Health Insurance Open Enrollment

paydawg

paydawg

Active member
My company is switching it up this year and dropping Kaiser from our health insurance options.  Anybody know much about Anthem? 

It's either Anthem PPO or Aetna PPO (15% higher premiums) with roughly same deductible and max out-of-pocket limits. 
 
paydawg said:
My company is switching it up this year and dropping Kaiser from our health insurance options.  Anybody know much about Anthem? 

It's either Anthem PPO or Aetna PPO (15% higher premiums) with roughly same deductible and max out-of-pocket limits.
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Sounds like a company cost benefit move.

Can't help you on which PPO to choose.
 
My company's health benefits have deteriorated each of the last 3 years thanks to Obamacare.  I'm even considering putting my daughter on a separate plan instead of going for the company's family plan.  It sucks that I'm subsidizing other families with two or more kids when I only have one. 
 
If it makes you feel better, you should have another kid to get back at the system...Take that Obama!
 
paydawg said:
My company's health benefits have deteriorated each of the last 3 years thanks to Obamacare.  I'm even considering putting my daughter on a separate plan instead of going for the company's family plan.  It sucks that I'm subsidizing other families with two or more kids when I only have one.
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Obamacare has nothing to do with employer plans...your company simply doesn't want to pay the increase in premiums and passing the increase to you.
 
zubs said:
If it makes you feel better, you should have another kid to get back at the system...Take that Obama!
Click to expand...

Under Obamacare, 3 or more kids and you pay the same premium, as each additional kid is free.  So it's the orthodox jews, mormons, and hispanics who really benefit from Obamacare.  Or really just the mormons, as the orthodox jews and hispanics are all covered under Medicaid anyway.
 
paydawg said:
My company is switching it up this year and dropping Kaiser from our health insurance options.  Anybody know much about Anthem? 

It's either Anthem PPO or Aetna PPO (15% higher premiums) with roughly same deductible and max out-of-pocket limits.
Click to expand...

We have Anthem PPO from my employer for the last few years and so far no complains/issue.  My employer also gives the option to go Kaiser but it's much more expensive and in-network coverage seems lot more limited than Anthem so I chose Anthem.
 
WTTCHMN said:
zubs said:
If it makes you feel better, you should have another kid to get back at the system...Take that Obama!
Click to expand...

Under Obamacare, 3 or more kids and you pay the same premium, as each additional kid is free.  So it's the orthodox jews, mormons, and hispanics who really benefit from Obamacare.  Or really just the mormons, as the orthodox jews and hispanics are all covered under Medicaid anyway.
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Haven't seen any consistency here. My wife's employer charges separately per kid (and more if the kid is 18 or older) while mine charges the same amount no matter how many kids you have or their ages.

My wife's charges a different amount depending the age of your spouse. Mine is the same price regardless of my age or my wife's age.

Both are plans the companies switched to in the past 12mos and are Obamacare compliant.

Short story: Employer plans are not at all consistent under Obamacare and anyone telling you that Obamacare is the reason they are doing something is most likely not being truthful.
 
paperboyNC said:
WTTCHMN said:
zubs said:
If it makes you feel better, you should have another kid to get back at the system...Take that Obama!
Click to expand...

Under Obamacare, 3 or more kids and you pay the same premium, as each additional kid is free.  So it's the orthodox jews, mormons, and hispanics who really benefit from Obamacare.  Or really just the mormons, as the orthodox jews and hispanics are all covered under Medicaid anyway.
Click to expand...

Haven't seen any consistency here. My wife's employer charges separately per kid (and more if the kid is 18 or older) while mine charges the same amount no matter how many kids you have or their ages.

My wife's charges a different amount depending the age of your spouse. Mine is the same price regardless of my age or my wife's age.

Both are plans the companies switched to in the past 12mos and are Obamacare compliant.

Short story: Employer plans are not at all consistent under Obamacare and anyone telling you that Obamacare is the reason they are doing something is most likely not being truthful.
Click to expand...

Clarification:  I was referring to the true Obamacare plans purchased off the exchange.  Employer-based plans, as you alluded to,  are Obamacare-compliant but not really "Obamacare".
 
WTTCHMN said:
Clarification:  I was referring to the true Obamacare plans purchased off the exchange.  Employer-based plans, as you alluded to,  are Obamacare-compliant but not really "Obamacare".
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That is a covered california thing as far as I know.
 
