Healthcare Increase!

stessier · Post by **stessier** » Fri Sep 11, 2015 5:32 pm

We get our info the first week of October (or thereabouts).

Isgrimnur · Post by **Isgrimnur** » Tue Sep 22, 2015 1:45 pm

It may not seem like much — just an extra hundred dollars or so a year.

But the steady upward creep in health insurance deductibles has easily outpaced the average increase in a worker’s wages over the last five years, according to a new analysis released on Tuesday by the Kaiser Family Foundation.

Kaiser, a health policy research group that conducts a yearly survey of employer health benefits, calculates that deductibles have risen more than six times faster than workers’ earnings since 2010.
...
One in five workers has a deductible of $2,000 or more.

LawBeefaroni · Post by **LawBeefaroni** » Tue Sep 22, 2015 1:53 pm

But it's also probably responsible for the slower increase in premiums.

WSJ wrote:Some economists argue the damped rate of increase is linked to the recession and its aftermath. Others credit changes in health coverage and the health-care system, such as higher deductibles. This long-running trend helps keep premiums down, while increasing employees’ out-of-pocket costs.

The average cost of employer health coverage passed $17,000 for a family plan this year, despite continued muted growth on a percentage basis, according to a major survey.

The average annual cost of an employer family plan rose 4%, to $17,545, from $16,834 last year, according to the annual poll of employers performed by the nonprofit Kaiser Family Foundation along with the Health Research & Educational Trust, a nonprofit affiliated with the American Hospital Association. The share of the 2015 family-plan premium borne by employees was 29% of the total, the same percentage as last year.

For an individual worker, the average annual cost of employer coverage was $6,251 in this year’s survey, also up 4% over last year. The employee contribution was 18%.

The reasons behind the relatively slow pace of growth in premiums are a topic of debate, and many analysts expect an upshift in health-care costs in coming years.

Jeff V · Post by **Jeff V** » Tue Sep 22, 2015 1:53 pm

Isgrimnur wrote: One in five workers has a deductible of $2,000 or more.

$2000 would be sweet. Mine is more than $8000 this year.

Isgrimnur · Post by **Isgrimnur** » Tue Sep 22, 2015 2:05 pm

I'm at $5k at the moment.

If I were still single, I'm sure the deductible would have been higher than my AGI last year. When it gets to the point where a catastrophic illness would qualify me to start deducting them from my taxes while insured, something is terribly wrong.

LawBeefaroni · Post by **LawBeefaroni** » Tue Sep 22, 2015 2:11 pm

Jeff V wrote:
Isgrimnur wrote: One in five workers has a deductible of $2,000 or more.
$2000 would be sweet. Mine is more than $8000 this year.

Family or individual? I'm going to guess that that $2000 number is for individuals.

Jeff V · Post by **Jeff V** » Tue Sep 22, 2015 2:14 pm

LawBeefaroni wrote:
Jeff V wrote:
Isgrimnur wrote: One in five workers has a deductible of $2,000 or more.
$2000 would be sweet. Mine is more than $8000 this year.
Family or individual? I'm going to guess that that $2000 number is for individuals.

Family. Are less than 1 in 5 workers on family plans?

coopasonic · Post by **coopasonic** » Tue Sep 22, 2015 2:24 pm

Those workers have seen their deductibles climb from a yearly average of $900 in 2010 for an individual plan to more than $1,300 this year, while employees working for small businesses have an even higher average of $1,800 a year. One in five workers has a deductible of $2,000 or more.

Context seems to indicate that number is for individual coverage.

LawBeefaroni · Post by **LawBeefaroni** » Tue Sep 22, 2015 2:27 pm

Jeff V wrote:
LawBeefaroni wrote:
Jeff V wrote:
Isgrimnur wrote: One in five workers has a deductible of $2,000 or more.
$2000 would be sweet. Mine is more than $8000 this year.
Family or individual? I'm going to guess that that $2000 number is for individuals.
Family. Are less than 1 in 5 workers on family plans?

