South Dakota Health Exchange Pricing

[MichaelB]

Here's a link to South Dakota exchange prices. The most complete we've seen so far. with pricing broken out by age and rating area. South Dakota Department of Labor and Regulation - Division of Insurance - Companies Licensed to Sell Long-term Care Insurance in South Dakota

 

[Gatordoc50]

Is there a standard multiplier for the state or federal exchanges for couples and families? I think the New York exchange had a multiplier of 2 for couples and 2.85 for families.

 

[teejayevans]

Rates jump 2X going from 40->60. I thought 60 was the new 40 ;-)
TJ

 

[W2R]

Finally we get some idea as to what a plan might cost for a 60-year-old. The Gold individual (not group) plans for a 60-year-old in the four different areas of North Dakota average from $977 to $985.

IIRC that is almost exactly what Frank is paying for his (very nice, probably Gold) health insurance through his former workplace right now. As a retiree he has access to their health plans although he has to pay the entire amount.

What I gather from this rough comparison is that there are no surprises ahead - - neither a bonanza, nor devastatingly higher prices than previously.

Of course, it could be different in Louisiana. We are going to be relying on the federal exchanges. But at least this gives us some idea.

 

[Mulligan]

Finally we get some idea as to what a plan might cost for a 60-year-old. The Gold individual (not group) plans for a 60-year-old in the four different areas of North Dakota average from $977 to $985.

IIRC that is almost exactly what Frank is paying for his (very nice, probably Gold) health insurance through his former workplace right now. As a retiree he has access to their health plans although he has to pay the entire amount.

What I gather from this rough comparison is that there are no surprises ahead - - neither a bonanza, nor devastatingly higher prices than previously.

Of course, it could be different in Louisiana. We are going to be relying on the federal exchanges. But at least this gives us some idea.

If this is the going rate for 60 year olds, many will get the opportunity for a subsidy even without getting it from the exchange. Premium costs will be so high they will get it on the back end when filing income taxes. Anything over 10% AGI can be deducted off taxes. A married 60 year old couple making 70k a year would have a sizable amount to file with this plan.

 

[Htown Harry]

One additional interesting thing about the age 60 table - they posted the catastrophic plan premium alongside the metal plans.

Most of the data published so far has not included this information.

The news and blog coverage focuses on the catastrophic plans as they might be used by young people, but they can also be an option for ER's.

They will be an alternative (variation?) to Mulligan's "pay 10%+ and take a partial deduction" scenario.

Who is eligible for catastrophic plans?
Catastrophic plans may only be offered to individuals who:

• are under age 30 before the plan year begins, OR
• Have received a certification from an Exchange that they are exempt from the individual mandate because they do not have an affordable coverage option or because they qualify for a hardship exemption

How is affordable coverage defined?
Coverage is considered unaffordable for individuals if their cost of coverage exceeds 8 percent of annual household income...

If the individual is not eligible for employer coverage, affordability is determined by comparing to household income the lowest cost bronze plan (taking into consideration any applicable federal premium subsidies) offered in the Exchange where the individual would purchase coverage.

Health Care Reform – CMS Issues Proposed Rule: Catastrophic Plans

For North Dakota, one region's average bronze premium is $709, or $8500 per year. Dividing by .08 yields $106,000.

So for a married couple, both age 60, the threshold phasing out eligibility for a catastrophic plan would be $200,000+ ?!?

Hmmm. More research needed, and maybe a new thread. Is my math right? What are the pros and cons of catastrophic policy vs. a metal policy for a high-asset, low-income ER type?

 

[Gatordoc50]

One additional interesting thing about the age 60 table - they posted the catastrophic plan premium alongside the metal plans.

Most of the data published so far has not included this information.

The news and blog coverage focuses on the catastrophic plans as they might be used by young people, but they can also be an option for ER's.

They will be an alternative (variation?) to Mulligan's "pay 10%+ and take a partial deduction" scenario.

Health Care Reform – CMS Issues Proposed Rule: Catastrophic Plans

For North Dakota, one region's average bronze premium is $709, or $8500 per year. Dividing by .08 yields $106,000.

So for a married couple, both age 60, the threshold phasing out eligibility for a catastrophic plan would be $200,000+ ?!?

Hmmm. More research needed, and maybe a new thread. Is my math right? What are the pros and cons of catastrophic policy vs. a metal policy for a high-asset, low-income ER type?

The way I read it, you would use the 106000 number for eligibility.

 

[teejayevans]

If this is the going rate for 60 year olds, many will get the opportunity for a subsidy even without getting it from the exchange. Premium costs will be so high they will get it on the back end when filing income taxes. Anything over 10% AGI can be deducted off taxes. A married 60 year old couple making 70k a year would have a sizable amount to file with this plan.

If you already have other deductions and as you said you lose that first 10%, then if you have 10K in premiums, then 3K will be deductible and that equates to $450 tax savings (15% tax bracket) or 4.5% refund. Is that what you call sizeable?
TJ

 

[Mulligan]

If you already have other deductions and as you said you lose that first 10%, then if you have 10K in premiums, then 3K will be deductible and that equates to $450 tax savings (15% tax bracket) or 4.5% refund. Is that what you call sizeable?
TJ

No, I was referring to the amount to deduct as sizable not the refund. But for me, there is also the 6% state tax refund, too. And believe me the pencil would be sharpened on everything else tossed in there too such as dental and vision.

 

[Mulligan]

If you already have other deductions and as you said you lose that first 10%, then if you have 10K in premiums, then 3K will be deductible and that equates to $450 tax savings (15% tax bracket) or 4.5% refund. Is that what you call sizeable?
TJ

It stands to be a little more generous than you think Teejay, using my example and assuming my math is accurate (correct me if I am wrong). A married couple would have $23,520 in medical premiums for the gold. This leaves approx. $16500 to deduct off taxes, allowing for the 10%. This would mean a refund of over $2400. Throw in a persons dental and vision and it could be even more now since the threshold has been reached. Of course many people may be claiming that already as I am still in the underwritten policy mode where premiums in my state have been substantially cheaper than that.