bostonwilly

They definitely don't have any offices in France or the UK so an L visa is out of the question. I've got an appointment to speak to their head of HR later today to discuss the visa thing, as to me it looks like a blocker unless they've worked out how to make it work.
Cheers

bostonwilly

Hi tht and newadventure, thanks for the info about how a 401k (or IRA) can be compared to UK pension options.
Cheers

bostonwilly

Hi Glasgow Girl,
What do you mean exactly by "liquidate" - spend it all?! Or just make sure it's in cash so it's easily transferable to a UK? No problem if the latter. Anyway I need to speak to an advisor about the finance things anyway.
Cheers

bostonwilly

Thanks to those who confirmed about vaccination info. I know about the current ban on processing various visas so that's another hurdle I will discuss with the company later.

And yes okay, the healthcare in the UK is not "free", but it is free after tax except for dental and eyecare costs and a few other things. From my point of view, considering budgets, I need to be aware of how much I still need to budget after I get my pay each month, whcih is why I refer to the UK as "free". So far I've not been able to find any estimation, predication or simulation tools for this on the net - do any of you know of one and can post a link? I did find that several healthcare websites are geo-blocked so I couldn't access them, including the website of the insurance provider which this company uses! Rather irritating.

For info, here's a summary of the healthcare and insurance plans they offer - please don't include this in any quotes in case I want to delete it for fear of incriminating myself


I've no idea if these levels of cover are good or bad - except for the Life AD&D which to me seems appalling, but they've told me it can be improved so I'll get the info on that.

My understanding of the way these costs will work is this:

• I have to spend up to the deductible before any plan will pay for anything - this is like an "excess" in UK insurance for cars, property, possessions, etc.
• The HRA means that I only have to pay 50% of that deductible.
• The most I will pay in any year is the "out of pocket maximum" - or are there still costs on top of that?
• So should I budget the 50% of the OOP + annual insurance costs? Or for a healthy family is that unreasonable?

Cheers

tht

These all seem like pretty standard options, the fact they have so many choices with 100 employees makes it seem like they are using a PEO or similar, the HRA is new to me, sounds like “self Insurnace” by them... again that sounds like a bigger company. See if any of these are HDHP, and if they offer an FSA or HSA. Even if your expect nothing to happen you want to malen sure you have to out of pocket maximum in savings... if the worst case happens like a car crash with the whole family putting you all in hospital that should be the max you pay (that said in a car crash where you are not at fault the other drivers insurance if they have it may be a place you can recover those costs). Or another expensive, but non accident example would be your wife having another child, be wary some plans exclude this for a waiting period.... The more important thing is which provider... United, Aetna, BCBS etc... here in CT the “good” local pediatrician will only accept certain carriers so that influences what I can personally go with....once you go ”out of network” things can get a lot more expensive...

tht

OP Save yourself some time.. the elephant in the room is salary...

Based on what you have said including location, desire to have a car an paid school / daycare. As very big approximation I would say, gross the ballpark you need to be looking at:

Sub $125k / PA - walk away
$125-175k / PA - do a carful budget to see if it will work
above $175k / PA you should be ab able to get by...

assuming only you can work... if your wife could that could be from both of you..

bostonwilly

Hi tht,
Thanks for the replies, suggested salary ranges and things to ask, very helpful. Explanation of healthcare savings considerations is very helpful too! I hadn't thought about accidents, obviously they can happen anyone who's healthy as much as anyone else.
The healthcare is with BCBS for HMO/PPO.
Cheers

tht

BCBS is the one our “good” pediatrician won’t take... but it’s always provider specific and local. The only way to get the real inside scoop is to have the “boss” (wife) join the local moms group on FB... that’s usually the best source of information there.

civilservant

That's likely just the network that you will be using. The company may self insure for health costs.

The plans stated seem very normal in terms of deductibles etc for an insurance plan.

bostonwilly

Thanks for the feedback.

So if 50% of OOP is the maximum I should expect to pay, does that come to $13.5k based on the plan details I posted?

50% x $15k PPO OOP for family + (4x$1.5k calendar maximum per member for dental).

Or have I misunderstood something?

