Your Medical Plan $Changes/Increases for 2011?

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Submitted by SD Transplant on October 21, 2010 - 8:31am

Well, glad to do a public service & report that my medical plan is going to go up 17.28% from 2010 to 2011.

What $changes/increases did u see on your medical plan for next year (it's enrolment time)?

Submitted by bearishgurl on October 22, 2010 - 3:10pm.

PatentGuy wrote:
. . . Bearishgurl, you are being a bit hard on the "newly insurable." Do you feel this way about people you already subsidize with food stamps or medicare or [fill in the blank]? . . .

PatentGuy, I think everyone who doesn't have an employer-paid health plan should be entitled to health coverage . . . for an appropriate price relative to their health care usage. If the "appropriate price" is more than they can afford and the care they are seeking is absolutely necessary, then there should be government program(s) in place to assist them in paying their premiums (w/o affecting ALL insureds' premiums). I don't believe people who have EARNED low premiums (thru prudence, good genes or luck or a combination of any of these) should be required to subsidize those who didn't (very often through their own current and prior addictions/abuse/neglect). This huge "neglectful" demographic is what comprises most of my "age group" that I am lumped-in with (for insurance rating purposes).

I could go on and on here but as ONE example, it might be a lot more fun for me to spend my time socializing, eating and drinking in "happy hour" 3 eves a week instead of spending those hours instead at the gym. But I choose to do what is best for my health. This doesn't make me "perfect" but it's where one of my priorities lie and my health care usage reflects this mindset.

I believe by age 50, most people's past decisions are a reflection on their current state of health.

Why don't you study the schedules for HDHP premiums with the various insurance companies for the 50-65 year old demographic, patentguy? You might be very surprised how little coverage is actually accessible for each premium category before out-of-pocket expenses in the thousands are required. And then study the premiums for a comprehensive plan (with lower copays and lower deductibles). They're in the stratosphere!!

Regarding social security (OASDI and death benefits), I have posted before that I believe the current laws unjustly enrich those who never worked, did not work the required amount of quarters and minors whose deceased parent did not work enough or for a high enough wage to justify the benefits paid to them. For these reasons, I am wondering if the fund is sustainable enough for those who DID contribute the required amount of quarters of FICA to be able to receive OASDI benefits when their time comes. SS has been totally mismanaged, IMO.

Submitted by Aecetia on October 22, 2010 - 3:24pm.

It is not sustainable unless something changes drastically: a big die off of old people, change the age at which people are eligible, more people paying into the system and paying higher percentages. Any combination of those may not set off riots, but it will certainly alienate those who are trying to eke out a living in this economy. This one is going to get ugly.

"This year, the system will pay out more in benefits than it receives in payroll taxes, an important threshold it was not expected to cross until at least 2016, according to the Congressional Budget Office."

http://www.nytimes.com/2010/03/25/busine...

Submitted by PatentGuy on October 22, 2010 - 6:08pm.

BG:

PG here. We're more of like minds than not. It's just that the "Brian's" have been in charge of the asylum, and the result is that more and more Americans feel entitled to have an equal outcome, be it health care, house, car, clothes, bank account, whatever, without having to put in an equal amount of work.

Why study your ass off to be an engineer, when you can major in art appreciation, and then complain that your are burdened with student loans you cannot afford to pay back?

The point you make about going to a bar instead of the gym - I can make the same point that I worked 80 hour weeks for the last 30 years (between grad schools and professional life), and as a result I make good (not great, but good) money. So, when Obama vilifies me based on my income in order to suck up to some labor union, yeah I get frosted about it. When I see some Brian or BGG types explain that the 50% of my income that I (self employed) already pay in Federal, Medicare, SS, CA, unemployment, workers comp insurance, property and sales taxes (not counting health insurance) is not "my fair share", well ... it's probably similar to how you feel about subsidizing America's legion of self-made (type II) diabetics.

