Val was recently shopping for health insurance. (Shoot the breeze thread) My office was as well. Our premium jumped 40%. We are a very small group with very few options.

I have noticed a trend for the insurance companies to offer the basics in preventative care and now tack on a deductible that "kicks in" as soon as you need diagnostic testing, minor surgery, major surgery or hospitalization,or other services. I realize we all have to share in the costs, but it's out of control. The cost of a single plan is now two times what a family plan was just a few years ago. Employers are passing most of the additional costs on to employees (at least in my world )

The state of MA now requires their residents to have health insurance, even if you are unemployed. There are programs to help those with low incomes, but the plans honestly leave a lot to be desired. The state has mandates of what the coverage must include. By 2009, you must have some preventative care, and a drug program and no cap on the policy. All good. However, if a single plan has more than a $2000.00 deductible, you don't meet the guidelines and are subject to a fine, as if you were not insured (even if this is the policy offered by your employer!).

I will now have a $1500.00 deductible such as the one I described above. Little cost if I visit a doctor for a checkup, but the minute I show up with an issue the $$ starts going out of the pocket, as soon as a test or lab work is ordered. MANY years ago, you paid for your own "well visits" and the insurance company paid when you were sick. Maybe we need to see more of that again, as I fear deductibles which apply to any illness or diagnostic testing may just keep some people away from the doctor's office.

I recently read how very often the same type of policy with the same coverages can be much less from state to state. What do you see in your area?

 

I have a "High-Deductible Health Plan" by choice. It is the lowest-cost (to the employee) option offered by my employer. Routine care is covered up front (so they say, I've not taken advantage of it in the two years under this plan); I'm responsible for the first $2,100 per year in charges for other than recommended routine care BUT I get to contribute $2,100 per year to a tax-free Health Savings Plan. If I use the money to pay the deductible, it is not taxed; if I don't use it it keeps rolling over until I do use it for qualified medical expenses. The money can even be used tax-free to pay for MediCare premiums or deductibles, if not spent earlier. There's even an additional "catch-up option" for those of us over 50. However, the rate of return on the account is really low, and my employer will stop paying the ($3/month, I think) fee on the account when I retire.

I was amazed to find that a thirty-something co-worker with 3 children found that the high-deductible plan with HSA met his needs at a lower cost than the other options.

Unfortunately, I think that the deductible has to be $2,100 to qualify for the tax-free "Health Savings Account." If that's true, you might be better off with a higher deductible paid with tax-free dollars. If you pay under a traditional plan, your out-of-pocket expenses have to be a pretty high percentage of taxable income to be deductible. You should have your employer check into HDHP with HSA; it may be a tough sell with the employees at first, but it could actually be the best deal for them.

Keep in mind that these comments are from a beer-fueled layman whose knowledge of public policy matters is limited to the newspaper and Newsweek.

 

Just re-read your original post. Mitt Romney's legacy policy is really screwed up: if the deductible is over $2k you violate MA law, but if it is under you don't qualify for a tax-free Health Savings Account under federal law. This tells me all I need to know about the legacy the presidential candidate left behind in MA.

 

Ed,

Our company is VERY small. There will be no cafeteria plan, HSA plans, or any of those kinds of benefits. Benefits are limited. According to the insurers, our group is too small to even offer more than one choice of health insurance plan so our insurance is what the boss wants it to be.

I'd opt for an HMO with the same company if given the choice. The price is about the same, and the deductible does not apply to most testing.

I hope I've stated the facts of the MA mandates correctly. Maybe there are instances where HSAs are allowed to cover large deductible plans, but that was not the way I read some of the notices received at the office. Overall, as said in another post, I'm not impressed with the program that Mr. Romney has founded.

Not sure where the solution lies. I know I posted much of this in another thread, and have started threads about it before. This issue concerns me more every time we renew our policy. People needing to buy their insurance own their own, or those working for small business continue to see hefty premium increases but receive less benefits each passing year.

 

I agree that there is inherent unfairness in the system: for example, my HSA makes my medical deductibles tax-free, while those under other plans can only deduct medical expenses if they exceed a fairly high percentage of income.

Many of the small business owners I know resent their role in employee health care. That's not what they're good at or why they went into business. Even the big automakers say they're disadvantaged having to compete against companies from countries where the government, not the employer, pays the bill.

I don't know an answer. Perhaps that is what separates me from the current crop of Presidential candidates: I know my limitations.

 

It's not just small companies. I work for an extremely large company (Around 100k employees in the US) and I have seen this increase in deductible for the last few years. For my family it's now around $4k a year for the family and all I seem to see is a increase in premium at each renewal. This year it went from $287 a month to $334 for the exact same coverage. The year before that it was $245 and the year before that $176

 

Hey, on another matter, think about taking a ride our way for the Nor'Easter, next summer it's only a 12 hour ride for you. Piece of cake in the S.

You were one of the first folks we met at SF05. It'd would be nice to see you again.

 

I'd like to see the New England group again. You and Rick graciously allowed me to join you for dinner; I remember Chazmo from FCT04; and of course everyone remembers Bill and Barbara and "Daydream Believer", etc. I've actually been hanging around in the New England forum quite a bit: you all have a lively group even if I haven't met a number of the players.

I'm looking at Nor'Easter. I wanted to go this year, but had to cut way back on car-related activities.

 

I'm in a similar plan. My employer also kicks in $500/yr to my health savings account. They also pay me $100 to take the annual physical that the plan covers for free.

I'm happy with the plan, but I suspect that it doesn't appeal to many people. When my enrollment docs were delivered to me they were all filled out by hand. I can't imagine that they would do that if tens of thousands of employees had signed up for this plan. A lot of people just wouldn't be able to justify the risk that comes with this plan. As long as you stay healthy it's great. But for family coverage the max out of pocket per year is almost $9000 if you stay in plan -- over $14,000 if you go out of plan. Ouch!

 

We enjoyed our dinner with you in WV. That was our first meet out of the New England area. I've seen you post in New England recently! We do have a cast of characters there, and they are great folks, always willing to help with a project.

We didn't have the Nor'Easter in 2007, it is a HUGE undertaking, but we are on for 2008, right in my backyard!