health care law - confused again

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defiantbadgirl -> health care law - confused again (5/21/2013 9:25:48 PM)
Not too long ago, I started a thread about the possibility of separating health insurance and employment (choosing the exchanges over employee based insurance). I learned from the thread that those with employee health insurance couldn't drop their coverage to sign up on the exchanges. People had to lack the opportunity of employee coverage to be eligible for the exchanges. Does this new article I just finished reading suggest otherwise, or am I interpreting it wrong? http://finance.yahoo.com/news/skip-obamacare-keep-old-plan-123222431.html

LafayetteLady -> RE: health care law - confused again (5/21/2013 10:45:13 PM)
You are interpreting it wrong.

MrRodgers -> RE: health care law - confused again (5/22/2013 2:12:32 AM)
It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. Yes, there is an introduction here of a bit of price competition but trust me kinkroids...it won't be much. This also can just as easily result in employers no longer offering insurance but I am not so sure how much flexibility they have on that count. I think if there are 50 or more employees, your employer then has a large enough group that by law, will be required to offer a group plan.

LafayetteLady -> RE: health care law - confused again (5/22/2013 3:21:47 AM)
quote: ORIGINAL: MrRodgers It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. Yes, there is an introduction here of a bit of price competition but trust me kinkroids...it won't be much. This also can just as easily result in employers no longer offering insurance but I am not so sure how much flexibility they have on that count. I think if there are 50 or more employees, your employer then has a large enough group that by law, will be required to offer a group plan. There are certain conditions that need to be met to use the exchange over the employer, and not many will qualify. But the article wasn't about that anyway. There are certain policies that were "grandfathered" making them exempt from the new health care laws (except for a couple of things like insuring children on parents' medical until 26). They won't have to remove lifetime caps, etc. Nothing really of value concerning whether or not the employee could choose NOT to accept the employer's plan. If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. So no, you won't have a choice between your employer and the exchange.

DesideriScuri -> RE: health care law - confused again (5/22/2013 4:19:54 AM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: MrRodgers It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. Yes, there is an introduction here of a bit of price competition but trust me kinkroids...it won't be much. This also can just as easily result in employers no longer offering insurance but I am not so sure how much flexibility they have on that count. I think if there are 50 or more employees, your employer then has a large enough group that by law, will be required to offer a group plan. There are certain conditions that need to be met to use the exchange over the employer, and not many will qualify. But the article wasn't about that anyway. There are certain policies that were "grandfathered" making them exempt from the new health care laws (except for a couple of things like insuring children on parents' medical until 26). They won't have to remove lifetime caps, etc. Nothing really of value concerning whether or not the employee could choose NOT to accept the employer's plan. If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. So no, you won't have a choice between your employer and the exchange. According to my ex (an HR Mgr.), employer plans don't have to change to meet standards (if they don't already) until they are renegotiated, at which point, the plans had to include the entirety of the changes. Now, this was also 2011 that I asked her about it, so things could certainly have changed since then. Since we got divorced in May 2012 and her employer didn't re-sign insurance papers until end of September, I have not talked to her about it since '11.

kalikshama -> RE: health care law - confused again (5/22/2013 4:41:22 AM)
The article does not appear to be about employer plans vs exchanges but old (grandfathered) employer plan vs new employer plan.

LafayetteLady -> RE: health care law - confused again (5/22/2013 9:50:06 AM)
quote: ORIGINAL: DesideriScuri According to my ex (an HR Mgr.), employer plans don't have to change to meet standards (if they don't already) until they are renegotiated, at which point, the plans had to include the entirety of the changes. Now, this was also 2011 that I asked her about it, so things could certainly have changed since then. Since we got divorced in May 2012 and her employer didn't re-sign insurance papers until end of September, I have not talked to her about it since '11. Plans that were in place in 2010 when the bill was signed are grandfathered, so I am guessing your ex's plan no longer is.

DesideriScuri -> RE: health care law - confused again (5/22/2013 11:05:01 AM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri According to my ex (an HR Mgr.), employer plans don't have to change to meet standards (if they don't already) until they are renegotiated, at which point, the plans had to include the entirety of the changes. Now, this was also 2011 that I asked her about it, so things could certainly have changed since then. Since we got divorced in May 2012 and her employer didn't re-sign insurance papers until end of September, I have not talked to her about it since '11. Plans that were in place in 2010 when the bill was signed are grandfathered, so I am guessing your ex's plan no longer is. Is it true (I'm fairly certain this is what she had said) that if nothing changes - at all - then the plans stay grandfathered? And, that an increase in premiums is an example of a change that would end the grandfather status?

