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Dang - again? Fn health ins.

Discussion in 'RD's Lounge' started by sirbob, Sep 21, 2018.

  1. sirbob

    sirbob Well-Known Member

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    How high can this possibly go? For the last 5 years I have shifted to a lower plan and still pay more every year...

    This years gift is a 14% increase - the good news is it the first time it has been lower than 20% in the last 5 years.

    Who has the answer? How do I get quality care for less ? (That sounds like a BS tag line of some company!)

    IMG_5739.JPG
     
  2. 4Waters

    4Waters Well-Known Member

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    I don't think it can be done. Health care is now unaffordable.
     
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  3. sintax

    sintax Well-Known Member

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  4. 530RL

    530RL Well-Known Member

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    Turn 65...... :)
     
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  5. DRYHEAT

    DRYHEAT Well-Known Member

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    The unaffordable care act. Working as planned :rolleyes:
     
  6. sintax

    sintax Well-Known Member

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    From what I understand, you can just cross the boarder and get free health care?
     
  7. DrunkenSailor

    DrunkenSailor Well-Known Member

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    2100 a month? Good god. Can't wait for our new packet...
     
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  8. Done-it-again

    Done-it-again Well-Known Member

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    We got a 1% deduction on our business plan. Lol. Thanks Blue cross.

    Damn it’s a crap ton of $$$$$.

    BD2A7F32-B219-409B-B4CC-6815D75AC721.jpeg
     
  9. havasujeeper

    havasujeeper Well-Known Member

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    A full time Starbuck's employee gets free medical insurance. Have you ever considered being a barista?
     
  10. sirbob

    sirbob Well-Known Member

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    Did I mention that we are all healthy and haven't cost big blue hardly anything for all the years we have health ins.
     
  11. sirbob

    sirbob Well-Known Member

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    With these rates I should - but no, I'm just a lowly self employed guy with and S-Corp.
     
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  12. sirbob

    sirbob Well-Known Member

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    Another example of the BS game they play...

    Note my plan is called the Silver 1850 - it got that name because when I originally went to it, our deductible was $1850 per year.

    Today I see my deductible is going to be raised anther $500, so it will now be $7500 per person.

    I started on the Platinum / then went Gold / then Silver / Then silver 1850 - giving up benefits every year! i.e. higher deductibles with less coverage - to go along with my increases in fees.


    Screen Shot 2018-09-20 at 4.47.16 PM.png
     
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  13. sirbob

    sirbob Well-Known Member

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    I wanted to hit the like button to show you I agreed, but I could not bring myself to "like" your comment!
     
    Last edited: Sep 21, 2018
  14. 2Driver

    2Driver Well-Known Member

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    Dont forget to thank McCain too.
     
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  15. Cdog

    Cdog Well-Known Member

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    We went with Christian ministries coverage. So far we like it better than regular insurance.
     
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  16. HOOTER SLED-

    HOOTER SLED- Supercharged MOTORBOAT!!!

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    Pssst....change the last few letters to HMO instead of PPO like the rest of us poor folk. :D
     
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  17. 2Driver

    2Driver Well-Known Member

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    True story. My buddy retires and has a pile of cash to use for expenses last year so he left his portfolio in growth related stocks last year.

    His reportable income was almost zero so he and his entire family qualified for free or near free Obamacare depsite being worth millions.

    My wife and I seriously discussed getting divorced and one of us take the kid and no income for next to free healthcare and the other take the income and buy Urklecare
     
  18. mjc

    mjc Nosy Neighbor

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    I have been looking Liberty health myself. My quote was 279 a month and if i finish diabetes education it should go down to 189.
     
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  19. namba860

    namba860 Well-Known Member

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    Bunch of bullshit!
     
  20. Singleton

    Singleton Well-Known Member

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    My sister is self employed. Both her kids are 18, in college and work to prove very limited income and get health insurance via school for next to nothing.

    Sister pays cash for everything doctor related and it has been cheaper then paying Ocare bullshit fees
     
  21. Inland Air Balance

    Inland Air Balance Certified in something

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    I'm no math genius, so I maybe wrong, but you need to make $13.54 P/Hr (closer to $18 pre tax) to afford your health insurance? And nobody up on the hill see's anything wrong with this? I'm Self employed and covered under a Union contract (Owner-Operator) so I am both fortunate and screwed at the same time.
     