But, let's be fair. It is one thing to subsidize "victims" of their own bad decisions, but quite another thing if someone is simply born with a medical condition. Maybe in another society where medical care was reasonably priced based on the service provided, they and their family could afford their care. But in this society, the rates for the uninsured cannot be paid by mere mortals and no one pretends they expect anyone to pay. I don't mind paying a piece of that care, which in and of itself is trivial next to the amount of taxes I pay to the drug companies to fill a tackle box full of pills for every old person.

We're an entitlement culture. Everyone is a victim. If you can figure out how to "change" this, you get my vote.

Submitted by Coronita on October 22, 2010 - 7:03pm.

PatentGuy wrote:
BG:

PG here. We're more of like minds than not. It's just that the "Brian's" have been in charge of the asylum, and the result is that more and more Americans feel entitled to have an equal outcome, be it health care, house, car, clothes, bank account, whatever, without having to put in an equal amount of work.

Why study your ass off to be an engineer, when you can major in art appreciation, and then complain that your are burdened with student loans you cannot afford to pay back?

The point you make about going to a bar instead of the gym - I can make the same point that I worked 80 hour weeks for the last 30 years (between grad schools and professional life), and as a result I make good (not great, but good) money. So, when Obama vilifies me based on my income in order to suck up to some labor union, yeah I get frosted about it. When I see some Brian or BGG types explain that the 50% of my income that I (self employed) already pay in Federal, Medicare, SS, CA, unemployment, workers comp insurance, property and sales taxes (not counting health insurance) is not "my fair share", well ... it's probably similar to how you feel about subsidizing America's legion of self-made (type II) diabetics.

But, let's be fair. It is one thing to subsidize "victims" of their own bad decisions, but quite another thing if someone is simply born with a medical condition. Maybe in another society where medical care was reasonably priced based on the service provided, they and their family could afford their care. But in this society, the rates for the uninsured cannot be paid by mere mortals and no one pretends they expect anyone to pay. I don't mind paying a piece of that care, which in and of itself is trivial next to the amount of taxes I pay to the drug companies to fill a tackle box full of pills for every old person.

We're an entitlement culture. Everyone is a victim. If you can figure out how to "change" this, you get my vote.

Ding ding ding...

Submitted by anon123 on October 22, 2010 - 8:18pm.

went from $144/month to $114 a month for the same plan, a 20% decrease. shocked when i ran the numbers, since this is the first decrease in my life. single, no kids, ppo.

Submitted by GH on October 22, 2010 - 8:19pm.

As a self employed person, the kind of health coverage I can purchase is full of loopholes, outs and restrictions.

My opinion. NOT participating in health coverage is the kind of civil disobedience required to FIX health care. Obama seems to believe that helping his clients by mandating coverage will fix things, but since his new law prices have skyrocketed.

Regular things like prescriptions, doctors visits, tests etc, should be paid for by individuals. The whole thing should work a lot more like car insurance, where the insurance company only gets involved where a big problem is involved, not for day to day needs.

In the mean time, with the downturn and corresponding increases, we were forced to ditch our coverage.

It is time to separate employment from insurance. Imagine if you were forced to work a W2 job to get groceries at a reasonable cost? Make group coverage available to EVERYONE. My understanding is that under Obamacare self employed will still not get the same coverage wage slaves get...

Think about this. You (or your company) spend $1,500 a month insuring your family ($18,000) a year or $180,000 over ten years. Take the $1500 and invest it even at a very low current rate of return say 2% and you can add another $30,000 or so to the total. That gives you 210,000 every ten years for medical catastrophes. I know the IRS will beat you to death for failure to pay into the insurance racket, but even then you are money ahead!

Submitted by bearishgurl on October 22, 2010 - 8:23pm.

anon123 wrote:
went from $144/month to $114 a month for the same plan, a 20% decrease. shocked when i ran the numbers, since this is the first decrease in my life. single, no kids, ppo.

anon123, if this is your ENTIRE premium for a HDHP, do you happen to be =<30 years of age?? If so, a lot of folks in your demographic (23-26 year-olds) just joined your ranks (to "flesh out" your premium-payor group)!!

Submitted by bearishgurl on October 22, 2010 - 8:28pm.

