Pulaski

And never mind the risk of getting sick or injured, you will be fined by the IRS if you don't arrange health insurance within, I think, three months.

SanDiegogirl

.... oh yes, forgot about this ......

kodokan

Bit puzzled... if HD plans are great for the healthy employee who's now paying low premiums and a few hundred dollars extra for a minor doctor visit, and banking the difference, then why are companies wanting their employees to switch? Surely the company wants employees to continue to pay high premiums for hardly ever accessing medical services.

Hubby's company offers a HD plan along with two traditional plans. They've just announced that as of next year*, the HD plan will be completely premium-free for employees and, as far as I know, they'll still continue to add a $1k bung to the emoloyee's HSA. So they're REALLY pushing it.

*Theyve actually said that they'll pay everyone's premiums for the remainder of 2016, but for 2017 onwards only the HD plan will be free.

I can see what's in it for us; as you know, I'm a big fan of the HD/ HSA scheme. But what's the upside for the companies? Less complacent employees who take more responsibility for their health, and are in the long term cheaper?

MidAtlantic

That is exactly how it is promoted by my employer and insurance company.

Pulaski

This, so far as I can tell, .... and either encouraging workers to become more healthy, or discouraging unhealthy workers from joining the company.

The loss of time and/ or inconvenience of unplanned absences from the workplace for health reasons is a significant cost to employers, and it can be significantly reduced by employing healthy people.

kodokan

The 'targeting healthy people' model makes sense. Lord knows the 'informed consumer' model is a deluded fantasy - every time, I ask in advance what the bill will be, and every time they're unwilling to give give me details and, when pressed, unable to tell me anything more helpful than 'ooh, probably somewhere in the $200-500 range, but we reeeeeeally don't know until it's submitted'.

hsc0307

Good reading.
I am sure I will be at the upper end of the premium range with Diabetes and Asthma

durham_lad

I think that the reason most folks choose the high premium/low deductible route for health insurance is that they are not as money savvy as the folks on this site. Recent surveys show that almost half of all Americans cannot afford to pay an unexpected $400 bill, so a trip to an emergency room or even a sudden illness requiring visit(s) to the doctor would catch them unprepared. Such an event would put them in serious financial difficulty if they had a high deductible plan and had not been saving in an HSA or elsewhere for this unexpected emergency.

Last year I had such an event resulting in a visit to the ER on a Sunday night and then visits to a cardiologist who ordered 3 tests. Two times at reception someone in front of me refused to have a test such as an echo cardiogram because they could not afford their share of the bill. My own out of pocket costs for the ER trip (I drove myself and spent 3 hours there), 2 cardio doc visits, 3 heart tests (echo, 48 hr heart monitor, and nuclear stress test), plus a visit to my own doctor cost over $5k. I dipped into the savings we had set aside for such spending but fully understand why plenty of folks are simply not prepared for such expenses.

https://www.washingtonpost.com/news/...d-400-expense/

Pulaski

Agreed, and they are the same people who pay $1,000 to rent a home that they could buy for $500/mth if they were ever disciplined enough to save a deposit.

As it is they will arrive at retirement still renting, instead of sitting on a paid-off asset that would give them almost free housing in retirement or they could sell, or refi, to release substantial capital.

sir_eccles

Sounds like a case of "affluenza" or "privilegitis" to me, you should have that looked at.

Setting aside the notion that they should "just save up" many people are disenfranchised by the banking system, preyed upon by pay day lenders and already burdened by medical debt.

Pulaski

It isn't causing me any problems.

petitefrancaise

Our health insurance is "aetna" but not really - it is funded by the company and aetna administers it.

They are also really pushing the HD/HSA option too. On the website for employees it is possible to do a search for a medical procedure with pricing as a filter. The same MRI of a knee can vary in price from $550 (Radiology clinic) to over $3k (local hospital) within a 10 mile radius of my house. So I can understand why they want us all to be "aware" consumers.

username.exe

My workplace is in open enrolment right now, so I have about a week to decide how I'm going to do it this year. Last year I was pretty green and had about two weeks to digest a massive packet of info from HR before having to sign up to a bunch of healthcare, life insurance options etc.
This thread has piqued my interest; but after a year or so in the US I'm still getting to grips with a lot of the finer details.

A HD plan would probably work for my family as we tend to take good care of ourselves and rarely if ever visit the quacks.

If I turn down the group plans offered, work will still give me a 'credit', but only about half as much as if I buy one of the plans they offer. That said, I'll likely be spending a few hundred as opposed to roughly $10k in premiums.

When I last looked into HSAs, I came to the conclusion that it wouldn't work for me as you lose the balance of whatever is in the account after 12 months.
Is this just peculiar to my workplace? Is there an alternative HSA product that I can buy on an open marketplace outside of work, and have my salary apportioned there pre-tax?

Also, where does one go to purchase an HD plan if they're not offered through work - on the exchange or do you just ring around and get quotes?

One final question - how do you all go about picking the optimum level of life insurance for yourself and your spouse/partner? Some kind of calculation on assets and liabilities, or do you just plop for the biggest payout?

Thanks all for the discussion.

Pulaski

I think you have confused a Healthcare Spending Account with a Healthcare Savings Account. The difference is primarily set by the IRS, not your employer. A Spending account is a "use it or lose it" account whereas a Savings account is yours for keeps, and I think is usually held at a bank, not in your employer's HR system, so mine is held with Wells Fargo. Because a Savings account is yours to keep, it stays with you when you switch jobs, whereaI don't believe that is true with a spending account.

If your employer doesn't offer a HD plan, then they necessarily won't be able to offer a Healthcare Savings Account, as by IRS rules you are required to have HD health insurance to be allowed a Healthcare Savings Account.

cautiousjon

I would imagine that most of the people who plan to get married also plan to say "for richer, for poorer, in sickness and in health" in their wedding vows. This would be one of those things that you tackle together as a couple.

Indeed.

My employer provided cadillac-style insurance for the last 20 or so years until it was removed at the end of last year, and replaced with a high-deductible health plan + HSA arrangement. The cadillac insurance was absolutely incredible, but the HDHP isn't so bad. Most people seem to be thinking of it as something similar to what we had before, except with a $4,000 - $6,500 premium. Once we hit the max deductible, the company covers everything beyond that for the rest of the year. I understand that many employees with ongoing health issues or those with spouses who have ongoing health problems hit the max deductible in January, and then pay virtually nothing else for the rest of the year.

Indeed. My company self-insures, but doesn't charge the employees any premiums. If an employee has a spouse that has the option of getting health insurance with their own employer, but instead chooses to get covered as a dependent on the employee's insurance, the employee now has to pay a $2,600 'spouse health insurance contribution' premium per year. We had cadillac-style insurance until the end of last year, and the company found that the employees were, unsurprisingly, covering their spouses under the company's health insurance, even if the spouse had coverage with their own employer. This premium is a little disincentive to encourage the spouse to use their own company's insurance. I know many who pay the premium though, as my employer offers a PPO plan via United Healthcare that has a very large (pretty-much USA-wide) network, or an HMO via Kaiser Permanente.

Indeed. In addition to an HSA, my employer also gives us the option to set up an LPFSA (Limited Purpose Flexible Spending Account). The LPFSA can only be used to fund eye or dental expenses until the funds in the HSA have been exhausted. However, the company's LPFSA allows an annual rollover of funds of up to $500, so you can guess how much I funded mine with. If I leave the company, I am pretty sure that the LPFSA will close (but not the HSA, of course), so if that happens, I'll just go to an optician and buy one or two pairs of (prescription) Ray Bans if there is still money in the account.