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Two sided question: 1- Does anyone have any experience getting themselves/their family on ACA? Was it easy enough? Experiences with using the insurance itself? Any surprises? 2-Has anyone worked at a business where your health insurance was dropped and you were told to get ACA? I own a small (seven full time employees) company and currently pay 100% of the employee single health care premium, with the employees being responsible themselves for paying the family premiums. At this point, health care costs are getting almost as big as payroll as an expenditure, and our insurance isn't even that great. We are too small a pool for any bargaining power. I have called a couple of brokers, and they aren't interested in dealing with ACA or answering questions, most likely because they don't get any or as much of a commission. So, I was thinking of cancelling our insurance, then giving all the employees a thousand bucks a month to find their own through Obamacare. I have looked for forum style info, but any forum you get on to discuss ACA quickly turns political and negative. Any experiences?
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Sep 29, 2015 13:40
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I got myself on ACA. It wasn't too difficult, the hard pill to swallow was that my cost more than doubled while my coverage got significantly worse. I have been self insured for more than 5 years now, and am 31, fwiw.
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Sep 29, 2015 14:57
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Shooting Blanks posted:I got myself on ACA. It wasn't too difficult, the hard pill to swallow was that my cost more than doubled while my coverage got significantly worse. I have been self insured for more than 5 years now, and am 31, fwiw. Huh, I was kind of hoping that the costs for my employees (and myself) would maybe go down a bit, even if at the cost of slightly worse insurance. I don't want to make their premiums (or mine) worse than they already are.
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Sep 29, 2015 15:06
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topher2915 posted:Huh, I was kind of hoping that the costs for my employees (and myself) would maybe go down a bit, even if at the cost of slightly worse insurance. I don't want to make their premiums (or mine) worse than they already are.
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Sep 29, 2015 15:11
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Tendai posted:I don't know about your specific situation but this may vary by state. I know that the people here in New Mexico where I live got a lot more assistance and cheaper prices than I had expected, myself included, but it's also a state that probably has a pretty low average income. I would check whatever your state site for it is to get an idea of what an average price might be. I'm in Texas, so I don't think there is a state site. It may be I just need to take the plunge and if if is all hosed up re-enroll in private at the end of the year.
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Sep 29, 2015 15:31
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Oh dang, I didn't realize they were only in some states, sorry. Good luck in any case!
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Sep 29, 2015 16:33
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topher2915 posted:I'm in Texas, so I don't think there is a state site. Lmao Texas got f'd by the republicans in power who wanted to give a finger to Obama by rejecting the expansion of Medicaid
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Sep 29, 2015 18:39
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They would rather break healthcare and leave people uninsured than let Obama get credit for something good
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Sep 29, 2015 18:40
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At this point, it's not really hosed up. FYI open enrollment starts November 15, so you need to decide pretty soon. What you pay is what you get, so you may want to play around with the plan options for Texas on healthcare.gov to see what it would cost to get a Gold or Platinum plan (higher premiums and lower cost sharing) for your employees compared to what you're paying now. If you want to wait for a bit more down the road, the ACA has a program called SHOP in which employers can sign their employees up for the small business exchange and provide them with a few insurance options rather than just send them off by themselves. It might end up being an option between what you have now and just forking over money. Also, have you looked into the small business tax credit? http://www.irs.gov/uac/Small-Business-Health-Care-Tax-Credit:-Questions-and-Answers I also recommend checking out these folks: http://www.smallbusinessmajority.org/small-business-resources/index.php#healthcare
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Sep 30, 2015 02:47
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I guess it really depends on what state you live in. Here in Louisiana, you have to be disabled or elderly and living in a care facility in order to qualify for jack squat, they clearly hate their own citizens and want everyone to die horribly. At least if you're broke they'll waive you from having to pay any penalty fees, but they won't let you enroll or anything. But earlier this year when I broke my finger pretty badly while living in Chicago with Illinois Medicare (I'm a grad student), I got it X-rayed, splinted, checked out by an orthopedic surgeon, a general checkup to clear me for surgery, four titanium screws implanted in the finger, ten post-surgery rehab sessions, and two followup surgeon checkups and I paid a grand total of $17.80 for all of it, including the co-pays and pain meds. Thanks Obama! Without the surgery my finger would have healed several millimeters shorter, causing long-term damage to the fleshy bits inside that would have taken significantly more time and resources to fix later with a "real" job and insurance.