GH wrote:
. . . Regular things like prescriptions, doctors visits, tests etc, should be paid for by individuals. The whole thing should work a lot more like car insurance, where the insurance company only gets involved where a big problem is involved, not for day to day needs.

Absolutely, GH! But there are a LOT of people who think they need to make a dr. appt. for everyone in their family for a hangnail or the common cold. These are the ones "clogging the system" with low co-pays and a lot of time on their hands.

These types make it expensive for ALL of us!

Submitted by bearishgurl on October 22, 2010 - 8:42pm.

PatentGuy wrote:
. . . When I see some Brian or BGG types explain that the 50% of my income that I (self employed) already pay in Federal, Medicare, SS, CA, unemployment, workers comp insurance, property and sales taxes (not counting health insurance) is not "my fair share", well ... it's probably similar to how you feel about subsidizing America's legion of self-made (type II) diabetics.

But, let's be fair. It is one thing to subsidize "victims" of their own bad decisions, but quite another thing if someone is simply born with a medical condition. Maybe in another society where medical care was reasonably priced based on the service provided, they and their family could afford their care. But in this society, the rates for the uninsured cannot be paid by mere mortals and no one pretends they expect anyone to pay. I don't mind paying a piece of that care, which in and of itself is trivial next to the amount of taxes I pay to the drug companies to fill a tackle box full of pills for every old person. . .

Patentguy, I agree. I previously posted about "unlucky" persons you just mentioned with "birth defects." See:

http://piggington.com/ot_anyone_hear_the...

The current crop of seniors (WWII and "Greatest Generation") DID NOT have warnings on the sides of their cigarette packs early on, when they first became addicted. It was NOT WIDELY KNOWN that saturated fat clogged arteries and was a killer (my mom used to keep a can of lard in the middle of her stove . . . lol). It was a "cultural thing." That's why the plethora of pills now that you mention here. I choose NOT to live that way. I will find alternative therapies as I get older and my need arises for remedies to physical ailments. I will NOT go the "tackle-box-full-of-pills" route. That's just not for me.

Submitted by Hatfield on October 22, 2010 - 9:18pm.

I am self-employed, insured by Pacificare, offered through Costco although I received a notice awhile back that no new policies will be issued through Costco. Existing policies would still be honored. For the time being anyway.

My premium went up 34% this year, the largest YoY increase I've experienced.

With respect to the health care bill, I was in favor of having either a public option or health-care coops. Was greatly disappointed when these were eliminated.

I would have liked to have seen an experiment where health insurance followed the Auto Club model - a private corporation whose only shareholders were the insureds.

Submitted by paramount on October 23, 2010 - 9:42am.

davelj wrote:
paramount wrote:

Sooner or later I'll wise up and walk away from my house.

You and lots of other Piggs say this (often)... and then never actually do it. I'm waiting for one single Pigg to "strategically default." One. Please be that person. Then we can say that at least one Pigg walked the talk in this department.

Words are plentiful; deeds are precious.

Any more violent crimes in my hood and I will walk.

Submitted by UCGal on October 24, 2010 - 4:06pm.

flu wrote:
Ok...So I have to ask...Did any of you or will any of you actually benefit from the health care changes. I guess folks with preexisting conditions that aren't covered by a group policy from an employer will.. But I'm just curious if this is beneficial to anyone whom I consider in the need category (un-insurable or harder to insure category). I hope the answer is yes....

We're a pretty typical family - except that my husband and I are older than typical for having young kids.

I ran the numbers... since "preventative" care is paid for 100%, but the premiums only went up $5/month compared to the grandfathered plan. (I work for Mot, we're splitting and one part is grandfathered, one part is "new" and therefore subject to HCR. We'll come out ahead. $60/year = 3 copays. But no copays for pap, mamogram, kids checkups. That's $80/year savings. I'm ahead $20/year. Other than that, the coverage is exactly the same.

If I were on one of the other plans offered by my work the benefit would be the elimination of the lifetime max. For me, that's huge, since I've seen 3 immediate family members die of cancer. But that's a hypothetical...

