<p>I think most group plans provided by larger employers already comply with most ACA requirements. There are minor differences but not enough to amount to a lot of money. Employer group insurance has always been open enrollment without medical underwriting, so it’s not as if the insurance companies will be hit with the burden of suddenly insuring a bunch of new and very sick employees.</p>
<p>The financial pressures are still there, but they really aren’t a result of ACA – they are a result of the high cost of medical care. The financial issue that impacts individual rates is the need to absorb a large number of people who were uninsured precisely because they were too sick to find and hold onto full time jobs.</p>
<p>Well, Calmom, regardless of where the financial pressures are coming from, even the administration in their commentary in the 2010 Federal Register predicted a majority of group plans would lose their grandfather status and would be terminated.</p>
<p>Quoting from CNN:</p>
<p>“The Departments’ mid-range estimate is that 66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013,” wrote the administration on page 34,552 of the Register. All in all, more than half of employer-sponsored plans will lose their “grandfather status” and become illegal. According to the Congressional Budget Office, 156 million Americans—more than half the population—was covered by employer-sponsored insurance in 2013."</p>
<p>Of course, this is outdated because the group mandate has been delayed for a year, so we are now looking at 2015 instead of 2014. The numbers indicate that 93 million people will lose their grandfather status and their plans. Good or bad, this will be a significant upheaval for the vast majority of people with insurance.</p>
<p>But you are missing the part that many of the benefits that are required by ACA were put in place immediately, so the premiums have already accounted for most of the extended benefits. Whether the employer plans are “grandfathered” or not isn’t the point - it is very common for employers to switch plans that are offered to employees, often as part of the process of shopping around for better rates.</p>
<p>Do you really think that free preventive care (as opposed to preventive with a small co-pay), the right to appeal, and rate review are going to significantly drive up costs?</p>
<p>Dstark, you’ve made me wonder if I should be double-checking the national in network coverage of the BCBS PPO…though I had already “escalated the call” when I received that info, meaning in theory someone up chain verified that! </p>
<p>GoldenPooch, once you get a rep on the line, just escalate the call. You’ll get at least more authorative answers they may still be wrong…</p>
<p>Catera…Maryland is interesting. That would certainly be one way to both control costs and ensure access nationally were other states to adopt it…it seems to be the missing piece here as most folks on this thread have had to attempt cost-benefit analysis with incomplete network info and the general feeling that an oversight in the decision can still result in a catastrophic medical situation with minimal coverage. Eg. Liver transplant. Why on earth isn’t that a national list?</p>
<p>It would be a lovely thing if we could just sign up with the plan that suits and know we’d be covered according to the metallic level and OOP max without network concern. Perhaps via the national advisory on fee schedules under ACA we’ll end up with that kind of ultimate uniformity. </p>
<p>Right now for me, a silver HSA PPO with BCBS seems to be the closest I can get to emulating the “carefree” coverage I had in the single-payer, universal system in which I grew up.
It of course requires pre-funding the HSA to neutralize the deductible and OOP, then paying $1236/mo family or $996 couple. But at this point, whether I pay for it in taxes (like my former country) or I pay for it as an employer or I pay for it as an individual is kind of MOOT, because in truth, the cost is about the same.</p>
<p>I just want to be COVERED, no loopholes, no quibbling, no fine print or oddball legislative contraindications, JUST COVERED.</p>
<p>Calmom, I agree with you that ACA is less likely to impact large employers than small businesses; however, it seems that almost 10% of employees for large employers have plans currently deemed unaffordable pursuant to the mandate. The percentage is higher for large companies with a lower wage workforce. These employers will probably try to minimize their healthcare costs either by downgrading plans, converting workers to part-time status or even paying the penalty. Anyway, we are not going to know for sure until 2015.</p>
<p>“The percentage is higher for large companies with a lower wage workforce. These employers will probably try to minimize their healthcare costs either by downgrading plans, converting workers to part-time status or even paying the penalty.”</p>
<p>Ah, GP, don’t be such a downer. If the companies pay the penalty, that’s more money to the govt. If they convert workers to part time status, they’ll probably be eligible for big subsidies, and maybe even food stamps. And if you lose your job, you can get unemployment and maybe even welfare. It’s all good, right?</p>
<p>Don’t give up on calling the insurance company for information. Somebody has to answer the phone eventually! I really recommend that if someone tells you something important, that could affect your life, to ask where it is in print. I have had people tell me, with complete certainty, something that totally conflicts with what they have published.</p>
<p>Busdriver, I can only imagine how much fun it would be trying to get some of this stuff in writing from BS/Anthem. I think I would rather run a marathon; it would be less taxing. :)</p>
<p>“Geography: Does the young adult live in a different state?
Young adults can stay on their parents’ plan after they leave the nest, even if they are married—and they need not be claimed as a dependent on their parents’ tax forms. But if the child lives far away, local doctors may be out of the family plan’s network, meaning out-of-pocket costs could be high.
If young adults are healthy and the cost of their parents’ plan is significantly lower than what they could get on their own, they might schedule routine doctor visits for when they come home and use the family insurance only for emergencies in their own state.”</p>
<p>GP, why don’t you just call an independent insurance agent to help you since you don’t qualify for a subsidy. Let the agent get all the answers to your questions.</p>
<p>Emilybee, I have spoken to a few agents (not in the last few weeks) who knew less than I did. They all said to wait until we had more information. I do have an agent that I have worked with in the past and will make an apt with her, but I am waiting until I know exactly what questions I want to ask her.</p>
<p>Yes, everyone pays the same rate regardless of age and that was part of the problem with the individual market becoming so outrageously expensive in NY - because no young and healthy’s could afford it, only the old and sick bought indy insurance. Now, because there is the mandate under ACA and everyone had to be insured, prices on the individual market in NY- both on and off the exchange - have dropped about 50%.</p>
<p>Hayden, that patient who received emergency care also received a large bill. The hospital expected payment and in some cases pursued it relentlessly resulting in a negative credit report or bankruptcy. So, the taxpayers may have ultimately paid for the bad debt, but thousands of patients suffered irreparable financial consequences. I hope in the future, the ACA will reduce those situations. </p>
<p>Also, not all emergency room visits were emergencies. Thus, urgent or chronic illnesses persisted without appropriate treatment. Thus, the majority of the uninsured patients did not receive care.</p>
<p>“Young adults can stay on their parents’ plan after they leave the nest, even if they are married—and they need not be claimed as a dependent on their parents’ tax forms. But if the child lives far away, local doctors may be out of the family plan’s network, meaning out-of-pocket costs could be high.
If young adults are healthy and the cost of their parents’ plan is significantly lower than what they could get on their own, they might schedule routine doctor visits for when they come home and use the family insurance only for emergencies in their own state.”</p>
<p>I would think that a large, national insurance carrier would have networks all over the US, and paying out of network wouldn’t be a factor. It seems in this case, if your kid is out of state, that you’d be well served by having a plan that covers doctors/hospitals in network everywhere. I still plan on making my kiddo get his physicals here at home, just because it’s a doctor that we know and trust, but if there were chronic issues, it would have to be out of state. Right now it costs us zero additional to have him on our plan, so it’s kind of a no brainer.</p>
they may still be wrong…</p>