Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Employee insurance and ACA
Old 10-31-2013, 07:59 AM   #1
Thinks s/he gets paid by the post
 
Join Date: Nov 2006
Posts: 2,268
Employee insurance and ACA

This may be a dumb question because I really dont understand all that much about the ACA. Ive browsed most of the threads here but still only have a very basically understanding.

My wife and I work at the same place. I have HI that covers me and she has HI that covers her and our son. The total cost is about $200 per month. The coverage isn't very good but that's another story. The exact same coverage goes to $1100 next year when we retire. Same coverage, same company but higher retiree rates. That seems very high to me considering we will be 50 and 46 but ages are not taken into affect at all.

Here comes the part where I dont understand the ACA. I went to eHeathinsurance and browsed the plans under the "2104 ACA compliant plans" tab. I backdated our ages to make us the ages that we will be next year and came up with plans ranging from about $500-$850. I assume thats with no subsidy since the rates are still high and I was never asked how much money I make.

Can anyone explain to me if there's any reason to stay with my company plan? I do know that if I ever leave the company plan I can never go back to it but at this point I dont see that as a problem. I see everyone talking about signing up at the government run site and all its problems, but I dont understand the relationship between that and signing up for HI thru eHealthinsurance or directly at an insurance companies site. Is there any difference? If I sign up for one of the plans I found am I getting HI thru Obamacare? Is getting HI on the open market the same thing?

Lastly, a friend of mine said he has to stay under the retiree plan even though its much higher than a similar plan under ACA because he has a pre-existing condition and signing up under Obamacare will be too expensive. Isnt HI under ACA supposed to cost the same for anyone of his age no matter if he has pre-existing conditions or not?
__________________

__________________
utrecht is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 10-31-2013, 08:11 AM   #2
Thinks s/he gets paid by the post
 
Join Date: Feb 2012
Posts: 1,104
DW and I (both 62) are in a somewhat similar situation. We have access to previous employer's insurance (local government) at full cost, which is ~$1100 a month. No deductible, reasonable copays; similar to what I had throughout career in government and private sector. We both enjoy excellent health but work on it.

I find HI to be confusing and something I have great suspicions of; as in will it really cover what might happen. As what we have is actually self insured but managed by United Healthcare, I tend to trust it. I know of cases where employer has stepped in on behalf of employee.

I assume we could save some bucks but I'm a believer in you get what you pay for, and we can afford what we have. I have option of leaving and coming back to it at any time (I did this when I entered private sector following career but decided work was simply no longer fun). Hence I've sort of taken a "meh" attitude to the new plans or anything available on market.
__________________

__________________
H2ODude is offline   Reply With Quote
Old 10-31-2013, 08:36 AM   #3
Thinks s/he gets paid by the post
 
Join Date: Nov 2006
Posts: 2,268
Ours is also self insured and managed by United Healthcare, but we have a $3000 deductible ($9k for the family) and overall fairly poor coverage. I tend to think that a bronze plan thru any company will be better overall coverage. I just dont understand the ramifications of making the switch.
Is a bronze plan purchased thru a broker like eHeathinsurance the same thing is going thru the government run state websites?
__________________
utrecht is offline   Reply With Quote
Old 10-31-2013, 09:02 AM   #4
Thinks s/he gets paid by the post
2B's Avatar
 
Join Date: Mar 2006
Location: Houston
Posts: 4,330
Using ehealthinsurance.com can be used to buy an ACA compliant policy but I'm not sure how you would qualify for a subsidy. On the Texas site there is a link for getting the subsidy that I didn't follow.

When looking at policies, be very careful. The deductibles and networks vary considerably for the plans I've looked at. The HMOs don't seem to have any out of network options but the PPOs do. Make sure you are comparing apples to apples with your current employer option.

My COBRA is $830/month with a $3,000 deductible/$11,000 max OOP. This is less that the $975/mo - $5,000 deductible/max OOP I found with BCBS. If I really got sick, I'd be better off with the lower max OOP from BCBS but DW and I typically don't meet the $3,000 deductible now. When I got rate info, I put in our birth dates so I don't understand what you did to get your quotes.

If your COBRA is higher than the policies available I would expect there to be some advantageous features to it. Look over the features carefully and compare it to what you find to be the best plan on the open market. The lowest monthly price may not be the best option.

The ACA does away with "pre-existing conditions" on getting HI. Your friend knows not of what they speak.
__________________
The object of life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane -- Marcus Aurelius
2B is offline   Reply With Quote
Old 10-31-2013, 09:24 AM   #5
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,613
Quote:
Originally Posted by utrecht View Post
My wife and I work at the same place. I have HI that covers me and she has HI that covers her and our son. The total cost is about $200 per month. The coverage isn't very good but that's another story. The exact same coverage goes to $1100 next year when we retire. Same coverage, same company but higher retiree rates. That seems very high to me considering we will be 50 and 46 but ages are not taken into affect at all.

