"Yesterday was our annual deadline to sign up for our insurance thru H’s retirement plan.
We have the Family Plan at roughly $2000 a month (but H’s company picks up all except $400). It looks like our choices come under the Cadillac tax levy (thankfully)."
Just barely, but only for this year. Next year you could easily hit the threshold.
We had a Cadillac plan and other than monthly, paid next to nothing. We had an OV co-pay, a few dollars for an Rx. It confused me because, technically, we had a $200 deductible, but it only seemed to show up if there were something uber-major we needed (my emergency surgery, eg. But there, all I paid was that $200.)
Thing is, we can talk about this as a wonderful benefit. But the flip side of the ability to freely use med services is, well, the ability to do almost anything without consideration for its necessity. I could name a number of tests I had where my concern could be considered legit, but not necessary or medically called-for, at the time, based on the rest of the detail. These were cases where my doc said he didn’t think I needed it, but if it reassured me, my ins would cover it.
The consideration isn’t whether some would like the best plan out there for the least cost, whether some consider it an employee perk. It’s finding a way to control the excess.
Btw, looks like my options for 2016, the lowest possible deductible from my preferred carrier is $1000. (The plans comparable to what I now have start at 3k and go up precipitously.) The next lowest ded is $1400 and the rest of the offering (co-insurance %, ER cost, in-patient, etc,) are actually better on the 1400 plan. You need to calculate based on the whole offering and the chance you’ll use little vs have some crisis.
Btw remains to be seem what the threshold will be- the expectation is that it will go up. (Of course, so will costs, as they nearly always do.)
Does anyone know what the W2 amount in 12c-DD includes? Is it full cost of insurance or just employer’s part?
YOU are not liable for the Cadillac tax in any event; it’s a tax on employers. And the Cadillac tax does not take effect in 2016, in any event.
Total cost.
Thanks. So what kind of deductible/max out of pocket cost would family insurance with the total price of 27.5K have? I would assume that these numbers should be close to 0.
“YOU are not liable for the Cadillac tax in any event; it’s a tax on employers. And the Cadillac tax does not take effect in 2016, in any event.”
It is possible that mom2collegekids and others would rather be responsible for paying the Cadillac tax than deal with the likely alternative, that her company would ditch the good plan and move them to a plan that covers less, with a higher deductible and larger copays.
It’s not just the deductible but the ability see the doctor of your choice. Our current plan is valid in any state and I won’t have to get different policies for my kids should they decided to go out of state.
I think the Cadillac reality check isn’t just saying, ditch “a good plan” and everything goes to pot and everyone ends up in a deep hole. We don’t know what alternatives employers will come up with. It may not be prohibitive, especially with employee pressure.
I got a multi-page pamphlet from the exchange, lining up all plans, with plan detail (not every bit, but the highlight bullets) and some sample premium prices at different ages. It includes, eg, deductibles and max out of pocket. Need to warn that, to see the Silver “Cost Sharing Reductions,” you need to run your exchange’s online calculator, plug in your own age, MAGI, and family info.
Eg, whats listed as a $4500 deductible on one plan, came down, sometimes steeply, when I ran various numbers. If you qualify for the exchange, don’t just look at list prices.
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It is possible that mom2collegekids and others would rather be responsible for paying the Cadillac tax than deal with the likely alternative, that her company would ditch the good plan and move them to a plan that covers less, with a higher deductible and larger copays.
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Possibly. Until now, users of employer-paid Cadillac plans have been shielded from the high cost of the fantastical benefits they enjoy. If their employers pay the tax rather than pass it along to the employees, they’ll continue to be shielded. If their employers require them to pony up a little more, they’re still far better off than users of the individual market, even under the new law. On the individual market, the only way to have both low monthly premium contributions AND low out-of-pocket is to be low-income.
