busdriver that cost is shockingly low. That is what single coverage cost for my large group (self insured plan). Husband/wife or parent/child which is what you reference is about twice that.
I know it’s shockingly low, though I wonder what my W-2 will say at the end of this year.
My point is that if a big company can pay that little and get that much, why can’t the exchange plans be cheaper? They cover huge numbers of people, don’t they have any negotiating power? They have set reimbursement rates too, and limit the providers you use, so why not?
Your w-2 will have the true cost of the plan. If it is different than the $9700 your mistaken that is the cost.
I cannot recommend imports of prescription drugs plus it would be illegal in two ways. Prescription medications can only be legally imported with approval from the Secretary of HHS.
A major issue is the supply chain. You need to make sure no tampering occurs from manufacturer to wholesaler to pharmacy to you. There have been some sad cases of adulterated drugs making it to pharmacies and patients due to rogue wholesalers. As a result, FDA now has pedigree requirements on all prescriptions. Every pharmacy needs to be able to produce the history of their medications within a 72 hour window. It needs to list every stop the medication made on its way to the pharmacy. If that cannot be done, you can get fined by the FDA. This came into full enforcement on November 1.
There have been some significant increases over the past year or two on some generic drugs. From what I heard is that new legislation starting in 2016 will limit certain increases and so, they wanted to increase the price before legislation became active.
Yes, Tom, I realize that about the W-2. That’s where I got my information from. However, I am curious to how it will change at the end of this year. No doubt that number will go up.
And my point is, if it would work for a big company to pay that little in Silicon Valley and get that much, why don’t any of the companies in Silicon Valley do it? Are they stupid? Do they not want to save money? Or is it that they realize that one of their employees gets sick, they have to get health care here, not in Iowa where health care is half the price.
And then the other part is age. Your company is giving you the average price for its employees, young and old. I can’t get insurance for the average person-- I have to buy insurance for two old people, because I’m insuring two old people. If Mr. Fang and I were both 50, we’d pay a lot less. If I were insuring myself and Fang Jr and not Mr. Fang, we’d pay a lot less.
"My point is that if a big company can pay that little and get that much, why can’t the exchange plans be cheaper? "
Busdriver, you may be missing how your situation is very different and how the numbers do work for others here. (And it sounds like you may not know the real full price for your benefit.) Strong unions in big corporations like yours can insist the employer offer a supreme plan and then that the company artificially keep the employee cost low by paying a hefty part of those costs. Your union(s) have a leverage that we don’t. Your company is also offering an insurer tens of thousands of potential clients. Maybe they are getting a volume discount from the insurers they work with.
Why aren’t exchange plans cheaper? Most often, they are. They just aren’t the level of sweetheart deals some big employers can offer-- low monthly for exceptional coverage.
When DH was on the Cadillac, at his U (much fewer employees, but with a faculty union,) we paid just under $9600/year for family. (His plans only offered individual or family.) When we were offered Cobra, the cost was $21,600 for the family plan. As Fang said, this shows you the harder number. For us, that was $1800/month, to stay on that employer plan, versus just under $800 previously.
No we didn’t keep it. It was a level of golden glow we couldn’t see, for the up front cost. As I said, the direct cost from the insurer for the plan we chose instead was 37% less. (Less than 2/3, by eliminating the fluff, taking a higher deductible, etc.) Then we saved considerably more via the exchange, to keep costs proportional.
The mismanagement of funds is starting to make the news…
http://www.foxnews.com/politics/2015/06/16/feds-cant-verify-nearly-3b-in-obamacare-subsidies/
And just to keep the someone from having to bring their heart rate back down because of this particular news source (wait for it … wait for it…THAT"S not a news source). Here is the original governmental source.
http://oig.hhs.gov/oas/reports/region2/21402006.pdf
Yup…doesn’t plan to do a timely reconciliation of the questionable payments…just continue to dish out the ‘free’ $$.
Oh boy…
Here we go again.
“For the 100 payee group-months included in our sample…On the basis of our sample results and our review…we concluded that CMS did not verify that it correctly applied…financial assistance payments that it made during the period January through April 2014.”