Here comes the part where I dont understand the ACA. I went to eHeathinsurance and browsed the plans under the "2104 ACA compliant plans" tab. I backdated our ages to make us the ages that we will be next year and came up with plans ranging from about $500-$850. I assume thats with no subsidy since the rates are still high and I was never asked how much money I make.

Can anyone explain to me if there's any reason to stay with my company plan?
My understanding -- at least for employees -- is that you couldn't use the Exchange directly (or be eligible for subsidies) if you are offered employer-sponsored group coverage that costs less than 9.5% of your income. But if $1100 per month is more than 9.5% of your income, you would be eligible. (I don't know for certain if that also applies to retirees eligible for employer coverage, but I think it does.)

Also -- if you don't need any cost sharing or premium subsidies, even if you can't use the Exchange itself you could always buy directly from an insurer. (And you wouldn't have to endure the pain that is healthcare.gov, either.)

The other thing is the quality of the plan. Are the plans you are seeing on the individual market similar to your employer plan in terms of cost sharing? (I'm guessing they have more cost sharing, but at $250-600 per month cheaper you could self-insure a considerably higher deductible.)

Quote:
Originally Posted by utrecht View Post
Is a bronze plan purchased thru a broker like eHeathinsurance the same thing is going thru the government run state websites?
For the most part, if no subsidies are in play, yes, it should be substantially the same (though all the glitches may make it look otherwise). I don't believe the same plans offered off the exchange can be offered for a higher price through a broker.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote
Old 10-31-2013, 10:13 AM   #6
Recycles dryer sheets
 
Join Date: Jul 2013
Location: San Diego
Posts: 136
I'm tentatively targeting the beginning of 2014 for my retirement. I'm not completely sure that I can control income that first year; I want to move and hope to make > 250K profit. For that reason I'll probably take COBRA for the first year. It'll be $444 (vs c$700) with no deductible and $1500 OOP max. Thereafter, I can easily control my income and bring the subsidised monthly cost down to around $50. Kinks should be out of the sign-up process by then too!
__________________
Jackanory is offline   Reply With Quote
Old 10-31-2013, 11:13 AM   #7
Thinks s/he gets paid by the post
 
Join Date: Jul 2012
Location: Mississippi
Posts: 1,878
Ehealthinsurance doesn't sell plans with subsidy ( not yet but they can ), anyone can sell a ACA compliant plans.

The main reasons to stay with a retiree plan were it was available if you had preexisting conditions and many companies payed part of the cost. If your former employer is no longer paying for the insurance then you are probably seeing the full cost as a retiree.

The exchanges provide plans with subsidies, the open market does not, All are required to be ACA compliant.

You don't have to stay on a employee retirement plan ( or COBRA ), you can use the exchange with subsidies if you qualify.
__________________
rbmrtn is offline   Reply With Quote
Old 10-31-2013, 02:32 PM   #8
Thinks s/he gets paid by the post
 
Join Date: Nov 2006
Posts: 2,268
So if the employer isnt paying any of the cost (which it appears here) and income is too high for govt subsidy, there is no reason not to buy HI on the open market?
__________________
utrecht is offline   Reply With Quote
Old 10-31-2013, 03:49 PM   #9
Thinks s/he gets paid by the post
 
Join Date: Jul 2012
Location: Mississippi
Posts: 1,878
Quote:
Originally Posted by utrecht View Post
So if the employer isnt paying any of the cost (which it appears here) and income is too high for govt subsidy, there is no reason not to buy HI on the open market?
I think that is correct. If you don't qualify for subsidies then no reason to use the exchange, buy what ever you can find with the best deal. If you have an employer retiree plan that subsidizes that may be the best option, cost wise. And preexisting conditions ( real or imagined ) don't stop you from purchasing.
__________________
rbmrtn is offline   Reply With Quote
Old 10-31-2013, 04:19 PM   #10
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,613
Quote:
Originally Posted by utrecht View Post
So if the employer isnt paying any of the cost (which it appears here) and income is too high for govt subsidy, there is no reason not to buy HI on the open market?
I'm pretty sure that's true. There may be glitches now that make it look otherwise, but I believe the law requires that the base (unsubsidized) price of a policy offered on the exchange can't be sold at a higher price off the exchange. If that is indeed the case, then yes, you can find something on the open market and not deal with the shortcomings of healthcare.gov if subsidies and cost sharing are not in play.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote
Old 10-31-2013, 05:57 PM   #11
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
audreyh1's Avatar
 
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 16,521
Quote:
Originally Posted by utrecht View Post
So if the employer isnt paying any of the cost (which it appears here) and income is too high for govt subsidy, there is no reason not to buy HI on the open market?
That's what I intend to do. At this point I'd rather avoid going through the buggy exchange.