LafayetteLady -> RE: health care law - confused again (5/22/2013 1:34:40 PM)
quote: ORIGINAL: DesideriScuri quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri According to my ex (an HR Mgr.), employer plans don't have to change to meet standards (if they don't already) until they are renegotiated, at which point, the plans had to include the entirety of the changes. Now, this was also 2011 that I asked her about it, so things could certainly have changed since then. Since we got divorced in May 2012 and her employer didn't re-sign insurance papers until end of September, I have not talked to her about it since '11. Plans that were in place in 2010 when the bill was signed are grandfathered, so I am guessing your ex's plan no longer is. Is it true (I'm fairly certain this is what she had said) that if nothing changes - at all - then the plans stay grandfathered? And, that an increase in premiums is an example of a change that would end the grandfather status? That I don't know, however, even if the plan that was re-signed is the same as the old, my understanding is that it now falls outside of the grandfather clause. But I could be wrong.

mnottertail -> RE: health care law - confused again (5/22/2013 1:38:02 PM)
quote: ORIGINAL: DesideriScuri Is it true (I'm fairly certain this is what she had said) that if nothing changes - at all - then the plans stay grandfathered? And, that an increase in premiums is an example of a change that would end the grandfather status? The old no ex-post facto law prohibition. But if you change it, new business.

MrRodgers -> RE: health care law - confused again (5/22/2013 5:26:13 PM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: MrRodgers It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. Yes, there is an introduction here of a bit of price competition but trust me kinkroids...it won't be much. This also can just as easily result in employers no longer offering insurance but I am not so sure how much flexibility they have on that count. I think if there are 50 or more employees, your employer then has a large enough group that by law, will be required to offer a group plan. There are certain conditions that need to be met to use the exchange over the employer, and not many will qualify. But the article wasn't about that anyway. There are certain policies that were "grandfathered" making them exempt from the new health care laws (except for a couple of things like insuring children on parents' medical until 26). They won't have to remove lifetime caps, etc. Nothing really of value concerning whether or not the employee could choose NOT to accept the employer's plan. If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. So no, you won't have a choice between your employer and the exchange. It is my understanding that for any company with fewer than 50 employees, the employer will not be required to offer a company sponsored (contribution) health insurance plan. This is one who is for Obama care's treatment of small businesses. Here Requirements for those companies with less than 50 employees. Here This one is good on the subject of the uninsured. Here

defiantbadgirl -> RE: health care law - confused again (5/22/2013 8:15:45 PM)
quote: ORIGINAL: MrRodgers It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. What about deductibles that are too high? Many businesses keep premiums low by only offering high deductible policies. What if a low income worker whose company only offers high deductible health insurance has a spouse with a chronic condition and can't afford the deductible? Would the government provide subsidies to pay most of the high deductible? If the employee dropped the chronically ill spouse from their high deductible policy, would the newly uninsured spouse then be eligible to sign up for a low deductible policy on the exchanges?

defiantbadgirl -> RE: health care law - confused again (5/22/2013 8:26:44 PM)
quote: ORIGINAL: LafayetteLady quote: ORIGINAL: MrRodgers It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. Yes, there is an introduction here of a bit of price competition but trust me kinkroids...it won't be much. This also can just as easily result in employers no longer offering insurance but I am not so sure how much flexibility they have on that count. I think if there are 50 or more employees, your employer then has a large enough group that by law, will be required to offer a group plan. There are certain conditions that need to be met to use the exchange over the employer, and not many will qualify. But the article wasn't about that anyway. There are certain policies that were "grandfathered" making them exempt from the new health care laws (except for a couple of things like insuring children on parents' medical until 26). They won't have to remove lifetime caps, etc. Nothing really of value concerning whether or not the employee could choose NOT to accept the employer's plan. If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. So no, you won't have a choice between your employer and the exchange. Can an employee's housewife choose between being covered on her husband's high deductible policy or signing up for a lower deductible on the exchanges?

Real0ne -> RE: health care law - confused again (5/22/2013 8:32:29 PM)
quote: ORIGINAL: DesideriScuri quote: ORIGINAL: LafayetteLady quote: ORIGINAL: DesideriScuri According to my ex (an HR Mgr.), employer plans don't have to change to meet standards (if they don't already) until they are renegotiated, at which point, the plans had to include the entirety of the changes. Now, this was also 2011 that I asked her about it, so things could certainly have changed since then. Since we got divorced in May 2012 and her employer didn't re-sign insurance papers until end of September, I have not talked to her about it since '11. Plans that were in place in 2010 when the bill was signed are grandfathered, so I am guessing your ex's plan no longer is. Is it true (I'm fairly certain this is what she had said) that if nothing changes - at all - then the plans stay grandfathered? And, that an increase in premiums is an example of a change that would end the grandfather status? maybe but that is not the way the article read. My take is they are referencing status not price.

