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Old 08-30-2010, 10:38 AM   #21
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Anyway, it does have a lifetime limit of 1MM, $2000 deductable, up to $4400 out of pocket and costs a 60 yo about $550 per month.
Have you compared it to reg. ins. co?
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Old 08-30-2010, 10:42 AM   #22
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Hah, that's certainly up for debate....I've yet to come across someone eligible for the risk pool that could afford the premiums. The premium for age 55+ in Virginia is $616 per month. A $2500 deductible HSA plan with 100% after deductible is about half that price on the individual market, so I don't know where they got the "equal a standard rate for a standard population" bit. The PICP benefits also require co-payments after deductible, they are not paid 100% and there is an out of pocket maximum of $5,950.
I was wondering about that as well. Is it the fed run pool and no opt out by the state? The Virginia price is higher than the Minnesota risk pool price, which is not a federal plan and the price does not have to comply with the federal price guidelines. When Minnesota was looking at what to do it realized that its current plan would cost older people more than a federal plan but the federal plan was fatally defective by having the 6 month wait. Do you have a link for me on the Virginia plan?
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Old 08-30-2010, 10:45 AM   #23
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Yep. DW is in our risk pool and those eligible for the fed pool will pay roughly 50% less in premiums than she pays. And to think I once believed going naked on health insurance coverage was a bad idea...
I read that applicants for the risk pool in Texas were being told to try to go without and wait for the fed pool as it would be so much cheaper. What a risk to have to take!
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Old 08-30-2010, 10:47 AM   #24
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One of the biggest problems I have with this risk pool is that they will not allow HIPAA-eligible individuals to get into the risk pool. HIPAA rates for a similar policy can be 2-4x that price.
Yup. Just like you can't move from a risk pool to the fed pool. Again, it is the "six months without insurance" problem.
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Old 08-30-2010, 10:51 AM   #25
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I was wondering about that as well. Is it the fed run pool and no opt out by the state? The Virginia price is higher than the Minnesota risk pool price, which is not a federal plan and the price does not have to comply with the federal price guidelines. When Minnesota was looking at what to do it realized that its current plan would cost older people more than a federal plan but the federal plan was fatally defective by having the 6 month wait. Do you have a link for me on the Virginia plan?
https://pcip.gov/StatePlans.html

Click on Virginia. Looks like MN is one of the cheaper states. Are you sure it's not the federal plan? It is one of the PCIP plan states according to that link.

Florida is $773/month for age 55+. Yikes.
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Old 08-30-2010, 11:04 AM   #26
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https://pcip.gov/StatePlans.html

Click on Virginia. Looks like MN is one of the cheaper states. Are you sure it's not the federal plan? It is one of the PCIP plan states according to that link.

Florida is $773/month for age 55+. Yikes.
Thanks, I'll poke around later. Yes I am sure Minnesota is not the federal plan. It is the oldest risk pool in the country and when I last checked it had the highest enrollment. It also is cheaper than most if not all state pools that offer similar coverage. (three million lifetime limit, relatively low maximum out of pocket). You can even get an HSA plan through the pool if you want.
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Old 08-30-2010, 11:05 AM   #27
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Thanks, I'll poke around later. Yes I am sure Minnesota is not the federal plan. It is the oldest risk pool in the country and when I last checked it had the highest enrollment. It also is cheaper than most if not all state pools that offer similar coverage. (three million lifetime limit, relatively low maximum out of pocket). You can even get an HSA plan through the pool if you want.
Maybe they are running both?
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Old 08-30-2010, 11:22 AM   #28
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Yes, there are two different plans. I did not know that there also was a fed plan run in Minnesota. The plan in your link is a federal plan that you could go on instead of the Minnesota risk pool. It is run separately from the pool as Minnesota chose to do nothing and did not want to change its risk pool to comply with federal requirements. The price structure is different than the Minnesota pool, which has five year rate bands. This means that if you are 55 and on the Minnesota pool your rate would be $546 for a $2000 deductible or $396 for a $5000 deductible. So your rate is lower than under the fed plan. The fed plan has a $2500 deducible and a rate of $583 if you are 55 or older. But, because of how the rate banding works, if you are 60 your rate on the Minnesota pool goes up to $612 for a $2000 deductible or $596 with a $5000 deductible. Though arguably the Minnesota plan is still cheaper because of the deductible differences.

The analysis is complicated because prescription drugs are treated differently.

