Health Plans Up Significantly in 2014

[MichaelB]

The California calculator seems to give the same result as the Berkeley calculator, the same as the KFF calculator but with less granularity. The premium levels do not seem out of line to me. They are expensive, but actually a bit less than current policies with limited underwriting for the same age range.

 

[gerrym51]

You think maybe comments like these might have had something to do with it?

you know i put in the quote about covering more people.

does anybody here think the affordable care acts primary purpose is to get more people covered?

 

[REWahoo]

does anybody here think the affordable care acts primary purpose is to get more people covered?

I don't believe the politics behind the ACA are a subject for discussion on this forum.

 

[bondi688]

You think maybe comments like these might have had something to do with it?

So if any politics crept in in a thread, should that alone abort a very important discussion? Because if it is true that the health insurance premium can amount to 30% of the amount people plan to withdraw to fund the retirement, it needs to be confirmed that it is not a misunderstanding or exaggeration. ( I suppose Michael B just said that the calculator does not appear to be way off base ) Like I said, if that is true, people have to budget very differently or change the withdrawal rate to not go above a critical level.

 

[Bestwifeever]

So if any politics that crept in in a thread should abort a very important discussion? Because if it is true that the health insurance premium can amount to 30% of the amount people plan to withdraw to fund the retirement, it needs to be confirmed that it is not a misunderstanding or exaggeration. Like I said, if that is true, people have to budget very differently or change the withdrawal rate to not go above a critical level.

So far this thread has been civil and enlightening. It would be a shame for people to drag partisan politics and Porky into it, wouldn't it?

 

[gerrym51]

So far this thread has been civil and enlightening. It would be a shame for people to drag partisan politics and Porky into it, wouldn't it?

bestwife ever-we need you to start a new aca thread.i will keep my comments straight on facts

 

[Bestwifeever]

bestwife ever-we need you to start a new aca thread.i will keep my comments straight on facts

I'm glad you started a new thread. I am reading about the ACA but really don't have anything to say about it .

 

[audreyh1]

Whether or not they've succeeded is a matter of debate, but they definitely haven't seceded.

I got a notice that the Texas Health Risk pool will be wound down next year - maybe as early as Jan 2014. It depends on the TX legislature, of course. This affects your family too, no?

I read somewhere that some states were scrambling to wind down their risk pools sooner rather than later because there is more "transition money" available sooner rather than later. (not sure of the terminology).

 

[MichaelB]

I got a notice that the Texas Health Risk pool will be wound down next year - maybe as early as Jan 2014. It depends on the TX legislature, of course. This affects your family too, no?

I read somewhere that some states were scrambling to wind down their risk pools sooner rather than later because there is more "transition money" available sooner rather than later. (not sure of the terminology).

Policies on the state exchange satisfy the same need as the risk pool, so there is no need for both. I would expect to see this happen everywhere there is a risk pool.

 

[youbet]

It makes sense that rates should rise.

• The elimination of lifetime caps
• Not being able to screen people for pre existing conditions
• limitations of being able to increase rates based on age
• Substantially increasing the procedure and benefits (e.g. free contraception.)

All of these increase the cost for an insurance company to provide medical insurance. Now the quality of the product is higher so it certainly makes sense for the cost to be.


How much of an increase in premium we will see I have no idea, but they almost certainly will rise.

+1

While one can always argue that the increased benefits are necessary and justified, they will cost money. Out of the gate, there is little being done to control or reduce costs. Maybe something will happen later. Until then, higher rates seem to be the logical outcome.

 

[youbet]

My recollection is that FL is one of the states that has an elected insurance commissioner (most are appointed by the state's governor). You have what the electorate paid for.

Having the govenor appoint various commissioners works out real well for us here in Illinois since the governors are always subject matter experts and well known for their honesty and integrity.

 

[audreyh1]

Policies on the state exchange satisfy the same need as the risk pool, so there is no need for both. I would expect to see this happen everywhere there is a risk pool.

No state exchange in TX.

 

[MichaelB]

No state exchange in TX.

There will be a state exchange, run by the federal gov't.

 

[REWahoo]

I got a notice that the Texas Health Risk pool will be wound down next year - maybe as early as Jan 2014. It depends on the TX legislature, of course. This affects your family too, no?

No, DW went on Medicare this month so thankfully we don't have to be concerned about finding her a policy once the TX Pool goes away (I'm already on Medicare).

I feel for those who do have to make the transition - that has to be stressful wondering what will be available and how much it will cost.

 

[gerrym51]

i just read on a website that for 2014 open enrollment will be oct 1 2013 to 03/312014. for years after this it will be only oct thru december of prior year.

only exceptions are qualifying event

 

[Calico]

Having the govenor appoint various commissioners works out real well for us here in Illinois since the governors are always subject matter experts and well known for their honesty and integrity.

I left Illinois more than 30 years ago. I now enjoy living in a state where 9 out of 10 governors do NOT retire early to prison. Your post made me laugh out loud and brought back memories!

 

[MichaelB]

i just read on a website that for 2014 open enrollment will be oct 1 2013 to 03/312014. for years after this it will be only oct thru december of prior year.

only exceptions are qualifying event

This is how many of the guaranteed issue policies are managed today. Helps reduce the possibility of people enrolling only when they need expensive care.

 

[audreyh1]

No, DW went on Medicare this month so thankfully we don't have to be concerned about finding her a policy once the TX Pool goes away (I'm already on Medicare).

I feel for those who do have to make the transition - that has to be stressful wondering what will be available and how much it will cost.

Wow - the timing for your wife was very fortuitous.

