Affordable Care Act Scene 2 - Insurance Premiums

<p>You need to pay 7.65% x 2 to cover SS and medicare.</p>

<p>General info: </p>

<p>“The Self-Employment Tax is how an independent contractor pays Social Security and Medicare payroll taxes. In the case of employees, the employer and employee split the cost of these payroll taxes, each paying 7.65% of eligible wages. An independent contractor, by contrast, is both the employer and the employee, so a self-employed person pays both halves, or 15.3% total.
The 15.3% self-employment tax is composed of a Social Security tax of 12.4% on the first $113,700 of net self-employment income (for 2013), and a Medicare tax of 2.9% on all net self-employment income. The $113,700 amount is called the Social Security wage base, and represents the maximum amount income from wages and net self-employment income subject to the Social Security tax.”</p>

<p>If the family was set up to do so, I’d consider starting a small, inexpensive business to help out my kid. Not necessarily for subsidies, though that’s a positive, but for the kid to feel productive. Something where the kid has skills or interests in. Nobody can match the concentration and obsession of an Aspie, following their interests. They can be so successful in the right environment sometimes. In our case, we’d do a cheap tech start up company if we had to.</p>

<p>I am not in love with kmcmom13’s analysis. </p>

<p>Where is the cost of the subsidized insurance? </p>

<p>I would keep the 12,000 out if it at first. </p>

<p>Compare the cost of insurance without working with the subsidized insurance costs and all the taxes and fees from working. </p>

<p>Then I would consider the benefit and costs of working, eventuall SS income and the 12,000.</p>

<p>If the parents just pay for him, if he doesn’t have enough income to be subsidized, it’s the insurer full rate. I think that’s where we were. But right, the 12k (plus taxes to be covered) should have the subsidized rate figured in. 4k in premiums versus 12k-plus to pay him plus the then cost of subsidized premiums. Did I say that right?</p>

<p>LF, if that is true, the income of 12,000 is too low, we need a new hypothetical. :)</p>

<p>The subsidized premiums would be 2% of 12K, or $240 a year, for a Silver plan. A Silver plan would have substantial cost-sharing subsidies for this hypothetical person.</p>

<p>"Cost of BCBS Georgia 27 yr old plan - SILVER - $335 with $3500 DED and $4500 OOP Max</p>

<p>Net cost per anum: $4,020 premiums plus $4500 MAX OOP incl prescription = $8,520 – "</p>

<p>We have the above. I would like to see the subsidized silver plan numbers. </p>

<p>I would like to see the bronze plan numbers too. Both unsubsidized and subsidized.</p>

<p>The 12,000… </p>

<p>Some people will see this as a loss. Some will see this as a transfer.</p>

<p>dstark, I wans’t sure how we got 12k. [Federal</a> Poverty Guidelines](<a href=“http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html]Federal”>http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html) if you need 133%, for one person, it’s over 15k. What did I miss?</p>

<p>$240 in premiums a year? </p>

<p>Compared to 4,000 in premiums? </p>

<p>“Kid! Here is a shovel. Get to work!” :)</p>

<p>Hmmm. There are quite a bit of cost savings. How much can the kid save in oop costs?</p>

<p>You just need 100% of FPL to be eligible for subsidies. I put $12K because I was too lazy too look up what 100% of FPL is, exactly; it’s $11,490.</p>

<p>LF, it is CF’s theoretical. :)</p>

<p>Maximum OOP would be $2250 for this kid if he got the subsidies. That’s the limit for people just over the poverty line.</p>

<p>LF, subsidy eligibility kicks in at 100% FPL. A person who is eligible for Medicaid is not eligible for subsidies. In a Medicaid-expansion state, everyone with incomes up to 138% of FPL is eligible for Medicaid. But Georgia didn’t expand Medicaid, so subsidy eligibility begins at 100% FPL in that state.</p>

<p>Ok, but my calculator doesn’t even yield me results til I put him in at 16k. I used age 29 and see a net roughly $50. Oh, we have Medicaid. Maybe I can’t run this. I see.</p>

<p>So… It would be about a 4,000 savings. ( I am including the out if pocket maximum. Taxes. Not really counting potential SS income).</p>

<p>I can see people doing this.</p>

<p>^ in Georgia, I believe someone said it was NOT a medicaid expansion state, meaning to be eligible for subsidy, one needs to earn $11,490 (as opposed to the 138% figure.)</p>

<p>-- If the goal is strictly to provide healthcare, the min expense full pay would be the apx $4,000 in premium…plus possibly the OOP max. Still cheaper than employment if you don’t care who the money is going to and if one DOES want the NOT-CLASSIFIED-AS-UNEMPLOYABLE young adult to be seeking meaningful work outside the household.</p>

<p>-- If the goal were to employ the young adult, obviously CF is correct that it would be better for family money to be used to pay the individual. His OOP would be approx $500 on the 94 plan, and his deductible about $175 – that’s it for the year. His approximate premiums would be more like $75-ish a month, or 900.</p>

<p>SO…the cost to “employ” said kid would be 12k + 15.3% + expenditure of about $1575 all in for healthcare (easily taken from said kid’s pay…)</p>

<p>So, the approximate Premium PLUS OOP cost savings comparatively would be let’s say FULL PAY $8500 versus SUBSIDIZED $1575.</p>

<p>-- loose numbers in quotes because I don’t know the exact plan discount at this rate for this state, but I do know the exact plan discount at 150% PL and am extrapolating. The individual would for certain be eligible for the BCBS 94 plan, which nets an actuary value of 94/6.</p>

<p>

Busdriver, I’m with you – though I wouldn’t have the type of resources to create a new business. But as a parent, I’m not at all into the idea of subsidizing an adult child to be idle. An Aspie is capable of doing something productive; a parent who gives their unemployed child a job with real responsibilities is laying the foundation for the future. </p>

<p>Not all Aspies are technically oriented. Singer Susan Boyle has now been diagnosed with Aspergers-- she says that is a tremendous relief to her, as she had been led to believe that she was brain-damaged as child. Obviously, given the opportunity, she can earn quite a lot.</p>

<p>^ Another note – those figures are based on a GA HMO by BCBS for age 27 that was mid-level expensive with lower that typical OOP if full pay (eg. 4500 instead of 6000).</p>

<p>kmcmom13, If you have ideas about where a kid like that could find a fulltime job, I’m all ears. This hire-your-kid strategy so he can get health insurance is not relevant for my family for a variety of reasons, and anyway I sure would like my Aspie son to find a fulltime job. So far, no luck.</p>