I have no idea but I highly doubt that 1 in 5 families having a $2,000 deductible would be newsworthy. The article is paywalled so I can't source it. Here's KFF averages going to 2012.

So I'm sticking with the idea that the $2,000 number was for individuals.

Smoove_B · Post by **Smoove_B** » Tue Sep 22, 2015 2:41 pm

Wife's company announced a few weeks ago that for people that didn't opt into the voluntary wellness program last year...their premiums would be adjusted accordingly. Considering how little needed to be done in order to qualify for participation, I don't feel bad for any of them and apparently most were rather vocal last year that they wouldn't participate. I'll be very curious to see what the conversion rate is after new premiums are officially announced and applied for 2016.

LawBeefaroni · Post by **LawBeefaroni** » Tue Sep 22, 2015 3:03 pm

We had to log into a website and answer about 15 questions. For $50/month I'm sure we were pretty close to 100% participation.

Now I assume that each year will see more and more things you have to do but most places are probably still in the "answer some questions" phase with maybe some tracking of goals/progress.

Scuzz · Post by **Scuzz** » Tue Sep 22, 2015 3:06 pm

Well I turn 60 next month so my rates are going up. Also my current plan is changing the deductible from $2,500 to $4,500, so my broker is shopping for something different.

As for JeffV post up a bit. With a family plan I think there is a "family" deductible, so not everyone in the family has to meet the $2k deductible. usually it is something like $4k I think on such a plan.

I get this stuff explained to me every year and then I forget it in 3-4 months. I handle the insurance for my company. Just a few people, which makes it hard to find a plan.

LawBeefaroni · Post by **LawBeefaroni** » Tue Sep 22, 2015 3:15 pm

Scuzz wrote: As for JeffV post up a bit. With a family plan I think there is a "family" deductible, so not everyone in the family has to meet the $2k deductible. usually it is something like $4k I think on such a plan.

Yeah, usually for family plans the deductible is stated as "per person/family max". So if you have a $2,000/$5,000 that means that each person has a $2,000 max but if your combined total out deductible spending hits $5,000 you've maxed out.

Zarathud · Post by **Zarathud** » Tue Sep 22, 2015 4:06 pm

That's how my plan works, LawBeef. With 2 diabetic children and a wife with chronic medical conditions, the insurance company would hate me even when I'm healthy. I hate hitting the deductible by February.

Carpet_pissr · Post by **Carpet_pissr** » Tue Sep 22, 2015 4:13 pm

LawBeefaroni wrote:We had to log into a website and answer about 15 questions. For $50/month I'm sure we were pretty close to 100% participation.

Now I assume that each year will see more and more things you have to do but most places are probably still in the "answer some questions" phase with maybe some tracking of goals/progress.

We have to have a physical before a certain date, and input the data into some online health questionnaire to get our substantial credit (at least $50/month IIRC)

Jeff V · Post by **Jeff V** » Tue Sep 22, 2015 4:28 pm

Scuzz wrote:Well I turn 60 next month so my rates are going up. Also my current plan is changing the deductible from $2,500 to $4,500, so my broker is shopping for something different.

As for JeffV post up a bit. With a family plan I think there is a "family" deductible, so not everyone in the family has to meet the $2k deductible. usually it is something like $4k I think on such a plan.

I get this stuff explained to me every year and then I forget it in 3-4 months. I handle the insurance for my company. Just a few people, which makes it hard to find a plan.

My family is just 3 of us, so we actually pay more deductible per person than if we had $2000 a piece. A per-person deductible would work out much better, right now, nothing is covered until we pay $8000 among the three of us. The only time we exceeded that was the year my wife was pregnant and our son born, we were out of pocket $12,000.

LawBeefaroni · Post by **LawBeefaroni** » Tue Sep 22, 2015 4:38 pm

Jeff V wrote:
Scuzz wrote:Well I turn 60 next month so my rates are going up. Also my current plan is changing the deductible from $2,500 to $4,500, so my broker is shopping for something different.