Submitted by eavesdropper on October 24, 2010 - 5:05pm.

bearishgurl wrote:
.....Regarding social security (OASDI and death benefits), I have posted before that I believe the current laws unjustly enrich those who never worked, did not work the required amount of quarters and minors whose deceased parent did not work enough or for a high enough wage to justify the benefits paid to them. For these reasons, I am wondering if the fund is sustainable enough for those who DID contribute the required amount of quarters of FICA to be able to receive OASDI benefits when their time comes. SS has been totally mismanaged, IMO.

BG, with you on this one, and as you well know, I've ranted on this topic a few times. I'm so tired of hearing politicians go on about whether or not there will be enough to cover SS payments and Medicare for retiring seniors, yet NEVER mention the other groups that are sucking off the SS teat. There are now more applications for SS disability than there are for SS retirement payments. That's insane! This assault on the system by the allegedly disabled has been going on since at least the late 70s, and both political parties have stood by and done absolutely nothing. This is not what the SS system was set up to do, and if the politicians decided that there had to be some sort of program for disabled Americans, they should have set up an entirely new and separate program. The umbrella has been enlarged, over and over, to the size of a circus tent, but there's no fabric left to cover the frame.

They need to look at survivors' benefits carefully, also. Okay, I have to make a really humiliating confession here, but please don't let this dilute the message I am trying to send by doing so: I was watching an episode of MTV's "Teen Mom" recently (There! I said it.), and Farrah is trying to get her 15 month-old Social Security benefits. For the uninformed, Farrah is a 17 year-old high-school dropout with a super-Christian ultra-psychotic ex-cheerleader mother who was arrested for bloodying Farah's nose (actually, I was cheering the mom on when she did that, but she really is nucking futs!) and a baby girl who has had accidents from being left in dangerous situations so many times that betting pools have been set up in Vegas on when the kid's going to land up in the PICU. Well, it seems that Farrah got preggers, despite getting As in her advanced-placement abstinence-only education course. She cut off contact with the 18 year-old father 3 mos. into her pregnancy, and he died in an MVA two months prior to the baby's birth. Farrah has refused to allow the baby any contact with her father's family, despite their attempts to do so. However, this season we were treated to harrowing scenes of an overwhelmed Farrah struggling to make it as a single teen mom ("It's not faaaaairrr", she sobs at regular intervals), and increasingly sentimental revisionist tales of her history with Derek (the father), ultimately revealing that Farrah plans to apply for Social Security Survivor benefits for her daughter "who deserves them". Great! Taxpayers now get to foot the bill for at least 21 years of SS payments to a kid (actually the kid's mother) whose sperm donor paid roughly $2.91 into the system.

Okay, I'm pissed off enough about this. But now there will be how many other 15 yr-olds out there, lucky enough to have deceased baby daddies, making a beeline for the nearest SS office so they can cash in on this bonanza. In fact, I predict some sperm donor homicide in cases where the father hasn't had the decency to croak before his time.

Then there are the television shows and news reports on freaks of nature like Octomom and the Kirton family of "Autism x 6" who reveal how they struggle through their ordeal with NO government aid at all, but then let it slip that their offspring receive social security disability payments for ADHD and Asperger's Syndrome.

The Social Security Administration's definition of qualifying disability is as follows: "...condition must be severe enough to prevent them from doing any kind of work for which they are suited". ANY kind of work for which they are SUITED. That doesn't mean work that you have performed in the past, or the profession in which you got your degree. It means if you cannot work as an electrician, or as a nurse, or as a draftsman, you may have to take a job as a file clerk or a machine operator. Total disability in its genuine form is not often encountered. In FY 2009, there were over 2.8 million initial applications for disability benefits, over 430,000 more than FY 2008. In FY 2008, the number of initial applications exceeded FY '07's by 100,000. Does anyone else have difficulty believing that, in 2008, almost 3 million people developed a condition or sustained an injury that made them umnable to perform any type of work at all? Or that between 2007 and 2008, the number of these conditions/injuries increased by 400%?