Life is so damn complex. Imagine shopping for insurance right now and how many things you have to look at. And in the end, you may find that you have no real choice at all.
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Old 08-30-2010, 11:31 AM   #29
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Yes, there are two different plans. I did not know that there also was a fed plan run in Minnesota. The plan in your link is a federal plan that you could go on instead of the Minnesota risk pool. It is run separately from the pool as Minnesota chose to do nothing and did not want to change its risk pool to comply with federal requirements. The price structure is different than the Minnesota pool, which has five year rate bands. This means that if you are 55 and on the Minnesota pool your rate would be $546 for a $2000 deductible or $396 for a $5000 deductible. So your rate is lower than under the fed plan. The fed plan has a $2500 deducible and a rate of $583 if you are 55 or older. But, because of how the rate banding works, if you are 60 your rate goes up to $612 for a $2000 deductible or $596 with a $5000 deductible. Though arguably the Minnesota plan is still cheaper because of the deductible differences.

The analysis is complicated because prescription drugs are treated differently.

Life is so damn complex. Imagine shopping for insurance right now and how many things you have to look at. And in the end, you may find that you have no real choice at all.
Most people shopping for health insurance don't even know what their deductible is, how co-insurance works, or what their plan limitations are. Health insurance is by far the most complex insurance product that I know of. LTC and disability are complex too, but for other reasons.

Of course, if you get rid of all of the agents who can how it works to people, you will only have government employees to do that job. Ever tried to call the government to get information on Medicare? Who pays the government employees? Should be interesting to see how it unfolds...I can always just sell life insurance if they want to make my life difficult.
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Old 08-30-2010, 11:38 AM   #30
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Is your family healthy enough to qualify for an HSA plan? That would limit your max out of pocket to a much lower number.
Yes, we qualify medically. We are 3.5 and 5.5 years from Medicare. When we do the arithmetic each year and include our Flex benefit, it is almost the same annual cost between the HSA option and the PPO option (including drug).

Maybe it's worth another careful look. We are in a state of Fla retiree self-funded group with BCBS as the third party administrator. We are at least weighing a possible out-of-state move in a couple of years (pre-Medicare) and our current plan supports that with numerous out of state providers in most cities.

Too many "ifs, maybes, who-knows, and guesses" but at least we have coverage despite FIRE.
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Old 08-30-2010, 11:47 AM   #31
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Yes, we qualify medically. We are 3.5 and 5.5 years from Medicare. When we do the arithmetic each year and include our Flex benefit, it is almost the same annual cost between the HSA option and the PPO option (including drug).

Maybe it's worth another careful look. We are in a state of Fla retiree self-funded group with BCBS as the third party administrator. We are at least weighing a possible out-of-state move in a couple of years (pre-Medicare) and our current plan supports that with numerous out of state providers in most cities.

Too many "ifs, maybes, who-knows, and guesses" but at least we have coverage despite FIRE.
Keep in mind that if you have an HSA plan, you can max-fund the HSA up to the contribution limits and use any leftover money to pay Medicare premiums on a pre-tax basis at age 65. There is an additional catch-up contribution for ages 55+. I would think the out of pocket limit on an HSA plan would be less than a similarly priced traditional plan, but sometimes the differences in group coverage aren't that great and buying your own coverage might not make sense if it's heavily subsidized by the employer.
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Old 08-30-2010, 12:15 PM   #32
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It is very interesting to see the regional and state by state cost differences for the federal plan. The south half of the US is generally very high. The upper midwest/west tend to be much lower (though not what I would call low). Looks like Wyoming is the lowest. And then throw in a few oddballs for flavor.

It would be interesting to see what the cost comparison is for the state risk pools, both those that are complying with federal risk pool rules and those that operate their stand alone plans. Hard to compare though as coverage differs so much from state to state.
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Old 08-30-2010, 12:19 PM   #33
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Most people shopping for health insurance don't even know what their deductible is, how co-insurance works, or what their plan limitations are. Health insurance is by far the most complex insurance product that I know of. LTC and disability are complex too, but for other reasons.