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  22. musicFunsun

    musicFunsun I Love BoBo!!!

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    Having to pay that much for insurance is beyond ridiculous
     
  23. bowtiejunkie

    bowtiejunkie Well-Known Member

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    I keep wondering when does it makes sense for a healthy individual/couple to drop health insurance and pay cash? A bit difficult to do when you have kids. For several years now, the gross billing of all medical expenses (me, wife, two kids) has been less than sum of our premiums + co-pays + deductibles. I wouldn't drop insurance, too much risk, but I've got to wonder about young healthy people.

    The gross premiums between my portion and employer portion is nearly $30,000. Healthcare costs are out of control. It has increased much more as a % than my wage over the past 10 years (and that's getting a raise of 4-6% every year).

    Many small and medium tech companies are starting to cover healthcare 100%. Seems unsustainable as the company grows.
     
  24. Joe mama

    Joe mama Well-Known Member

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    I had a mri with contrast and have a 4800 deductible. The amount to pay out of pocket towards deductible was 1700. The lady says if you want to pay cash the total will be 470 but won’t count towards the deductible.Wtf that’s a no brainer unless you know your going down hill fast. The whole insurance deal is screwed and I pay over 500 bucks a month just in case.
     
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  25. Go-Fly

    Go-Fly Where Are My Shoes?

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    Remove government, remove regulations, remove the middle man and welfare insurance. Until then, you have to insure your family and 14 other people that tell you to shut up, go fuck yourself and pay the bill.
     
  26. Halvecto

    Halvecto Well-Known Member

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    Look into the Indemnity ("Fee for Service") Health Insurance plans to fulfill the MEC requirement, then pair it with a high deductible catastrophe policy. It is about the only way to get coverage at a reasonable expense until you qualify for Medicare, unless an HMO is available.

    I am a business owner. I went to the indemnity plan for my family and utilize a Christian health-sharing program as overall coverage. The savings, quality of choice and care is very, very significant. It is a different process, but it's worth it for me.

    People forget or feel entitled, but insurance is a benefit, not a right. Insurance companies are for-profit. When they are forced by law to offer coverage for everyone, no matter the likelihood of need, they will price it to win. All insurance is built to beat you. Auto, Health, Life, etc. They try to make us think they are doing you a favor. Insurance is best when understood to be used for major, unexpected, irreparable accidents. Not to fix every little problem. It's not an investment, free medicine, rental cars etc. card. The math works for someone. They aren't giving it away out of the goodness of their heart.

    When Insurance is presented as the "penicillin" for all ills, run. It isn't a problem preventer, it aids in being a problem solver in situations that are outliers.
     
    Last edited: Sep 21, 2018
  27. Bear Down

    Bear Down Well-Known Member

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    Truth.. PPO here, family of 5 $142 per week and includes vision and dental (LOCAL 630). I bitch about it , but I am fortunate especially when my son had an MRI For $15 co pay.
     
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  28. HOOTER SLED-

    HOOTER SLED- Supercharged MOTORBOAT!!!

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    Lol....yup but sounds like you got Union gig pricing.....you pay maybe double what I do....pretty damn good for PPO coverage. Shit, I said the Union word....gonna get these fuckers panties in a bunch now. :D
     
  29. sirbob

    sirbob Well-Known Member

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    I'm certainly not looking for a freebie or for them to "give it away" but jeez you can't tell me that the cost increases I have seen are justified when looking at me or my family. Its bullshit cost shifting.

    Are you in Ca? if so could you please share the companies you are using? I'd like o look into those options.

    Thank You!
     
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  30. sirbob

    sirbob Well-Known Member

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    I've never hear of this? I see that Halvetco mentioned something like that also. I am familiar with Catholic healthcare West as a provider but not an insurance. have they now become an ACO? (accountable care organization) and provide ins. with the care?
     
  31. sirbob

    sirbob Well-Known Member

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    I had a MRI done a couple of years ago and got the bill and it was full price. I called the ins company and said I got pre approval - whats the problem?