But the Social Security Administration continues to approve the applications, and make the payments. Believe it or not, obesity is a qualifying condition, and lawyers recommend that their non-obese patients gain 60 or 70 pounds to increase their chances, not only at approval of benefits for a co-morbid condition, but at a judgement that will not be reviewed in the future, since obesity is so difficult to treat.

I can't imagine that the fund is large enough to sustain anything NOW, much less years from now. I find it shocking enough that these kinds of payments are being made to individuals who have made little or no contribution to the fund. If lawmakers are ignoring this area of the SS crisis or, worse yet, totally unaware of it, the fallout will be devastating.

BTW, here's a link to an interesting article published in the Washington Post last March during the health care debate. It's about a Tea Party leader/activist, quite vocal in his calls against government intervention and interference in the lives of Americans, who apparently doesn't object to intervention in the form of monthly disability checks. I'm experiencing some doubts regarding his claims of total disability in light of the work he does with his antigovernment group and the blog he manages to maintain. Perhaps I just don't have a heart....

http://www.washingtonpost.com/wp-dyn/con...

Submitted by eavesdropper on October 24, 2010 - 6:06pm.

bearishgurl wrote:
GH wrote:
. . . Regular things like prescriptions, doctors visits, tests etc, should be paid for by individuals. The whole thing should work a lot more like car insurance, where the insurance company only gets involved where a big problem is involved, not for day to day needs.

Absolutely, GH! But there are a LOT of people who think they need to make a dr. appt. for everyone in their family for a hangnail or the common cold. These are the ones "clogging the system" with low co-pays and a lot of time on their hands.

These types make it expensive for ALL of us!

And I definitely like this. The cost of health care will never go down until it becomes competitive. And competition will never come to pass until people become consumers - actual consumers who shop for and compare providers, tests, drugs, etc., and rate their quality and cost-effectiveness. Admittedly, it's not the same as buying produce at the Safeway, and I don't mean to downplay the complexity and importance. But until people have more of an investment in the system, things won't change. People that are heavily insured and who do not experience serious illness, either personally or in their families, are too far removed from the shortcomings and problems of the system to be affected by them. It's the people who are affected by them that effect change. We need to move people closer to the system, and the suggestions from GH and BG are a good way to do that. Not only will this help to remedy the problems of the existing system, it will significantly reduce the rate of trivial overutilization.

Also, I don't know about everyone else, but I've experienced regular yearly increases in health insurance premiums since the early 90s, at least. This period spans three employers for me, and three for my husband. Every year, we have to pay a larger amount in monthly premium share, which typically reflects a premium hike by the insurer being passed onto employees. Less frequently, our co-pays go up.

Interestingly enough, for those Piggs who have voiced complaints about the health benefits of Federal employees: my husband recently returned to Federal government employment. He is at a high level (as a result of both extensive education and experience), but his pay is comparable to, or a bit less than that offered by private industry (where he has toiled for the past fifteen years). Of the many choices offered, out of medical necessity we enrolled in the most expensive health plan that provided the best coverage across the board. The coverage is must less comprehensive than either of us had in private industry/education, and we are paying much more in out of pocket expenses. For instance, I've never paid anything for mammography or ultrasound or MRI examination of the breast; however, I can now look forward to ponying up a couple hundred dollars for the privilege and pleasure of the GE Senographe DMR+ experience, i.e., the equivalent of having the my tits repeatedly put through a wringer washer. For those of you too young to know what that is, I've included a link to YouTube footage (is there ANYTHING people won't put on film?); the comparison to mammography starts about 1 minute into the film clip.

http://www.youtube.com/watch?v=9BsDkGNxWOA

I hope that I've cleared up a bit of the misinformation concerning the high life of Federal government employees.

Submitted by bearishgurl on October 24, 2010 - 9:08pm.

eavesdropper, thanks for mentioning all the adults on "`questionable' SS disability compensation" (SSD) as well as kids qualifying for the same program (based alone upon their being prescribed Ritalin for "ADHD") . . . lol. It is little known by the public that the SSD (and the "SSI" program) has been raiding the OASDI program since their inception. These (over)payments to individuals who fed no FICA payments into the "system" are/will actually take away from those who did.

