, I may still die with my boots on anyway, as they say but maybe I won’t be quite as reluctant to move over!</p>
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<p>They are not new; they’ve been around for a long time. They are really designed for companies and individuals who are not eligible for a subsidiy. </p>
<p>While I have no doubt that the exchanges are a way for corporations to cap future cost increases (like the transition from defined benefit pension plans to 401k’s), private exchanges can also provide more ee choice. According to the walgreen’s announcement, employees in some state will be able to choose among 25 different plans: from HMOs to high deductible catastrophic plans. As calmom alluded to, such administration would be problematic if a company wanted to try to offers such a robust program with in-house resources.</p>
<p>kmcmom13, the estimates of retirements are in the low hundreds of thousands, which isn’t a large figure compared to the workforce, especially when spread out over months and when you consider the natural pace of retirements. But we’ll see. These estimated retirements were, if you remember, cited as a key statistic for showing the ACA costs jobs but they are, as you note, something else.</p>
<p>My health insurance has been offered through an exchange for years - albeit one established by NYS not a “private” entity. None of the plans offered are government run plans. They are either private insurance company plans or BC/BS. Every year during open enrollment we get to pick from dozens of different plans at various price points. This is pretty much the same system the Fed govt, including Congress, has (and what people have been screaming they want.) </p>
<p>IMO, the crux of the matter is are the companies going to pay the subsidy or not, not where the insurance coverage is purchased.</p>
<p>I’m entering late to this discussion and from a point of admitted lack of knowledge. I cover my family through my employer with a $500/month contribution. It’s a decent plan but has some issues I’m not thrilled with. Should I look around at other options under the ACA? Is it possible that there might be a family plan for $6K/yr or will it be a lot more? I’ve always just gone with what my employer offers, and yes we have some significant pre-existing conditions.</p>