Irvinecommuter said:
paydawg said:
My company's health benefits have deteriorated each of the last 3 years thanks to Obamacare.  I'm even considering putting my daughter on a separate plan instead of going for the company's family plan.  It sucks that I'm subsidizing other families with two or more kids when I only have one.
Click to expand...

Obamacare has nothing to do with employer plans...your company simply doesn't want to pay the increase in premiums and passing the increase to you.
Click to expand...
I wouldn't say it has "nothing" to do with them.

If it costs more to cover more people, then those costs are passed on by the doctors and the insurance companies to who?
 
irvinehomeowner said:
Irvinecommuter said:
paydawg said:
My company's health benefits have deteriorated each of the last 3 years thanks to Obamacare.  I'm even considering putting my daughter on a separate plan instead of going for the company's family plan.  It sucks that I'm subsidizing other families with two or more kids when I only have one.
Click to expand...

Obamacare has nothing to do with employer plans...your company simply doesn't want to pay the increase in premiums and passing the increase to you.
Click to expand...
I wouldn't say it has "nothing" to do with them.

If it costs more to cover more people, then those costs are passed on by the doctors and the insurance companies to who?
Click to expand...

Well...considering the unisured are the most expensive to care for and their bills have always passed on to those insured, adding more insured to the mix would decrease the overall cost.

But employer based plan costs are largely based upon those in the group.  If your coworker was seriously hurt last year, all the premiums for that group will go up.  So if you want to blame someone, blame your coworkers
 
Irvinecommuter said:
Well...considering the unisured are the most expensive to care for and their bills have always passed on to those insured, adding more insured to the mix would decrease the overall cost.
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Not necessarily.

This has been rehashed before but it hasn't been proven that insuring more of the population actually decreases costs. I don't remember where I read it, but it could actually increase costs because insured tend to use more medical services than uninsured.

There is also the ecosystem costs where more services will either not be covered or cost more due to cost/usage ratios. And because of government involvement, there is also dollar value loss due to red tape (my soapbox).
 
Hence the cadillac tax. I have really great coverage through work where basically everything is covered with a fixed $20 copay. Next year I have to pay 10% on all services even after I hit my deductible, which is increasing from $0 to $1500. I'm not actively looking to use more services just for kicks but I definitely think doctors were more ready to refer me to specialist after specialist knowing that I wouldn't object to cost, since there was no cost to me. The idea is to make people more aware of the prices to make consumers drive down costs. But it sucks to lose all the great benefits.
 
Irvinecommuter said:
But employer based plan costs are largely based upon those in the group.  If your coworker was seriously hurt last year, all the premiums for that group will go up.  So if you want to blame someone, blame your coworkers
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This is still the case for large employers. Under Obamacare small employers have the option (maybe mandatory?) to join bigger pools that spread out the risk.

Honestly the biggest driver of health insurance costs are the ones that don't use it like insurance. They might pay $1,000/mo in premiums and then spend $1,000/mo on prescription drugs & doctors visits. So the rare instance when they need a $30,000 surgery comes from the rest of the group.
 
My company's coverage is through United Healthcare.  All my doctors accept it.  I am considering a company whose coverage is Anthem.  One of my doctors says he is considered "out of network."  He used to accept it but would not agree to the reimbursement rates.

On a side note, not related to the OP's questions, my premiums have remained unchanged for the past three years.  My out-of-pocket limit, however, has risen substantially each year.  In terms of Obamacare, my doctors have all mentioned that they will not accept  the Obamacare-specific plans.
 
elgringo said:
My company's coverage is through United Healthcare.  All my doctors accept it.  I am considering a company whose coverage is Anthem.  One of my doctors says he is considered "out of network."  He used to accept it but would not agree to the reimbursement rates.

On a side note, not related to the OP's questions, my premiums have remained unchanged for the past three years.  My out-of-pocket limit, however, has risen substantially each year.  In terms of Obamacare, my doctors have all mentioned that they will not accept  the Obamacare-specific plans.
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Again...there are no Obamacare-specific plans.  The coverage you get through the health exchange are all private company plans (i.e. United Health, Anthem, etc.).  There are no "special Obamacare plans".
 
You really need to carefully check each plans PPO network.  Both companies have multiple PPO plans with different networks.

If you go to the Aetna website to check your doctor availability you'll see the many plan options.  You need to make sure you have the right one. 
 
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