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Sep 30, 2015 04:15
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Time Trial posted:At this point, it's not really hosed up. FYI open enrollment starts November 15, so you need to decide pretty soon. What you pay is what you get, so you may want to play around with the plan options for Texas on healthcare.gov to see what it would cost to get a Gold or Platinum plan (higher premiums and lower cost sharing) for your employees compared to what you're paying now. I will check out both those links, thanks. The tax stuff I have half-rear end looked into, but am setting up a meeting with a CPA in the know to get his thoughts on how we might capitalize. The SHOP I think will be the way to go for us.
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Sep 30, 2015 13:01
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topher2915 posted:I will check out both those links, thanks. The tax stuff I have half-rear end looked into, but am setting up a meeting with a CPA in the know to get his thoughts on how we might capitalize. With only 7 employees there aren't too many options. Some insurance carriers are starting to do small group self-funded insurance with stoploss. Essentially you'd be paying the claims yourself after the carrier administrates them for you, and any catastrophic claim would be capped at whatever the stoploss provision is. I think most companies are requiring like 20 lives for this though, but it might be worth looking in to. However, now that there's guaranteed issue on the individual market, there's less reason to insure as a small group as opposed to individuals. In theory the rates will converge to prevent anti-selection.
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Oct 12, 2015 18:17
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One thing to know with ACA is that if you make less than $16,500(ish)/year, you will get zero financial assistance unless you are first declined for medicaid in your state. If you make over about $40,000/year you will receive less assistance. That being said, once I jumped through all the hoops (getting declined for medicaid, proving my income, etc.) The health plan I chose has been amazing. After reimbursement, I pay $50/mo for a $0 deductible plan with $5 and $10 copays for most doctors visits/medications/lab tests. What was a pain in the rear end (besides the hoop jumping) was when I updated my info. When you make a change to your deductible or application, the marketplace terminates and then reinstates your plan. Your insurance hears about the termination immediately, but it can take 30-90 days for them to get the reinstatement paperwork, so you have to call them right away to keep your coverage. In my case, my insurance company had a 'believe me' policy where they didn't charge me for anything until they received paperwork from the marketplace confirming that I did indeed still have healthcare.
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Oct 14, 2015 04:01
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The state exchange worked pretty well. Then I moved to a state that threw a hissy fit and refused to build an exchange and had to use the healthcare.gov federal exchange which sucks loving donkey balls. If you live in a state that takes this seriously its not too bad. Woe be unto your employees if you live in a wack as gently caress red state. E: whoops looks like the latter applies to you. Enjoy.
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Oct 14, 2015 04:18
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Reik posted:With only 7 employees there aren't too many options. Some insurance carriers are starting to do small group self-funded insurance with stoploss. It's funny because I underwrite small groups about the OP's size in Canada and there's no way we would allow anybody that small to go the refund or ASO route. Insurance companies and brokers up here would be tripping over each other to insure OP's company.
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Oct 14, 2015 19:54
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1500quidporsche posted:It's funny because I underwrite small groups about the OP's size in Canada and there's no way we would allow anybody that small to go the refund or ASO route. Insurance companies and brokers up here would be tripping over each other to insure OP's company. 
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Oct 14, 2015 20:20
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Tendai posted:This is one of those things that's best responded to with It depends on your view. Health insurance here is basically drug coverage + alot of stuff that is worthless. We make hand over fist on small businesses because the owner wants something stupid like major dental and the entire group ends up shelling out for it. I keep toying with the idea of making a thread about it here because honestly every time I think this is the lowest we'll go suddenly the ground drops out.
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Oct 14, 2015 20:46
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topher2915 posted:1- Does anyone have any experience getting themselves/their family on ACA? Was it easy enough? Experiences with using the insurance itself? Any surprises? Long story short, her medical expenses went from $900-1000 a month to a little over $100. Thanks, Obama.
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Oct 14, 2015 20:54
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I had a personal experience with the ACA website earlier this year. I was changing employers, transferring from a school in the US to a school overseas. My healthcare from my US employer ended on July 1, and my new healthcare didn't start until I arrived in my new country mid-August. I had the option of enrolling in continued coverage through COBRA, or going on the marketplace. I was only looking for two months of coverage, and it was just as an 'emergency just in case.' type of thing. I knew I had to get two or three prescriptions filled during that time, but they were inexpensive so it wasn't a huge factor. Cobra was going to be approximately $450 for each month, but a near identical plan from the healthcare.gov website was approximately $205. I spent maybe an hour on the website, and then approximately 10 minutes on the phone with my new provider on two occasions as things were getting set up. So, a little bit of time and ACA helped me save over $200 a month. Thanks, Obama!
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Oct 17, 2015 10:59
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