I will be trying to figure out the transition. I suppose the state risk pools going away makes me eligible for the federal exchange, although I don't really understand the mechanism, or if I even need to go through an exchange. I guess I'll be figuring this out later this year, once I am notified of an official deadline.

Worrying about the cost - well, state risk pools are expensive! I don't expect it to be worse, but I might not be able to keep my current high deductible which keeps down my cost.

 

[pb4uski]

I seem to recall someone on one of these health care threads commenting that they didn't understand actuarial value or AV. I was reading something this morning that seemed to have a reasonably cogent explanation of AV so I thought I would post it here.

What is actuarial value and why is it important?

“Actuarial value” is a measure of how much of the average covered medical costs are paid by the health plan versus by the consumer. A 70-percent AV plan is predicted to cover 70 percent of an individual’s covered benefit costs during the year. If you buy a plan with an AV value of 70 percent, that means that you can expect to pay 30 percent of your medical costs through deductibles, co-payments and other cost sharing. Importantly, though, AV values are calculated based on averages and predicted costs. So although comparing AV values will help you compare all the different benefit plans, you cannot assume that a silver plan will cover exactly 70 percent of your costs. You may use more or less services than the average person.

Platinum, gold, silver and bronze have AVs of at least 90%, 80%, 70% and 60%, respectively.

Also see What the Actuarial Values in the Affordable Care Act Mean

 

[gerrym51]

I seem to recall someone on one of these health care threads commenting that they didn't understand actuarial value or AV. I was reading something this morning that seemed to have a reasonably cogent explanation of AV so I thought I would post it here.



Platinum, gold, silver and bronze have AVs of at least 90%, 80%, 70% and 60%, respectively.

Also see What the Actuarial Values in the Affordable Care Act Mean

here is an entire list from covered california gives every plan and actuarial value

http://www.healthexchange.ca.gov/So...BEX Standardized Designs w final av calc.pdf

 

[rbmrtn]

This is how many of the guaranteed issue policies are managed today. Helps reduce the possibility of people enrolling only when they need expensive care.

That's the way most group policies work, you enroll/make changes during the open enrollment period.

 

[Mulligan]

It appears more and more, those on grandfathered individual plans will lose them quickly, which unfortunately includes me. It appears people with BCBS will lose them quickly.

So what happens to the plans that don't meet the new minimum standards? They will likely disappear. A handful of existing plans will be grandfathered in, but the qualifying criteria for that is hard to meet: Members have to have been enrolled in the plan before the ACA passed in 2010, and the plan has to have maintained fairly steady co-pay, deductible and coverage rates until now.
The insurers in the Blue Cross Blue Shield Association are major players in the individual market. They are readying new product lineups for 2014, according to Kim Holland, the trade group's executive director of state affairs. She expects most existing Blue Cross individual plans to be discontinued.
"They are going by the wayside," she said. "Plans will have to conform to the higher level of benefits."

http://finance.yahoo.com/news/most-individual-health-insurance-isnt-101200230.html?.tsrc=attcf

I read in another article that insurance companies may stall the mandatory conversion process up to a year, by reenrolling them in plan this year, and then converting after the yearly renewal process occurs during the following year instead of January 1. A rare example of how increasing short term profits of company benefits the consumers finances, short term also.

 

[gerrym51]

It appears more and more, those on grandfathered individual plans will lose them quickly, which unfortunately includes me. It appears people with BCBS will lose them quickly.

So what happens to the plans that don't meet the new minimum standards? They will likely disappear. A handful of existing plans will be grandfathered in, but the qualifying criteria for that is hard to meet: Members have to have been enrolled in the plan before the ACA passed in 2010, and the plan has to have maintained fairly steady co-pay, deductible and coverage rates until now.
The insurers in the Blue Cross Blue Shield Association are major players in the individual market. They are readying new product lineups for 2014, according to Kim Holland, the trade group's executive director of state affairs. She expects most existing Blue Cross individual plans to be discontinued.
"They are going by the wayside," she said. "Plans will have to conform to the higher level of benefits."

Most Individual Health Insurance Isn't Good Enough for Obamacare - Yahoo! Finance

I read in another article that insurance companies may stall the mandatory conversion process up to a year, by reenrolling them in plan this year, and then converting after the yearly renewal process occurs during the following year instead of January 1. A rare example of how increasing short term profits of company benefits the consumers finances, short term also.

the bigger problem for a grandfathered plan would be adding more members

 

[Mulligan]

the bigger problem for a grandfathered plan would be adding more members

That process would take considerably longer to play out than the apparent immediate elimination of the plan itself next year. I would imagine virtually no one would drop their plan voluntarily, as the costs to join exchange will be significantly higher.

 

[ziggy29]

I would imagine virtually no one would drop their plan voluntarily, as the costs to join exchange will be significantly higher.

If you don't join the exchange, you could have to pay way more than 9.5% of your income in premiums. If that is the case for someone, why pay (say) 15-20% of your income in premiums by keeping your old plan when you can pay 9.5% (or less) through the exchange?

There are certainly a few situations where someone would want to pay (possibly a lot) more and keep their current coverage. But if a couple earns $35K and they can either pay $12,000 a year to "keep their plan" or $2,500 a year through the exchange (after subsidy)... what am I missing?

Now that Megacorp has kicked me to the curb, I'm doing the math and seeing that our situation will be fairly close to the hypothetical above. In any event, it looks like we'll be getting an 8-month short term policy to bridge the gap between Megacorp and the Obamacare exchanges (at 1/3 the cost of COBRA and almost as much coverage), as preexisting condition exclusions and avoiding gaps in "creditable coverage" for the purposes of HIPAA aren't really factors any more as long as you can make it to January 2014 before they become relevant.