My companies insurance is self funded, administered by Horizon BCBS.

 

How are the changes impacting the cost structure in a self funded program? I keep hearing this but have yet to see anyone explain it.

 

Mainly it would be the new mandates - like covering children up to age 26, birth control coverage, etc. I am sure there many other additional cost drivers. Also, remember that there are new and substantial taxes being applied to existing services and products that are causing the providers to increase their rates to 'insurers' - in this case the company is the actual 'insurer' since it is self-funded overall (absorbing all actual claims). These all drive new cost to companies that self-insure.

 

Since 2007 most companies have been very focused on 'cost take out'. This whole thing goes in the opposite direction. And large companies already had to deal with 50 sets of different state laws. Now they have to deal with a brand new layer of federal laws and regulations - ugh.

 

If companies continue to offer insurance - and I believe many will look to see how to drop it - they will pass the additional cost AND risk of cost to their employees. They have to to survive as they can not have unchecked cost increases.

If your company can provide GOOD insurance (Cadillac Coverage), they are facing taxation/penalties from the government which will lessen their ability/desire to do so from what I have read.

 

My portion of the premium has doubled from last year for the PPO plan, more or less forcing us to take the high-deductible plan. It's a gamble, given that I have three active, adventurous sons at home who are not immune to mono, staph, broken bones, and have a running "stitches above the neck" contest. We could be OOP (out-of-pocket) more than $7,000 this year if there is one major illness or injury. Kind of a new definition of "insurance".

Mainly it would be the new mandates - like covering children up to age 26, birth control coverage, etc. I am sure there many other additional cost drivers. Also, remember that there are new and substantial taxes being applied to existing services and products that are causing the providers to increase their rates to 'insurers' - in this case the company is the actual 'insurer' since it is self-funded overall (absorbing all actual claims). These all drive new cost to companies that self-insure.

 

Since 2007 most companies have been very focused on 'cost take out'. This whole thing goes in the opposite direction. And large companies already had to deal with 50 sets of different state laws. Now they have to deal with a brand new layer of federal laws and regulations - ugh.

 

If companies continue to offer insurance - and I believe many will look to see how to drop it - they will pass the additional cost AND risk of cost to their employees. They have to to survive as they can not have unchecked cost increases.

Forcing coverage of kids up to age 26 never was high on my list of likes. This and the preexisting condition clause are 2 things I could see driving up cost. Some of the others not so much, like covering BC. I would guess most insurance covers that now, at least every insurance we've had did/does. The added taxes will be another key factor and will be "interesting" to see the affect it has.

If your company can provide GOOD insurance (Cadillac Coverage), they are facing taxation/penalties from the government which will lessen their ability/desire to do so from what I have read.

 

My portion of the premium has doubled from last year for the PPO plan, more or less forcing us to take the high-deductible plan. It's a gamble, given that I have three active, adventurous sons at home who are not immune to mono, staph, broken bones, and have a running "stitches above the neck" contest. We could be OOP (out-of-pocket) more than $7,000 this year if there is one major illness or injury. Kind of a new definition of "insurance".

I'm confused by your first line. Why would they face penalties if they are offering insurance?

Forcing coverage of kids up to age 26 never was high on my list of likes. This and the preexisting condition clause are 2 things I could see driving up cost. Some of the others not so much, like covering BC. I would guess most insurance covers that now, at least every insurance we've had did/does. The added taxes will be another key factor and will be "interesting" to see the affect it has.

 

They were forced into that in 2010. As well as covering preventive care at 100%. Covering maternity with no waiting period is going to be a big added cost as well. I speaking to the Individual side of things.

SO is this worse than the GOP and people like myself state back during the election, or better?

Some health insurance gets pricier as Obamacare rolls out - latimes.com These people vote...........:lol::clap::isurrender:

 

The founding fathers had it right with the electoral college. The people should not be relied upon. I think you should have to take a competency test to vote.

I'm confused by your first line. Why would they face penalties if they are offering insurance?

 

Part of the way that Obamacare is to be funded is by taxing people with "Cadillac Plans" as extra income. That's why the unions are up in arms.

Okay. I always get confused when I hear people saying their healthcare rose. Mine has risen and was going to rise regardless and they told us in 2010 to be prepared for a significant rise in 2015. This all seems normal to me but maybe it is just where I work at.

 

That is the issue. Our health care costs are so disproportional to the rest of the world that Obamacare was supposed to be the way to make it more competitive. That was the idea, but as the legislation came into being and was finally rolled out....it's going to do anything but. Almost everyone saw this coming, but here we are. Something needs to be done about how much health care in our county outpaces the rest of the world by so much. This....this aien't it.

That is the issue. Our health care costs are so disproportional to the rest of the world that Obamacare was supposed to be the way to make it more competitive. That was the idea, but as the legislation came into being and was finally rolled out....it's going to do anything but. Almost everyone saw this coming, but here we are. Something needs to be done about how much health care in our county outpaces the rest of the world by so much. This....this aien't it.

 

I thought you drank the kool-aid on the first bolded part!

 

The problem is that the law creates a massive influx of revenue streams but does nothing to make anything more 'affordable.' No cost containment, no true lowering of rates. Just more dollars flowing into the system via mandatory participation and new taxes. If anything, the 'competitive marketplace' is less competitive.

 

The free market is not free at this point. That is not a financial 'free' but a reference to consumer freedom. Adam Smith's pure law of a free market states that consumers will stop buying if prices get too high. And thus, this action will force the marketplace to adjust its prices back to a reasonable level. Under AHCA that mechanism is gone. The consumer is forced, by law, to purchase the product - regardless of cost/price.

 

Is it easier for insurance companies and companies that provide their own employee insurance to be a consumer advocate and aggressively negotiate with providers across 50 states (plus now the Federal government) or is it easier to raise rates on buyers and employees? The answer is - the later. So no one is working to keep cost in check. Instead they will just raise rates, deductibles, co-pays, etc.

 

PS - I do not believe in the 'let the free market forces' work that is the standard 'alternative'. Medical services - even under the best conditions - would not be 'the answer' either.

I get my open enrollment packet tomorrow.

I get my open enrollment packet tomorrow.

Make sure you are sitting down when you open it...

Part of the way that Obamacare is to be funded is by taxing people with "Cadillac Plans" as extra income. That's why the unions are up in arms.

 

What is considered a Cadillac plan?

I'm confused by your first line. Why would they face penalties if they are offering insurance?

 

Not offering insurance...Offering GOOD insurance. The article I read called it Cadillac-level coverage. If no one has a Cadillac, the guys driving the 1998 Mercury won't feel so bad.

Make sure you are sitting down when you open it...

 

I already know what to expect. I am in our Executive Committee meetings.