IOW, the first 4 months.
Read the full report, including the CMS response and then the IG’s response to that. No one should stop at just what Fox says. I’m not disputing that there are flaws, but see the report itself.
I did see the report. What is there that leads you to believe that the first 4 months are not indicative of the following 12 months given
If there is no reconciliation the existing problem continues. And why is the sample group population not valid. Are you saying the CMS is intentionally misrepresenting the issue?
I guess nobody can give me a scenario why any couple of my and my husband’s age living where we live should buy that Platinum plan that I previously referenced? Maybe the only scenario would be, “We don’t understand mathematics.”
CF, the premiums may be deducted from taxes.
How are drug costs treated between plans?
I think in certain cases if one or both parties in a couple have known health issues where the costs can run high each year a plan above bronze may make sense.
When I last took an in-depth look at plans I found there to be slightly more provider participants in the higher level plans. In other words, a certain Doctor may not take Insurance X - Bronze but might take the silver or gold level plans.
If you think you will reach your deductible and OOP max very early in the plan year the plan with greater benefits might make sense.
That doesn’t fall under out of pocket?
The part that’s over 10% of average gross income can be. But other health expenses are equally as deductible, so this doesn’t help here. If I can buy the Silver and pay X for premiums and Y for copays and other health expenses, I’m never better off buying Platinum and paying more than X + Y for premiums and copays.
If a person is self employed, he or she can deduct the insurance premiums. The 10 percent of income number does not apply.
The platinum plan may not work for you. Doesn’t work for me. Doesn’t mean the platinum plan doesn’t work for anybody. If I was a big user of drugs, I would take a look. Drug costs are treated differently among levels of plans.
Very few people use platinum plans.
"Busdriver, you may be missing how your situation is very different and how the numbers do work for others here. (And it sounds like you may not know the real full price for your benefit.) Strong unions in big corporations like yours can insist the employer offer a supreme plan and then that the company artificially keep the employee cost low by paying a hefty part of those costs. Your union(s) have a leverage that we don’t. Your company is also offering an insurer tens of thousands of potential clients. Maybe they are getting a volume discount from the insurers they work with.
Why aren’t exchange plans cheaper? Most often, they are. They just aren’t the level of sweetheart deals some big employers can offer-- low monthly for exceptional coverage"
I think they only way I can understand exactly why my employer is able to spend so little money on good health care plans is to actually talk to the people that work in that department, not speculate on why. Supposedly the real full price for my benefit is on my W-2, is it not? Is this some sort of bogus number? It might have been a good idea for the government to figure out how to get such a great deal for their ACA plans, also. Seems that with hundreds of thousands of people covered in each state on these plans, that they could have negotiated a good deal with the insurers also, if that’s all it comes down to.
“And my point is, if it would work for a big company to pay that little in Silicon Valley and get that much, why don’t any of the companies in Silicon Valley do it? Are they stupid? Do they not want to save money? Or is it that they realize that one of their employees gets sick, they have to get health care here, not in Iowa where health care is half the price.”
I dunno. Maybe they are stupid. Maybe they aren’t figuring out the way to get the best price. Not too many employees at my company work in Iowa. In fact many of them actually work in California, or on the east coast, where the prices are high. Then again, until we have someone from one of those big companies in Silicon Valley weigh in on exactly what their company pays, it’s all speculation, isn’t it?
Seems to me that the ACA plans should be offering people a huge group discount, with all the people in their plans, they should have the same negotiating power that a large company would have, or more.
The typical reasons to buy above Bronze are because (a) you don’t want to (or somehow can’t) handle variability in your health expenses and prefer to pay as close to a flat fee as possible and/or (b) you have calculated your presumably high medical needs and discovered that the more expensive plan results in lower overall costs to you. These are unusual situations which is why Bronze plans are overwhelmingly more popular.
My COBRA plan that is about to expire, the one that’s very expensive? That’s from a large Silicon Valley tech firm. Mr. Fang retired from a big Silicon Valley tech firm. I know exactly what the average insurance cost was at his company, because we’re paying it.