As for JeffV post up a bit. With a family plan I think there is a "family" deductible, so not everyone in the family has to meet the $2k deductible. usually it is something like $4k I think on such a plan.

I get this stuff explained to me every year and then I forget it in 3-4 months. I handle the insurance for my company. Just a few people, which makes it hard to find a plan.
My family is just 3 of us, so we actually pay more deductible per person than if we had $2000 a piece. A per-person deductible would work out much better, right now, nothing is covered until we pay $8000 among the three of us. The only time we exceeded that was the year my wife was pregnant and our son born, we were out of pocket $12,000.

Usually plans will have both a per person and family max. It doesn't matter how many people make up the family. If yours doesn't have a per person and family max, it's definitely non-standard.

And obviously deductible is not to be confused with out-of-pocket maximum.

Post by **ImLawBoy** » Tue Sep 22, 2015 4:46 pm

FWIW, my plan has a family deductible of $2,400 (I think), and an out-of-pocket maximum of $8,250. We don't have any individual deductibles or maximums. Annual enrollment is coming up soon - not sure what changes we'll see there.

Jeff V · Post by **Jeff V** » Tue Sep 22, 2015 4:53 pm

LawBeefaroni wrote:And obviously deductible is not to be confused with out-of-pocket maximum.

I'm pretty sure our out-of-pocket maximum is "all the money in the world + $1". In fact, there are lifetime limits just in case you get the idea that life is somehow priceless.

The deductible is based on the entire family. No expense is covered until the deductible is met. This has the added effect of discouraging people from going to the doctor when serious conditions might still be in a more treatable state.

Isgrimnur · Post by **Isgrimnur** » Tue Sep 22, 2015 4:55 pm

Lifetime limits on essential health benefits went away with the ACA.

Jeff V · Post by **Jeff V** » Tue Sep 22, 2015 5:23 pm

Isgrimnur wrote:Lifetime limits on essential health benefits went away with the ACA.

Ah, ok. I must have been remembering that from a few years ago -- I remember thinking that if my dad had such a plan, he'd have been dead and (and probably destitute before that) a lot earlier than he was.

I'm sure that once King Trump is in charge, those lifetime maximums will return (and probably be less than the annual deductible).

coopasonic · Post by **coopasonic** » Tue Sep 22, 2015 5:30 pm

My deductibles are 1250 individual and 2k family, but I pay 30% after that (up to 3500/7000). I guess I can be happy with that.

We are switching to a new provider for 2016 and I don't think we see what that means until next month. To date this year my family of four's healthcare expenses are zero so we are paying for everyone else.

Post by **ImLawBoy** » Tue Sep 22, 2015 5:31 pm

coopasonic wrote:My deductibles are 1250 individual and 2k family, but I pay 30% after that (up to 3500/7000). I guess I can be happy with that.

We are switching to a new provider for 2016 and I don't think we see what that means until next month. To date this year my family of four's healthcare expenses are zero so we are paying for everyone else.

Those of us who hit our out-of-pocket maximums by June appreciate your support.

Scuzz · Post by **Scuzz** » Tue Sep 22, 2015 5:32 pm

JeffV, I think your plan may have changed and you just don't know it. I knew lifetime limits went away with ACA. I also think you have a family deductible regardless of numbers in the family. But I will admit that every time I think I know what ACA did I run into something that doesn't fit what I thought I knew.

Isgrimnur · Post by **Isgrimnur** » Tue Sep 22, 2015 5:37 pm

Had a guy at my first job that I was friendly with, even gamed with, that I tormented about insurance costs after he had sinus and knee surgeries in back-to-back years. Not to mention his two germ factories at home.

Kraken · Post by **Kraken** » Tue Sep 22, 2015 7:16 pm

We enjoy such good health that I don't even know what our deductible or maximums are. We never even come close to needing to know. Hope that doesn't change anytime soon.

Dental, OTOH...wife needs $14,000 worth of reconstructive toothwork this year and next. Insurance pays a maximum of $1,750 pp/yr. At least dental insurance is still comparatively cheap.