Many SSI recipients are simply immigrants who were brought into this country (when they were already over 60 years of age) by "sponsors" who promised the INS that they would financially support them for life as a condition of their residency and eventual green card. When the sponsor(s) fell on "hard times" (i.e. lived beyond their means, overmortgaged their propertie(s), etc.), they claimed they were no longer able to "support" their elderly relative (still living with them) so the relative applied for SSI (to help with household income). MANY were successful (esp. here in South County).

eavesdropper, you are absolutely correct in that the government and Congress are "looking the the other way" from this (and the aforementioned "loopholes") when trying to determime why the OASDI fund may not be solvent for you and me to collect when our time comes (God forbid should any younger Piggs EVER be able to). The working public should be very angered by these systematic raids of their FICA withholdings to this Ponzi scheme for which the uses of the $$ are allocated at the whim of whoever's currently supposed to be "minding the store." I for one am outraged, but a fat lot of good this will do me :=[

Submitted by patb on October 25, 2010 - 7:03am.

paramount wrote:
My losses

1. My pension
2. 401k cut by 50%
3. Vacation time cut
4. Lost all sick time
5. Lost holidays (including July 4th)
6. And now choice in Healthcare

But oh yes, were supposed to be happy to have a job.

We've been duped into thinking unions are bad; if I was union my employer wouldn't be getting away with stripping our benefits without a fight.

Sooner or later I'll wise up and walk away from my house.

Why not start a union?

Submitted by justme on October 25, 2010 - 10:12am.

Air-ogi, that is a very good point.

>>So what is going on is that as prices are rising, more and more healthy people are leaving the insurance pool. And it's an interesting cycle, since as more healthy people leave the pool, the higher the rise in the insurance rates, resulting in more healthy people leaving the pool.

Submitted by hugo75 on November 10, 2010 - 10:38am.

Employer: large private university

2010 (Single employee)

  • Monthly Premium: $36.00
  • Monthly Employer Contribution: $397.56
  • Annual Deductible: $0
  • Out-of-pocket maximum: n/a
  • Primary Care: $20 copay in-network ($10 copay for university medical practice)
  • Specialist: $30 copay in-network ($20 copay for university medical practice)
  • Urgent Care: $50 copay
  • Emergency: $100 copay
  • Hospital Services: covered 100% in-network

    2011 (Single employee)

  • Monthly Premium: $88.97 (147.14% increase)
  • Monthly Premium (if participating in an employer-sponsored wellness plan): $68.97 (91.58% increase)
  • Monthly Employer Contribution: $370.82 (6.73% decrease)
  • Annual Deductible: $250
  • Out-of-pocket maximum: $1,250
  • Primary Care: 10% co-insurance after deductible ($10 copay for university medical practice)
  • Specialist: 10% co-insurance after deductible ($20 copay for university medical practice)
  • Urgent Care: $50 copay
  • Emergency: $100 copay
  • Hospital Services: 10% co-insurance after deductible
  • Submitted by Ricechex on November 10, 2010 - 6:30pm.

    paramount wrote:
    This year the only choice we have is Cigna; all other options have been dropped.

    So just to review, in the last 2 years I have lost the following:

    1. My pension
    2. 401k cut by 50%
    3. Vacation time cut
    4. Lost all sick time
    5. Lost holidays (including July 4th)
    6. And now choice in Healthcare

    But oh yes, were supposed to be happy to have a job.

    Meanwhile, public sector workers live in a fairy tale world of high pay and benefits including golden pensions and lifetime benefits.

    We've been duped into thinking unions are bad; if I was union my employer wouldn't be getting away with stripping our benefits without a fight.

    Sooner or later I'll wise up and walk away from my house.

    Paramount---that is just horrible! Those are huge losses in such a short time. I would have a hard time being positive at work, after being cut like that. Can you find another job with better benefits?

    As for me, payments only went up $6 bucks a month. Everything else stayed the same--copays, $30, etc. However, next year, I am waiting for the shoe to drop.

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