    The said we approved it but never said we were going to pay for it - WTF did I need the approval for?:mad:
     
  32. ONE-A-DAY

    ONE-A-DAY Well-Known Member

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    It’s an association program that assists with paying claims, technically it’s not insurance so it does not meet the ACA requirements for the coverage mandates (last time I researched it) so you still will end up with the IRS issues for not having coverage. The fines are not currently being enforced however the bigger concern would be calling attention to yourself at the IRS which in the long run could far more costly then the ACA penalties.
     
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  33. ONE-A-DAY

    ONE-A-DAY Well-Known Member

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    Anthem small business rates came down, the other thing to research is their smaller network options which could reduce the premiums further. If you need some help let me know and I can run the numbers for you.
     
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  34. sirbob

    sirbob Well-Known Member

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    I pay my taxes and file on time - I want a low profile around the gov agency that tracks that stuff. I don't even want to type the agency name.
     
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  35. sirbob

    sirbob Well-Known Member

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    I used to have an Anthem small group plan but for my S Corp, they said I could not longer use it with the ACA in place.

    Anybody know the minimum number of employees to have to qualify for small group plans?

    I have 4 now.
     
  36. Ziggy

    Ziggy SlumLord

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    I hated renewing my biz health plan. Most often we'd end up changing carrier each year to get the best rate. Always got their best rate to switch but yr 2 renewal generally was out of the park.
     
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  37. ONE-A-DAY

    ONE-A-DAY Well-Known Member

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    2, as long as one of the two is a non-owner and on payroll
     
  38. sirbob

    sirbob Well-Known Member

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    Then why am I being told I can't access that?
     
    Last edited: Sep 21, 2018
  39. Ziggy

    Ziggy SlumLord

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    Walt, how positive have the people with HSA's been? I considered it but never convinced myself on the idea.
     
  40. ONE-A-DAY

    ONE-A-DAY Well-Known Member

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    Not all that popular anymore, the rate advantage went away, the interest gained for investing the funds in the HSA IRA get you next to nothing and the annual maximums that you can put aside in the account were reduced. Just doesnt pencil out like it did 5 years or so ago.
     
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  41. Done-it-again

    Done-it-again Well-Known Member

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    Message sent.
     
  42. ONE-A-DAY

    ONE-A-DAY Well-Known Member

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    California or Arizona based business / payroll?
     
  43. Ziggy

    Ziggy SlumLord

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    Thanks. Glad I stuck with my intuition.
     
  44. Halvecto

    Halvecto Well-Known Member

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    Yes. I am in Southern CA.

    https://www.uhc.com/individual-and-family

    The Indemnity Plan is part of the MultiPlan PPO network, if that is important to you.

    I started there and went through the process to decide which plan works for my family of 6, actually 5, as I chose not to be on it. Personally, I am very comfortable with just the health-sharing program (covers the whole family) , which is essentially a cash-payer model with reimbursement; imagine a healthcare co-op of like minded/values people pooling resources to provide for each other. We are with Samaritan Ministries and find it terrific. Yes, it is what insurance is supposed to be designed to do. But the government gets involved and eliminates the "like-minded" and/or "healthy" requirement. Everything you read about HUGE discounts for cash pay is true. Contrary to assumption, Doctors, hospitals, offices like cash pay and are happy to "work" with you. They get more, quicker than doing the old bill $5k, get reimbursed $3k 90 days later, then having to chase down patients for the 20% and/or deductible.

    Full disclosure: I am not an Insurance agent, nor a full-blown expert on all things health insurance. I formerly held a life insurance license, but let it lapse to avoid conflict-of-interest situations in my primary work (investment advisor / equity research). There are others on here that are very fluent and experienced in Health Insurance, Medicare, etc. and could help with the ins & outs of this. Like @ONE-A-DAY But I, like you , was forced into doing some serious homework and research to get a better system & price in place for my family. The cost-benefit of the what you are facing, just didn't add up for me.

    As for the health-sharing, here is a good primer on the subject. https://www.calhealth.net/health-care-sharing-ministry-comparison-review.htm

    Keep in mind, they too have requirements and restrictions for being part of the program. As a committed Christian already pursuing a life with integrity and excellence to honor the Lord, these are not an issue for me. As stated, the purpose is to allow common values/interest people to commit to sharing needs over time. I realize it's not for everyone.