Real0ne -> RE: health care law - confused again (5/22/2013 8:39:35 PM)
quote: ORIGINAL: defiantbadgirl quote: ORIGINAL: LafayetteLady quote: ORIGINAL: MrRodgers It is my understanding that all employees have a choice. Either the company employees are healthy enough and make up a large enough group to make your premiums low enough to beat what the exchanges offer or you then go to the exchanges to buy it on your own without joining the group at work. Yes, there is an introduction here of a bit of price competition but trust me kinkroids...it won't be much. This also can just as easily result in employers no longer offering insurance but I am not so sure how much flexibility they have on that count. I think if there are 50 or more employees, your employer then has a large enough group that by law, will be required to offer a group plan. There are certain conditions that need to be met to use the exchange over the employer, and not many will qualify. But the article wasn't about that anyway. There are certain policies that were "grandfathered" making them exempt from the new health care laws (except for a couple of things like insuring children on parents' medical until 26). They won't have to remove lifetime caps, etc. Nothing really of value concerning whether or not the employee could choose NOT to accept the employer's plan. If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. So no, you won't have a choice between your employer and the exchange. Can an employee's housewife choose between being covered on her husband's high deductible policy or signing up for a lower deductible on the exchanges? I did not see any restriction that you could not be covered under both if you wanted as long as his policy is within the grandfather exeption. march 2010 I thin it was. the grandfather is option if you prefer your present policy, otherwise you can opt for ohaha care.

LafayetteLady -> RE: health care law - confused again (5/22/2013 9:25:01 PM)
First, I'm reading articles the same as you, apparently my comprehension is just better. The exchanges are for those who aren't offered other policies is my understanding, not something you can choose simply because you don't like the one your (or your spouse's) employer offers. I will repeat what I said earlier that apparently wasn't read. quote: If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. If you can think logically for a moment, if people were able to do what you want, then everyone would choose the exchanges unless their employers offered great coverage. The employers would be off the hook, and that isn't going to happen. If you really want answers to all this, then you need to speak to someone who handles these things. The employer's HR department, possibly the local social security or social services offices. Perhaps an insurance agent who sells health care policies. Look, I get it, you have chronic health issues and are wondering how all of this will impact you. It's understandable. But this is NOT the place to get solid answers. We are all reading the same articles, and as far as I know, no one here is an insurance agent in the US who might actually know for sure. In other words, we are offering our opinions based on our understanding of the article. While that may help you because we understand the articles better, it is still only our opinion and not a sure thing that you could "quote" to anyone else when trying to do what you want to do. GO to the sources who can give you definitive answers.

tazzygirl -> RE: health care law - confused again (5/23/2013 5:59:22 AM)
Who Participates in the State Run Health Insurance Exchange The ObamaCare health insurance exchanges are meant to offer affordable, quality health insurance to small employers and people purchasing their own health coverage. These groups have historically had trouble obtaining affordable healthcare plans that meet the current standards of health care under ObamaCare, the online marketplace is meant to remedy this. Although, the Health Insurance Exchanges are available to everyone, those who have other options that meet the standards of ObamaCare will not receive financial help. This includes those who make over 400% of the poverty level. Workers who already have health insurance through an employer can use the Health Insurance Exchanges. However, they may not be eligible for premium tax credits or cost-sharing reductions, unless their employer-based coverage is inadequate or unaffordable. http://obamacarefacts.com/obamacare-health-insurance-exchange.php Its open to everyone.

