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Yet another medical insurance thread ...

Yet another medical insurance thread ...

Old Feb 13th 2012, 5:35 pm
  #1  
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Wink Yet another medical insurance thread ...

Hi All,

Have read many of the threads about medical insurance. Lot's of very good advice and debate about the pro's and con's of private health/medical insurance, but not really anything that I think answers the question of what is a good insurance package. Also, lots of scare stories which make you wonder whether you would survive if something serious happened.

As background, we are coming to the USA on an E2 treaty visa. The business we are taking over does not currently provide medical or health insurance for the employees of 6. Thus, we are thinking, this would be good for the employees and something that will also address our needs.

So, many of you have expressed that even with your organisation health/medical insurance you have been hit with quite large bills. You have also mentioned that personal insurance offerings is extremely expensive. So based on your experiences what are the criteria for a good medical insurance package/offering and who do you recommend as best value for money.
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Old Feb 13th 2012, 5:41 pm
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Default Re: Yet another medical insurance thread ...

What sort of business is it?
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Old Feb 13th 2012, 6:06 pm
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Default Re: Yet another medical insurance thread ...

The following links are a good place to start concerning health care reform that offers tax credits for small businesses that provide health insurance for their employees.

http://www.sba.gov/content/health-ca...th-care-reform
http://www.businessweek.com/smallbiz...413_125807.htm

Also I believe that in 2014, there will be health care exchanges setup for small businesses that allows several small businesses to be under the same group policy which should reduce the costs and spread the risk of health insurance for small businesses.
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Old Feb 13th 2012, 6:45 pm
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Default Re: Yet another medical insurance thread ...

What's good is the company offering to pay the whole premium, with zero co-pay and deductible, but that's not going to happen is it.

So it's what ever is a comfortable compromise.

As the business owner and employer, well it'll all depend on what policies you can get and are willing to pay for.
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Old Feb 13th 2012, 6:51 pm
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Default Re: Yet another medical insurance thread ...

Most E2 Business's are not of the type where a good, or not so good, benefit package would be applicable.
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Old Feb 13th 2012, 7:19 pm
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Default Re: Yet another medical insurance thread ...

Find an independent broker in your area who specializes in health insurance. Evaluating insurance for a business is not a do-it-yourself task --especially when you are unfamiliar with how US health insurance works.
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Old Feb 13th 2012, 9:42 pm
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Default Re: Yet another medical insurance thread ...

Originally Posted by Bob View Post
What's good is the company offering to pay the whole premium, with zero co-pay and deductible, but that's not going to happen is it.

So it's what ever is a comfortable compromise.

As the business owner and employer, well it'll all depend on what policies you can get and are willing to pay for.
I pay the whole premium for my staff! Have to admit I don't cover the co-pay and deductible though. That would probably bankrupt me if one of them got really sick. Our out of pockets are quite low though for the general stuff, which is what I concentrated on when getting the plan quotes. I have paid 100% of the cost since 2007, and on average it's gone up 18% every year! It's dreadful
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Old Feb 13th 2012, 9:46 pm
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Default Re: Yet another medical insurance thread ...

Originally Posted by Stella Schuster View Post
Hi All,

Have read many of the threads about medical insurance. Lot's of very good advice and debate about the pro's and con's of private health/medical insurance, but not really anything that I think answers the question of what is a good insurance package. Also, lots of scare stories which make you wonder whether you would survive if something serious happened.

As background, we are coming to the USA on an E2 treaty visa. The business we are taking over does not currently provide medical or health insurance for the employees of 6. Thus, we are thinking, this would be good for the employees and something that will also address our needs.

So, many of you have expressed that even with your organisation health/medical insurance you have been hit with quite large bills. You have also mentioned that personal insurance offerings is extremely expensive. So based on your experiences what are the criteria for a good medical insurance package/offering and who do you recommend as best value for money.
I'm not sure there's a way to get around the co-pays and deductibles being scary! You're right that there are lots of different plans out there. What I concentrated on, when putting the plan in place for my business (I have 6 full time staff too!), was the everyday stuff that I knew we would use more of - doctors visits, prescriptions, preventative. Making sure these co-pays were low was my focus. If the worse happens, and a true emergency and lots of medical stuff is needed, then the co-pays aren't too bad either- although with any form of high medical intervention here, you're looking at thousands rather than hundreds. We have just changed to United Healthcare, but have had plans in the past with Blue Cross Blue Shield, and Aetna. We work through a broker, as they provide comparisons on all the plans that will give you more clarity on all of the components. As an employer, you can cover it 100% for the monthly pay (rare), or you can have a "we pay X, you pay Y" type deal on the monthly premiums. Some businesses don't offer healthcare at all so I'm sure your staff will be happy with anything you're prepared to do.
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Old Feb 13th 2012, 11:36 pm
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Default Re: Yet another medical insurance thread ...