LordMortis · Post by **LordMortis** » Tue Sep 22, 2015 8:04 pm

Kraken wrote:We enjoy such good health that I don't even know what our deductible or maximums are. We never even come close to needing to know. Hope that doesn't change anytime soon.

Dental, OTOH...wife needs $14,000 worth of reconstructive toothwork this year and next. Insurance pays a maximum of $1,750 pp/yr. At least dental insurance is still comparatively cheap.

My dentist want me to do orthodontia. I think I get about $1800 of orthodontics covered a year with a lifetime maximum of like $8000 and $8000 wouldn't come close to the work they want to do. So, nope. My ophthalmologist also wants me to go in for corrective surgery, which would take me away from work for 10 days, maybe longer while recover at home, as well as tank my life savings. Again. Nope.

We don't get news of cost increases until the end of the year.

Jeff V · Post by **Jeff V** » Wed Sep 23, 2015 9:52 am

Scuzz wrote:JeffV, I think your plan may have changed and you just don't know it. I knew lifetime limits went away with ACA. I also think you have a family deductible regardless of numbers in the family. But I will admit that every time I think I know what ACA did I run into something that doesn't fit what I thought I knew.

Yes, the family deductible works that way -- $8000 total, which for a family of 3 means I pay a lot more per person than three individual plans @ $2000. We pretty much need a 4th to stop getting especially screwed. And that $8000 was 2 years ago, I'm pretty sure it went up, I stopped paying attention because the only time we exceeded that was the year we had the baby.

As far as dental goes -- almost everything I need is not covered. Last year I needed a fused root separated and the lower tip of the root removed, with a bone graft added to keep my jaw from decalcifying. Not one cent of this $2000 procedure was covered. Where the root was trimmed, I actually need an implant to anchor a new denture. I've needed this for more than 5 years now; but again, insurance covers none of it -- and I don't have the $6000 needed to do this. I can probably save $2000 (the cost of the plane ticket) if I have this work done in the Philippines.

stessier · Post by **stessier** » Fri Sep 25, 2015 8:55 am

Just learned this year's information will start to arrive on Sept 28 - so sometime next week I should know the damage.

Octavious · Post by **Octavious** » Fri Sep 25, 2015 9:11 am

I think all your plans got worse while mine stayed the same lol. No deductible and the price hasn't gone up much the last 3 years. Shrug

Isgrimnur · Post by **Isgrimnur** » Fri Sep 25, 2015 9:28 am

Yesterday's team meeting indicated that it will be October when we get the new deets for the 11/1 start.

RMC · Post by **RMC** » Mon Sep 28, 2015 3:36 pm

Well, we just switched to my wife's insurance plan. She is a teacher, and her benefits are much better than mine at the hospital system I work for. The only draw back, is that her 'year' runs from Aug - July. So we switched this month, even though we were covered starting in Aug. Of course my employer than retroactively canceled my policy for last month, since I was covered under both plans. <sigh> I didn't ask them to do that, and I had paid my premiums, but they said it was 'policy' so now I have a few things that I have to get resent to my wife's plan.

But here is the basics of my wife's plan.

No copays for any service.
500 / Family Deductible, 250/individual
80/20 for all services over the deductible.
We can go anyplace and use any hospital in the area.

We are saving 400/month in premiums from my plan to hers. So with 4,800 in savings annually in just the premiums we will be paying less than my plan overall.

My Deductibles were a ton higher, and I had 35/50 copay's depending on Family Medicine or Specialists. I also had an ER Copay of 300 that her plan does not have. We try not to use the ER, but we have 3 kids so sometimes you have to use it.

Of course my oldest broke her arm in August, so we have already paid the 250 deductible for her, and I broke my toe in August, so had an X-ray and an office visit. So my deductible is most likely covered as well. <sigh>

Isgrimnur · Post by **Isgrimnur** » Mon Sep 28, 2015 3:40 pm

Will you adopt me?

