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Limited Plan
Old 12-03-2013, 08:33 AM   #1
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Limited Plan

I just got my open enrollment for 2014 from my employer. Yes, I still work. One of the options is a new plan called the "Limited Plan"

It is designed to cover a limited number of services for a lower monthly premium. There are no dollar limits, but only covers 12 office visits, one inpatient hospital admission (5 days max), three outpatient service, 24 prescriptions and ER visits per year.

My employer had a lower priced plan that had annual caps. It was dropped and replaced with this.

Has anyone else seen this type of plan available, either from an employer or an individual plan?

I thought this was the kind of thing that ACA was supposed to protect us from.
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Old 12-03-2013, 09:15 AM   #2
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Employers don't have to offer ACA plans until 2015 or so? Employers have a different ACA compliance schedule than individual insurance policies. Not sure of all the details.
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Old 12-03-2013, 09:19 AM   #3
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The purpose of HI is to protect you from what you can't afford to pay for yourself. Since I have a reasonable amount of assets, I am more interested in a high deductible plan that minimizes premiums. I do want unlimited coverage after the deductible/OPM. I wouldn't get near a "Limited Plan." I'd go on the exchange or buy direct a real health insurance plan.
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Old 12-03-2013, 09:27 AM   #4
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Originally Posted by InTheSticks View Post
I just got my open enrollment for 2014 from my employer. Yes, I still work. One of the options is a new plan called the "Limited Plan"

It is designed to cover a limited number of services for a lower monthly premium. There are no dollar limits, but only covers 12 office visits, one inpatient hospital admission (5 days max), three outpatient service, 24 prescriptions and ER visits per year.

I thought this was the kind of thing that ACA was supposed to protect us from.
ACA won't apply for employer plans and mandates until 2015; that was a change made a few months ago.

That said, this is not true insurance. Insurance protects you from a catastrophic loss. And with its limits on visits and services, the "no dollar limit" aspect is pretty hollow. Any medical event that would blow through these limits leaves open-ended financial exposure to the insured, up to and including financial ruin. IMO that is not "insurance".
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Old 12-03-2013, 09:40 AM   #5
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No, I'm personally not going with the Limited Plan. I guess I'll have to wait until 2015 to see what they do.

The way they word anything from HR, they are leaving themselves the option to drop HI and pay the penalty.
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Old 12-03-2013, 10:23 AM   #6
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Are you going to buy your own insurance directly then?
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Old 12-03-2013, 10:32 AM   #7
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There are caveats, but employer plans must meet "minimum essential coverage" requirements. If yours doesn't you may be eligible to purchase individual coverage on the exchange with premium assistance.
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Old 12-03-2013, 10:33 AM   #8
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Are you going to buy your own insurance directly then?
My employer does offer other plans for more money. They do offer the kind of coverage I need.
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Old 12-03-2013, 10:36 AM   #9
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There are caveats, but employer plans must meet "minimum essential coverage" requirements. If yours doesn't you may be eligible to purchase individual coverage on the exchange with premium assistance.
In my open enrollment packet, it says they offer coverage that meets the "minimum essential coverage" requirement.

I wonder if the insurance companies have found a loop hole in the ACA. Maybe when the employer mandate is in effect in 2015, this will go away.
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Old 12-03-2013, 10:38 AM   #10
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The way they word anything from HR, they are leaving themselves the option to drop HI and pay the penalty.
Unfortunately, this is probably going to be what a number of employers of lower paid workers will do. The other part is many of them will reduce raises and possibly cut pay to cover the penalty. In an absurd way, this may actually benefit the employee who will now be eligible for a subsidy.
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Old 12-03-2013, 10:43 AM   #11
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Unfortunately, this is probably going to be what a number of employers of lower paid workers will do. The other part is many of them will reduce raises and possibly cut pay to cover the penalty. In an absurd way, this may actually benefit the employee who will now be eligible for a subsidy.
Yes, I work for an employer with lots of lower paid workers, retail.
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