What state are moving into? That makes a difference as well, so a broker is a good idea to start, so you get info on state requirements and possibilities.
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Old Feb 15th 2012, 1:07 am
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Default Re: Yet another medical insurance thread ...

as lame as it sounds - also check the local coverage of doctors and dentists. we seem to have chosen the crappiest dental cover ever - and every dentist i get local recommendations for are NOT in network. i don't want to go to just any old dentists but i am really struggling to get one that's both recommended and in network.

so maybe ask your staff to tell you where they go now for doctor, ob/gyn dental etc and try and consider that the scheme you chose covers some of them if possible.
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Old Feb 15th 2012, 8:07 am
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Default Re: Yet another medical insurance thread ...

Your best bet would be to talk to a broker. I would start with the broker who is handling some of the other coverages you currently have, i.e. building insurance, liability for the company, perhaps even your auto and personal home insurance in the USA. They'll have some recommendations, and sometimes might even give you a slight discount if you keep all your various policies with them.

When I ran a company we paid everyone's health insurance 100%. Led to greater staff retention and morale, and was just the right thing to do. You'll need to assess your own business model and see if it is workable (hint: it's expensive). Another to consider is the regulations in your state. For example, I had a company based in Washington, DC. One of the regulations was that if I offered a type of insurance to the executives of my company I had to also offer the same coverage to the secretaries. There was no way to get it "by the company" and then not give it to everyone. This varies from state to state, but there are small little laws like this your broker might be able to better advise you about.

Good luck.
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Old Feb 15th 2012, 4:33 pm
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Default Re: Yet another medical insurance thread ...

The local paper had a report on the renewal of the Counties benefit package renewal. $17,000 a year on average.

Which can not be that far from the average wage.
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Old Feb 15th 2012, 5:19 pm
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Default Re: Yet another medical insurance thread ...

Originally Posted by Boiler View Post
The local paper had a report on the renewal of the Counties benefit package renewal. $17,000 a year on average.

Which can not be that far from the average wage.
Unless you read the fine print, it is sometimes difficult to determine what they are referring to. Many times the benefits includes vacations, holidays, short and long term disability insurance, FICA taxes paid by the employer, health insurance, and all other benefits but seldom includes tax credits or deductions offered to the employer. Sometimes even the premium paid for any overtime is included.
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Old Feb 15th 2012, 6:01 pm
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Default Re: Yet another medical insurance thread ...

Originally Posted by Michael View Post
Unless you read the fine print, it is sometimes difficult to determine what they are referring to. Many times the benefits includes vacations, holidays, short and long term disability insurance, FICA taxes paid by the employer, health insurance, and all other benefits but seldom includes tax credits or deductions offered to the employer. Sometimes even the premium paid for any overtime is included.
The majority of it was Health Insurance. Disability Insurance would have been in there as well.

It is the County so tax credits?
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Old Feb 15th 2012, 6:24 pm
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Default Re: Yet another medical insurance thread ...

Insurancce rates and policies will vary from state to state and the lack of clear information are comparisons is one of the biggest issues.

First you have to understand that even though you might pay $500/month premium as a single person or $1000 as a family you will still have to pay more when you get treatment. Most plans will charge you say $25 to visit the doctor and you'll pay a portion of the cost of drugs.

There will be probably be an annual deductible amount which is the amount you have to pay before before the insurance starts to pay. This can be $2k, $5k or more. When you've spent that amount your insurance will start to pay, but it will only pay a portion of your bills, it might be 80% and you have to pay the rest, this is a co-pay. However, the next amount to be aware of is your annual out of pocket maximum. This is the most you can pay for care (excluding premiums) in a year and it is usually several times more than the deductible, so $5k or $10k. The more you pay in premiums the lower will be your co-pays, deductible and out of pocket max.

If you want to compare some costs and benefits of various plans go the the Massachusetts state health insurance site and enter your information. MA tends to be expensive and these are for individuals so you'll probably get lower rates in a cheaper state and a group plan, but I would not consider a plan with lower benefits than the Bronze plan in MA. That is a good basic level of coverage for people who want a lower premium with higher deductibles.

https://www.mahealthconnector.org/po...ite/connector/
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