    And Walt @ONE-A-DAY is correct, it is NOT insurance. They make it very clear that it is a voluntary program. Similar to donor-advised-funds, they cannot mandate like a contract coverage. In the end, we trust someone or something. Big corporation or big group of like-minded people.

    Here are some links that may help:
    https://altruahealthshare.org/how-it-works/statement-of-standards/
    www.alierahealthcare.com/individual-family/
    https://www.solidarityhealthshare.o...Zm4_YkTe-uWeJVN4bzyC7vwdAhwZQX48aAjJXEALw_wcB
     
    Last edited: Sep 21, 2018
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  45. wsuwrhr

    wsuwrhr The Masheenest

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    I pay 1000 a month for us four.
     
  46. Activated

    Activated Deplorable

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    Our HSA is going to be our bridge from early retirement to Medicare...and hopefully after.

    We max out our contribution, but pay our claims out of pocket. If something major happens, and we don’t want to pay out of pocket, we can use the HSA card.

    We are closing in on 10k in the account at this point. Hope our plan works.
     
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  47. Halvecto

    Halvecto Well-Known Member

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    While we are on the subject and if any of you small business-owners are dealing with health-care coverage options for employees, I came across a little known program that came out of all the changes in Healthcare the last few years.

    QSEHRA - Qualified Small Employer Health Reimbursement Arrangement. It allows me to determine a maximum amount of reimbursement for health insurance or healthcare services on a monthly basis. Tax deductible to employer, tax-free to employee. You can set the amount for individuals and families. Employee gets their own healthcare and submits an invoice or receipt.

    It is basically an admin program that generates the necessary documentation to get the tax benefit and prevent taxable 1099 inc to the employee.

    https://www.takecommandhealth.com/qsehra-guide
     
    Last edited: Sep 21, 2018
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  48. Halvecto

    Halvecto Well-Known Member

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    Walt @ONE-A-DAY is clearly a qualified expert and to be sure, if the economics were different, a traditional insurance plan is likely the most straightforward path. But for self-employed or small-business owner 40+ yr. old couples with children, paying the equivalent of a second mortgage every month for the opportunity of a $5k deductible and 80% coverage to see the medical help I desire is incongruent. I understand there are HMO and other options and if you work for a large company with scale, the numbers are different.

    Not to be a smarty pants, but I researched this carefully. When you complete your tax return, this exemption is clear.

    Section 1501 of Affordable Care Act carves out Health Sharing as "exempt":

    APPLICABLE INDIVIDUAL
    .—For purposes of this section—
    ‘‘(1) IN GENERAL
    .—The term ‘applicable individual’ means,
    with respect to any month, an individual other than an indi-
    vidual described in paragraph (2), (3), or (4).

    ‘‘(B) HEALTH CARE SHARING MINISTRY
    .—
    ‘‘(i) IN GENERAL
    .—Such term shall not include any
    individual for any month if such individual is a mem-
    ber of a health care sharing ministry for the month.
    ‘‘(ii) HEALTH CARE SHARING MINISTRY
    .—The term
    ‘health care sharing ministry’ means an organiza-
    tion—
    ‘‘(I) which is described in section 501(c)(3) and
    is exempt from taxation under section 501(a),
    ‘‘(II) members of which share a common set of
    ethical or religious beliefs and share medical ex-
    penses among members in accordance with those
    beliefs and without regard to the State in which
    a member resides or is employed,
    ‘‘(III) members of which retain membership
    even after they develop a medical condition,
    ‘‘(IV) which (or a predecessor of which) has
    been in existence at all times since December 31,
    1999, and medical expenses of its members have
    been shared continuously and without interrup-
    tion since at least December 31, 1999, and
    ‘‘(V) which conducts an annual audit which is
    performed by an independent certified public ac-
    counting firm in accordance with generally accept-
    ed accounting principles and which is made avail-
     
    Last edited: Sep 21, 2018
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  49. rivermobster

    rivermobster Club Banned

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    I am under the impression that Trump did away with the penalties for not having insurance.

    Did I read or understand what he did wrong?

    Thanks.
     
  50. Cdog

    Cdog Well-Known Member

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    We have Aliera Care. Family plan is around $650 a month with better care options than what we had access to for $1500 a month going the traditional route.

    Fuck obama!
     
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