LafayetteLady -> RE: health care law - confused again (5/23/2013 1:08:17 PM)
But without tax credits, will it be affordable? Plus, my understanding is you can that it would be additional insurance. I'm not doubting what you are saying, but again, if people can choose their employer or the exchange, what is to stop employers from offering the worst plan available that meets the minimum standards in order to push their employees to the exchange? This would, theoretically save the employer the fines (they offer it, not their fault no one takes it), yet they still wouldn't be providing the insurance. The would get exactly what they are crying about now. Continue to not provide insurance, and not be fined for it.

tazzygirl -> RE: health care law - confused again (5/23/2013 1:51:17 PM)
It is my understanding that there are penalties levied against the employer depending on who joins the exchange as a result of affordability and offerings. Forbes ran a piece on this 2 days ago.... The strong penalty vs. the weak penalty The employer mandate actually consists of two different penalties, based on two different categories of employer behavior. These originate from Section 4980H of the Affordable Care Act. Subsection (a) requires steep penalties for employers who offer no coverage at all. Subection (b) requires modest penalties for employers who offer “minimum essential coverage under an eligible employer-sponsored plan.” This difference—between the strong penalty in 4980H(a) and the weak penalty in 4980H(b)—is crucial to understanding how things will play out in the future. Under the strong penalty, in which an employer “fails to offer to its full-time employees…the opportunity to enroll in minimum essential coverage,” and “at least one full-time employee” enrolls in an exchange, the employer has to pay a fine of $2,000 times the total number of full-time-equivalent employees at the firm, minus 30. (The employer mandate only applies to firms with 50 or more full-time-equivalent workers.) So if you employ 50 workers, that’s a fine of 20 * $2,000 = $40,000. And the fine isn’t tax-deductible, adding to the pain. Under the weak penalty, in which an employer does offer “the opportunity to enroll in minimum essential coverage,” but that coverage doesn’t meet Obamacare’s requirements for affordability or actuarial value, and at least one worker enrolls on an exchange instead, the fine is $3,000 times the number of workers who enroll on the exchanges. So, if you employ 50 workers, and three of them get coverage on the exchange instead, the fine is a much lower 3 * $3,000, or $9,000. (Technically, in subsection (b), employers pay the lesser of the weak penalty or the strong penalty, but this in most cases should be the weak penalty.) So: Employers avoid the strong penalty and gain eligibility for the weak penalty by offering “minimum essential coverage.” So what is “minimum essential coverage?” http://www.forbes.com/sites/theapothecary/2013/05/21/employers-can-minimize-their-exposure-to-obamacares-health-insurance-mandate-by-offering-low-cost-skinny-coverage/ 3 employees out of 50 isnt a huge issue. 40 out of 50 and that definitely changes.

defiantbadgirl -> RE: health care law - confused again (5/23/2013 2:47:49 PM)
quote: ORIGINAL: LafayetteLady First, I'm reading articles the same as you, apparently my comprehension is just better. The exchanges are for those who aren't offered other policies is my understanding, not something you can choose simply because you don't like the one your (or your spouse's) employer offers. I will repeat what I said earlier that apparently wasn't read. quote: If you think about it, that would be getting the employers completely off the hook for providing insurance. Just like there were some morons who subtly told employees that if they voted for Obama, they would be fired, likewise employers would search out and find the lousiest medical package they could (and in fact insurers are marketing this), so that employees would go to the exchanges. Then when it came time to fine the employer, they would shrug their shoulders, say they offered it, but no one would take it. If you can think logically for a moment, if people were able to do what you want, then everyone would choose the exchanges unless their employers offered great coverage. The employers would be off the hook, and that isn't going to happen. If you really want answers to all this, then you need to speak to someone who handles these things. The employer's HR department, possibly the local social security or social services offices. Perhaps an insurance agent who sells health care policies. Look, I get it, you have chronic health issues and are wondering how all of this will impact you. It's understandable. But this is NOT the place to get solid answers. We are all reading the same articles, and as far as I know, no one here is an insurance agent in the US who might actually know for sure. In other words, we are offering our opinions based on our understanding of the article. While that may help you because we understand the articles better, it is still only our opinion and not a sure thing that you could "quote" to anyone else when trying to do what you want to do. GO to the sources who can give you definitive answers. I did that. I contacted an insurance agent and she didn't know. Then, I called the health insurance commissioner's office in my state. The lady I spoke with advised me to examine options on the exchanges and if I found something better, to have my husband drop me from his employee insurance and sign up on the exchanges. When I told her I thought I wouldn't be eligible because the exchanges were only for people who couldn't get insurance through work, she reminded me that I was the wife, not the employee. But my state refused to set up its own exchanges, so they will be set up by the federal government. I keep wondering, since she's a state worker, could she be wrong about eligibility for federal exchanges? I read something about call centers for people with questions about the new health insurance law, but I can't find any phone numbers. Believe me, I've been trying to find sources with definitive answers. Also, this isn't just about me. I'm sure I'm not the only one on these boards with health issues and high deductibles. I seriously doubt I'm the only one with specific questions about the health insurance law.

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