Cheers

Rete

No one that I'm read has touched on the fact that you can participate in the Healthcare Savings Plan in the office where you have X number of dollars taken from your salary that is put into a special account that you can withdraw from during the year to reimburse yourself for out of pocket healthcare costs, i.e. co-pay for doctors, hospitals, meds or your deductible. It's been a few years since I've worked and can't recall if the funds put into the account from your paycheck are before or after taxes.

Glasgow Girl

The HRA is a Healthcare Reimbursement Account, totally different from a Healthcare Spending Account, HSA. It is important not to confuse them because they are totally different from each other. With that said you can have both at the same time but eligibility for an HSA is dependent upon the specific details of your benefits so you would have to check that with your employer. In your case, if eligible, I suspect you would have to fund that yourself. In a nutshell it is a useful vehicle to build up a tax free account for medical expenses and it belongs to you so you retain it if you leave the employer.

Going back to the HRA. The normal system is that the company deposits a sum of money into that account each year. In your case it sounds like they would deposit $2,000 per year (50% of your in network deductible). Some companies will allow you to roll that money over year after year, so you can build up a much larger balance if you do not use it. Some do not allow any rollover. Either way, the money is tax free to you but you can only use it for the medical expenses specified by the company (usually just about everything including dental and vision). The money belongs to the company though, not you, so it is a use it or lose it proposition, When you employment ends in most cases the funds are no longer available to use. This is very different from an Health Savings Account, HSA, so do not confuse them.

The basic intent appears to be provide basic routine medical service to you 50% of cost until you reach the Out of Pocket maximum. The HRA amount Is likely enough to cover you at 50% for routine visits, annual physicals, check ups, dental cleanings, basic fillings, eye tests, etc, but would not cover anything other than the most minor surgical procedure, chronic illness, childbirth, etc,

SanDiegogirl

That $1,500 maximum for dental cover is, I am assuming, the maximum amount the insurance will cover i.e it will pay for up to $1,500 treatment, per person, per year.

This is the usual way dental cover works.

SanDiegogirl

All these costs are in addition to the montly premiums - which you say are $500 per month

Glasgow Girl

Your maximum exposure is 100% of the Out Of Pocket maximum for medical and vision, less what the company will pay towards your deductible. So if you stay In Network then the exposure is $6,850/$13,700 minus 50% of the deductible covered by your HRA ($1,000/$2,000). So maximum exposure is $5,850/$11,700. If you go Out Of Network then $6,500/$13,000 using the same math. And, as SanDiegoGirl said your monthly premiums are in addition and totally separate from that.

Again, as SanDiegoGirl said your dental benefit is capped at $1,500. Therefore once the insurance has paid out $1,500 per person the expenses are 100% yours. But so long as your teeth are in reasonably good shape and your kids do not get braces that should be plenty (remembering that you have to pay a % of the cost regardless). If your kids need braces you are looking at ball park $5,000, maybe more maybe less depending upon the provider, probably more in the Boston area.

From the details you have provided, it sounds like this is how it will work (and is par for the course). You will pay for 100% of all costs until you meet the deductible, but your company will pay 50% of this via the HRA. Once you have incurred enough expenses to meet the deductible, you then will have to share the expenses with the insurance company without any further contribution from your HRA. The usual split is 50/50 but you should ask. This arrangement exists until you have reached the Out of Pocket maximum, thereafter the insurance company will pay out at 100%. If it is a 50/50 split then you will have to incur expenses of twice the Out of Pocket maximum before they pay out at 100% (because your share will have been half up to that point).

One other thing to note. It is really important to stay In Network. Out of Network expenses are typically significantly higher than In Network, that is why they are out of Network. With most Plans you are subject to BOTH the In Network and Out of Network deductibles, you cannot combine them. In your case it sounds like your plan will only pay 50% of the In Network deductible so going out of network would be a double whammy. In Network is usually just fine unless you have a serious condition and want/need to choose a specific provider.

Yes, US healthcare is ridiculously complex.As I mentioned previously, the plan looks like it will cover most routine healthcare needs pretty well and you will not have too much financial exposure. However if you have any chronic conditions, need serious tests, surgery or have another child then for sure you will incur signifiant expense.