RMC · Post by **RMC** » Mon Sep 28, 2015 3:59 pm

Isgrimnur wrote:Will you adopt me?

Just make your wife become a teacher, that's what I did. She is a High School Chemistry(Can teach all Sciences) Teacher.

It's awesome for her and the kids, she has plenty of time off, and her benefits are very nice. I will not even talk about the college plan that she has for the kids, and her retirement.

Kraken · Post by **Kraken** » Mon Sep 28, 2015 4:24 pm

My wife also has gold-plated academe benefits. I don't go to doctors but assume that our insurance is pretty great.

LawBeefaroni · Post by **LawBeefaroni** » Mon Sep 28, 2015 4:49 pm

State employees in Illinois have some good benefits. It just takes 9 months for the state to pay for them. Eventually the pension/health coverage bubble will burst. My pension sucks but it is 100% funded.

We just got an ominous email about a new forum for answering employee questions and concerns. The timing, right before open enrollment, is a bit suspicious. Bracing for some big changes.

stessier · Post by **stessier** » Tue Sep 29, 2015 3:36 pm

They just made the information available online.

The premiums for my plan (the highest deductible one) are not going up - $97/mo. The deductibles are - from $2600 -> $2800 (7.7%) for an individual and from $5200 -> $5600 (7.7%) for the family (in network - double each for out of network). The company continues to make a $1200/family donation to our HSA.

The only premium increase comes on the PPO plan going from $358/mo -> $384/mo for a family (+7.3%). Additionally, that plans' deductibles increase from $450 -> $550 (22.2%) for an individual and $900 -> $1100 (22.2%) for a family.

I think this means no functional difference for me. Depending on if we get a raise, I might increase my HSA contribution as I am not at the maximum yet, but I think I'll leave it alone until that time (next March).

Fireball · Post by **Fireball** » Tue Sep 29, 2015 5:18 pm

I have a $0 deductible and $5,000 out of pocket maximum as an individual. If I were to get married, we would have no deductible and a $10,000 OOP max, if I added him to my insurance. We enter "open enrollment" in October, but I don't think I'm going to change anything about my plan. I have pretty low co-pays and decent out of pocket costs for prescription drugs. I only take one pill each day, but the retail price of the prescription is about $15,000 per year. I pay $30 a month for the pills.

My premium is about $371 per month, of which I pay $93. That's up a bit from 2014, but down from 2013, before I was moved to an ACA Exchange plan.

I have separate dental insurance.

LawBeefaroni · Post by **LawBeefaroni** » Wed Sep 30, 2015 2:15 pm

Got a look at our materials today.

In-house plan went down 9% for single employees, up 1% for families.
HDHP plan went unchanged for single, up 4% for families.
Big Box PPO went unchanged in both categories.
Single w/kid and Spouse/Partner rates were mostly unchanged for all plans.

In-system and in-network deductibles were mostly unchanged but out-of-network deductibles went up a lot. OOPMs were unchanged for the most part.

Pharmacy is the same.

My particular dental product went away but I have a comparable option available and it's a decrease.

Vision is unchanged.

Health assessment/participation credit is ~$50/month.

Not what I was expecting, and in a good way. I thought there were going to be wholesale changes. I guess the workshops and forum are for the entities we absorbed but I have to believe their benefits are improving, not worsening.

So it looks like I'm going with the same plan:
$200/$600 deductible ($1500/$3000- $4000/$8000 net-OON)
$500/$1500 OOPM ($4000/$8000 - $8,000/$16,000 net-OON)
$10/$25 PCP/SPC copay
$150 ER Copay (waived if admitted)
$100 hospital copay

Haven't seen the other stuff like life insurance, AD&D insurance, parking/transit, etc.

Isgrimnur · Post by **Isgrimnur** » Tue Oct 06, 2015 5:12 pm

1/6th increase on premiums ($30 -> $35 /2 weeks).

As to the actual coverage levels, I'll have to compare materials when I get home.