Of course, if you get rid of all of the agents who can how it works to people, you will only have government employees to do that job. Ever tried to call the government to get information on Medicare? Who pays the government employees? Should be interesting to see how it unfolds...I can always just sell life insurance if they want to make my life difficult.
How much health insurance do you sell now that isn't group insurance? A couple of insurance agents I know both say that over time that market has dried up and mostly gone away. Individual plans are such a small part of the market these days.
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Old 08-30-2010, 12:23 PM   #34
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How much health insurance do you sell now that isn't group insurance? A couple of insurance agents I know both say that over time that market has dried up and mostly gone away. Individual plans are such a small part of the market these days.
About 95% individual and 5% group. The group market is a whole different animal and requires a different type of marketing. The groups I do are usually husband/wife groups that can't qualify individually or would be cheaper on a group basis. Many groups have simply dropped coverage because they can't afford to keep paying for their employees' costs as the rates get jacked up 20% a year. Another agent that I know locally who focuses mainly on group insurance has lost about half his business (and renewal commissions) in the past year just from groups dropping plans altogether.
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Old 08-30-2010, 01:06 PM   #35
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Keep in mind that if you have an HSA plan, you can max-fund the HSA up to the contribution limits and use any leftover money to pay Medicare premiums on a pre-tax basis at age 65. There is an additional catch-up contribution for ages 55+. I would think the out of pocket limit on an HSA plan would be less than a similarly priced traditional plan, but sometimes the differences in group coverage aren't that great and buying your own coverage might not make sense if it's heavily subsidized by the employer.
Thanks. This would all be within my state retiree plan. I think the HSA max is only $1500 per year (and none from the employer since I terminated). For the 3 year gap before MC, I had kind of decided it's not worth the trouble, but I will revisit it next open enrollment period.
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Old 08-30-2010, 01:10 PM   #36
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Thanks. This would all be within my state retiree plan. I think the HSA max is only $1500 per year (and none from the employer since I terminated). For the 3 year gap before MC, I had kind of decided it's not worth the trouble, but I will revisit it next open enrollment period.
Federal guidelines for max HSA contributions are $6,150 per family this year and if you're over 55 you can add another $1,000 to that. I'm not sure how that applies to self-insured plans though. Could the $1,500 max possibly be the out of pocket maximum for the policy?
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Old 08-30-2010, 01:14 PM   #37
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Thanks. This would all be within my state retiree plan. I think the HSA max is only $1500 per year (and none from the employer since I terminated). For the 3 year gap before MC, I had kind of decided it's not worth the trouble, but I will revisit it next open enrollment period.
Rich,
The employer contribution is just an incentive for you to move to the HSA. You may want to look at the HSA in terms of tax implications (and why you don't want the employer contribution).

The annual contribution will reduce taxable income by a percentage. Given current interest rates, you get a more in a tax reduction than you can earn on the contribution. At least that was my reasoning when I started my HSA this year (year 2 of retirement).

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Old 08-30-2010, 02:01 PM   #38
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Rich,
The employer contribution is just an incentive for you to move to the HSA. You may want to look at the HSA in terms of tax implications (and why you don't want the employer contribution).

The annual contribution will reduce taxable income by a percentage. Given current interest rates, you get a more in a tax reduction than you can earn on the contribution. At least that was my reasoning when I started my HSA this year (year 2 of retirement)
Thanks Rita. Time to revisit the issue. BTW it's not that I don't want the employer contribution, it's the fact that I will no longer be an employee so it's unavailable.

Rich
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Old 08-30-2010, 02:31 PM   #39
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With just a couple of years to go before Medicare kicks in, an HSA account might not be worth the hassle, especially if your taxable income is lower and you are able to deduct most of your premium cost. HSA account management has not been fully embraced by most of the large financial institutions, and where it has been the costs are high and options limited. Most HSA options are with separate businesses set up for that purpose with limited liability.

We have been using HSA's since '06. Pleased with the tax benefit, not so much with the account maintenance.

Edit - I don't mean to sound negative on HSA - they are a good idea and can be useful. Hopefully, the mainstream financial institutions haven't embraced them yet because of the credit crisis and not another reason. A decade of potential tax-deferred accumulation makes the effort worthwhile, and I'm not sure a couple of years would.
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Old 08-31-2010, 01:02 AM   #40
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What I have found most interesting about the Health Care Reform bills temporary bridge is the amount of people it will cover. Taking Oklahoma for example they are spending tons on advertising and when you read the fine print, state is getting $60MM from Fed's and only 1500 people will be able to get the coverage if they can afford it.

I was just surprised at the high cost of $40000 fed subsidy per person covered.

I know we couldn't afford the rates quoted, but suppose there are 1500 in the state that will, not sure.

PS If you look the $5B being spend nationwide, only 125000 will be covered. Will be interesting to see how many will end up signing up in the end.
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