From what little I've looked, I'm not seeing price differences.
__________________
Well, I thought I was retired. But it seems that now I'm working as a travel agent instead!
audreyh1 is offline   Reply With Quote
Old 11-01-2013, 07:25 AM   #12
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
donheff's Avatar
 
Join Date: Feb 2006
Location: Washington, DC
Posts: 8,649
Quote:
Originally Posted by utrecht View Post
Lastly, a friend of mine said he has to stay under the retiree plan even though its much higher than a similar plan under ACA because he has a pre-existing condition and signing up under Obamacare will be too expensive. Isnt HI under ACA supposed to cost the same for anyone of his age no matter if he has pre-existing conditions or not?
Pre-existing conditions (PRCs) are irrelevant under the ACA so your friend has it wrong. The only risk is if the law changes (e.g. repeal of the ACA) and HI companies are able to reject applicants or charge higher based on PECs again. But that seems like a remote possibility. The elimination of PECs and keeping kids on family policies until 26 are so popular they are bound to be retained in some fashion going forward.
__________________
Every man is, or hopes to be, an Idler. -- Samuel Johnson
donheff is online now   Reply With Quote
Old 11-01-2013, 11:59 AM   #13
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,613
Quote:
Originally Posted by donheff View Post
Pre-existing conditions (PRCs) are irrelevant under the ACA so your friend has it wrong. The only risk is if the law changes (e.g. repeal of the ACA) and HI companies are able to reject applicants or charge higher based on PECs again. But that seems like a remote possibility. The elimination of PECs and keeping kids on family policies until 26 are so popular they are bound to be retained in some fashion going forward.
It's a lot harder to put the genie back into the bottle than to keep him in there to begin with. I think it's extremely unlikely we'll see insurers able to underwrite based on medical history again.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote
Old 11-01-2013, 12:51 PM   #14
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
audreyh1's Avatar
 
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 16,521
Now it's looking like DH will be better off signing up too, even though he can keep his old insurance if he wants. He'll have lower premiums with a bronze plan, plus he'll be eligible for an HSA account.
__________________
Well, I thought I was retired. But it seems that now I'm working as a travel agent instead!
audreyh1 is offline   Reply With Quote
Old 11-01-2013, 06:59 PM   #15
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
audreyh1's Avatar
 
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 16,521
FWIW - I called BCBS with a couple of questions today. Mainly to get a feel for my "real" deadlines.

When you enroll on-line directly with BCBS, you make arrangements then for how you will pay such as a bank draft. The person on the phone didn't know how long it would take to get materials to a person, but what matters was the on-line enrollment deadline and arrangements for payment.

Your first payment has to be completed by Dec 15, and if you arrange for a bank draft, they will draft it on that date.

I'll probably take a couple more weeks to research our issues - now DH and me and HSA accounts, although the latter is not time critical. But creating an HSA account for DH is a motivating factor in switching him to a new ACA compliant plan.

And then I'll sign up. I want to receive all our materials before Dec 15 so it doesn't interfere with any travel arrangements and related mail forwarding.
__________________
Well, I thought I was retired. But it seems that now I'm working as a travel agent instead!
audreyh1 is offline   Reply With Quote
Old 11-01-2013, 07:24 PM   #16
Recycles dryer sheets
 
Join Date: Jan 2005
Posts: 487
Quote:
Originally Posted by audreyh1 View Post
I want to receive all our materials before Dec 15 so it doesn't interfere with any travel arrangements and related mail forwarding.
Have they come up with a new plan for mail, also? I kid, I kid.....
__________________
tinlizzy is offline   Reply With Quote
Old 11-02-2013, 06:46 AM   #17
Recycles dryer sheets
 
Join Date: Apr 2013
Location: Humble
Posts: 188
The other posts are correct - pre-existing conditions cannot be used to deny insurance with ACA.

I think a lot of retirees and potential retirees with employer health insurance are in the same boat with you. Meaning - maybe it's cheaper just to go ACA. My HI (PPO) will be ~$900/month (husband & wife) with retiree medical. I looked at ACA and a PPO plan could be ~$700/month.

I think the next thing that we could start seeing are the Mega-corps that still offer retiree medical will start dropping these. With ACA, maybe it's no longer something they need to offer to attract and retain the desired employees?
__________________

__________________
Turn_the_Page is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


 

 
All times are GMT -6. The time now is 10:05 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.