I just discovered something that shocked me. Today my wife and I went to the Healthcare.gov website and filled out our application. It was the same arduous process as last year, do you smoke? are you disabled? are you American Indian? (optional)… all the information we gave last year, and we had to redo everything. I could write a few pages about the process and how the plans have changed, but here is what shocked me. When we finished the application we got to look at all of the plans and the cost, and some looked reasonable after subsidy, but something didn’t seem right. We received a “scare letter” from Blue Cross telling us our premium next year even after subsidy would be much higher. So I checked the subsidy amounts at different income levels for 2016 and found a calculator for 2015 and the tax credit amounts (subsidies) are 25% to 37% higher in 2016 than 2015!! For a 2 person family, a small part of the increase is due to our age being 1 year older than last year (higher subsidies for older people) but the eligible income range is $20,000 to $60,000 and the increases went from 25% at the bottom and gradually increased to 37% at the top. For a 2 person family making $60,000 (the top), last year’s subsidy was $1012 per month, next year will be $1388. All I have been hearing about has been the large increase in premiums. I had no idea subsidies were going to increase a like amount. (My usual disclaimer: I did not write this law!)
Don’t generalize about this. This is going to vary very much by geographical area and age of the buyers.
Your calculation is true in your area, for someone your age. It’s based on the second-cheapest Silver plan that your 2 person family could buy. In your area, the second-cheapest Silver plan got much more expensive, and the subsidy went up to cover premiums for that plan.
In other areas of the country, their second-cheapest Silver plan could have stayed about the same price, gone up, or even gone down if a new insurer entered the market with a lower premium.
tl;dr The subsidized family has to pay the same this year as last year. Their subsidy might be different, but what they have to pay is the same if they have the same income.
Do people (under the age of 65) in the US really have so many medical problems that they cost on average $10,200 per person in medical costs? I.e. if people are afraid of high-coverage medical plans being subject to this tax, that must mean that the groups covered under them must be having a lot of medical costs.
^^Kaiser Foundation study estimated that 26% of plans for singles will be subject to the tax in '18. I haven’t seen an estimate for family coverage, however.
A nice anonymous CCer sent me this article about some people in Chicago who are discovering that their health care subsidies are going down this year, because a new insurer entered the market with cheaper premiums:
http://www.chicagotribune.com/business/ct-cook-county-aca-subsidies-1105-biz-20151104-story.html
This might be behind a paywall, but here’s the gist:
Per capita GDP in the US is about $53,000. If full coverage of all medical costs is over $10,200 per person (based on the assumption that a full coverage medical plan for an under-age-65 person would cost more than that and be subject to the extra tax), then that is over 19% of GDP. Is that high a percentage of GDP spent on medical costs really sustainable?
“based on the assumption that a full coverage medical plan for an under-age-65 person would cost more”
Wouldn’t one assume the opposite? It would cost less - in some cases much less - for younger people?
Total medical spending for the US is about $10K/person, and that includes Medicare recipients. The amount is sustainable, but the trajectory isn’t.
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Today my wife and I went to the Healthcare.gov website and filled out our application. It was the same arduous process as last year, do you smoke? are you disabled? are you American Indian? (optional)… all the information we gave last year, and we had to redo everything.
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Arduous? Apparently you never had to complete an application for individual coverage before ACA. You had to list every doctor, every condition, every surgery, every medication, going back 10 years or more. And not just for the applicant, but for every family member. And if they accepted you (they were perfectly free to decline you if you were too sick), and you then got an expensive illness, they’d go hunting for errors in your application. If you’d forgotten to list the ear infection that Johnny had 8 years before you applied, they might rescind coverage for the entire family. Fraud, they’d say. Blue Cross (now Anthem) was infamous for this.
http://articles.latimes.com/2009/jun/17/business/fi-rescind17
Insurance applications back then were not only truly arduous; they were a minefield.
“Arduous? Apparently you never had to complete an application for individual coverage before ACA. You had to list every doctor, every condition, every surgery, every medication, going back 10 years or more. And not just for the applicant, but for every family member. And if they accepted you (they were perfectly free to decline you if you were too sick), and you then got an expensive illness, they’d go hunting for errors in your application. If you’d forgotten to list the ear infection that Johnny had 8 years before you applied, they might rescind coverage for the entire family. Fraud, they’d say. Blue Cross (now Anthem) was infamous for this”
That is just obscene. People with employer provided insurance never had to go through this (thankfully, and nobody should). No questions except for names and birthdates of those you wanted covered. What individual coverage applicants went through was so wrong, it seems practically illegal. In fact, why even get health insurance if they are going to deny you for every possible claim? What a scam.