Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[skinsmarydu]

deleted post

Edited December 4, 2013 by skinsmarydu

[chipwhich]

It took me twice to make sure I wasn't reading your nonsense in error, in that you pay your employees' deductibles. You must make a buttload of money, since you already told me your payments per person/family.

 

Well those days are changing SMD.  Each year gets worse.

Like I said, we will all be in the High Deductible ship and paying our own deductibles for long.

What you might have missed is I said it was CHEAPER to pay the deductible and switch to a high deductible plan than to keep a normla HMO/PPO.

 

Meaning your husbands company probably pays more than I do per person. 

[Duckus]

My wife and I are looking around for insurance. 

 

I work for a small company and get reimbursed on insurance through work, but I pay for my wife (grad student) and daughter right now out of pocket.

 

Their insurance is about $400 per month. $500 deductible. $2,000 out of pocket maximum. 80/20 coinsurance. It has a $500,000 life-time maximum still (thought this was illegal?). Worst part - it has a really ****ty prescription plan. You have to use the university health center to pick them up - a total pain in the butt. Grad students are not on main campus that often. 

 

Got an ObamaCare quote last month. Figured I would share.

 

Platinum: $384.69 per month. $0 deductible. $3,000 maximum. Most coverage is 80/20 coinsurance. 

 

- A little bit cheaper

- $0 deductible 

- Far better prescription plan

- Same coinsurance

- No BS life-time maximum

- COmparable out of pocket maximum

 

Overall, I like what I see from the platinum platinum. Bette than my current plan. The gold plans were "blah"and I wasn't interested in the cheap ones with high deductibles. 

 

I will be getting more quotes in the next few weeks before deciding to enrolling via ObamaCare or not. 

Edited December 4, 2013 by Duckus

[twa]

Duckus, the quotes pre-enrolling were QUITE different than the ones given to me once applying....$1200 platinum

 

hopefully you will have better luck 

[Duckus]

Duckus, the quotes pre-enrolling were QUITE different than the ones given to me once applying....$1200 platinum

 

hopefully you will have better luck 

 

Just logged in before posting and re-ran the quotes. It was still $384.69 for the two of them (29 year old & 6 month old). I might be able to find cheaper via those sites like http://www.ehealthinsurance.com/ - so still need to look around.

[Elessar78]

Some choice quotes from Facebook (friends of friends of mine). Just shocking what people actually think, oh if it's NOT clear these are anti-ACA quotes:

 

"Not like you induced it, the whole county bought in to it (no pun intended). Well alotta folks did. I never thought it was a good idea. We never had health insurance when I was a kid, if ya got sick ya payed the doctor bill and that was that. And guess what, hospitals get monies from the state and the fed under the Hill-Butran act. So even if something catastrophic happened you were still covered. Still are as I understand it. This whole Obama care stuff stinks to high heaven and I'm not buying into it. Health insurance from its inception never did anything but drive cost to astronomical levels and open the door for $75.00 aspirin and a host of other out right fraud, fraud we all end up paying for at one point or another. I say demand this cluster **** be repealed and its authors be jailed for attempting to scam America on such a massive scale. But hey that's just my two cents, then again I work for a living and I know 200.00 a month can make one hell of a lot of difference. End Rant."

 

"You are right about driving up the costs. My sister recently had a 30 minute procedure done and her anesthesia was $11,000. That is ridiculous. People should not go bankrupt because of a health condition or treatment."

[twa]

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.

http://washingtonexaminer.com/doctors-boycotting-californias-obamacare-exchange/article/2540272

Obamacare Rules Could Add Big Costs for Volunteer FDs

http://www.firehouse.com/news/11267556/obamacare-requires-fire-departments-to-pay-for-volunteers-health-insurance

So far, the IRS hasn't decided what to do.

Efforts to reach spokesmen for the IRS were unsuccessful.

Under the fire chiefs' organization's interpretation, the concern goes like this:

The health care reform law, known officially as the Patient Protection and Affordable Care Act and derisively by Republicans as Obamacare, requires employers with 50 or more full-time employees to offer health insurance. Companies with fewer than 50 employees do not have to offer insurance. Full-time employees are defined as an employee who works 30 or more hours a week.

Such employers who don't offer health insurance must pay fines.

The requirement is complicated by differing interpretations about the status of volunteer firefighters within the federal government. The Department of Labor, according to the fire chiefs group, classifies most volunteers as non-employees, but the IRS considers all volunteer firefighters and emergency medical personnel to be employees of their departments.

"If the IRS classifies volunteer firefighters and emergency medical personnel as employees in their final rule, fire departments may be unintentionally forced to comply with requirements that could force them to curtail their emergency response activities or close entirely," the chiefs' group says on its website.

Mr. Barletta said the problem could be even more complicated if the IRS counts volunteer hose companies as one department in towns with more than one hose company or as part of a town's workforce. Definitions like that could bump the total numbers beyond the 50-employee threshold and require offering coverage that towns or hose companies cannot afford, he said. The IRS must also define what sort of volunteer duty counts toward the 30-hour-a-week limit.

[twa]

Earlier we touched on HSA's reducing income before the selfemployment tax(Larry referred to it as FICA tax)

This article looks at the combinations and potential deductions needed to reach what is your MAGI(adjusted gross income)and how it impacts taxes and subsidies

http://obamacareguide.wordpress.com/2013/10/20/figuring-your-household-income-part-two/

then throw in a HSA qualified plan is a higher premium for expanded out of network coverage(which makes no sense to me that the network only plan is not HSA eligible despite having the same ded ect)

just figuring out my possible MAGI's is giving me a headache w/o even throwing in the effects on subsidies or the maximum the taxpayer is required to pay via benchmarks...w/o even worrying the IRS will interpret the law differently than written.


I need to go to work for Chipwich   
 

[chipwhich]

I need to go to work for Chipwich 

 

Oh it's getting just as ugly for me.

My HSA eligible plans never provided any extended out of network coverage.  You had to remain in network, that concept is new to me.

This is why I have been saying you wont be able to determine much of anything from those spreadsheet comparison charts they give you on the healthcare website.  I have an insurance broker and representatives from BC/BS, Cigna, etc laying out all of the differences.  I can't figure them out on my own

 

Since the deductibles are skyrocketing, this year I switched my employees to an HRA plan (it was $1200 for individuals and $2400 for families to $2000 and $4000 respectively.  HRA is a Health Reimbursement Account which pays employees deductibles as they use it.  Under the HSA I was funding the deductible all at once (I tried doing it monthly but SOME employees were blowing through the deductibles in < 3 months).  Under the HSA if an employee never went to the doctor, they would get to keep that money.

 

I also switched to Cigna this year, last year I tried to switch to Cigna but only around 60% of my employees doctors participated in that plan, this year it jumped to 100%.  My benefits brokers and insurance company reps did all of the legwork to research this.  After switching to Cigna, I did find out some employees lost certain types of treatments that didn't appear on any spreadsheet comparing BC/BS to Cigna.  The spreadsheets only cover basic stuff like doctors visits, hospital visits, copays, etc.  It doesn't tell you what they actually cover, what needs referrals, when an MRI is "allowed" and "unallowed".  I ran into all this after the switch.

 

Now looking at $6000 and $12000 deductibles in the healthcare website, my head is spinning.

For everyone who has coverage now, I don't know of a single person who likes these new high deductible plans.

 

So basically what you get on the healthcare website is a chance to pick a cheap policy and hope it fits your needs.  After a year in that policy, if it doesn't fit your needs, I guess you can try something else.  I do admit I don't know how Obamacare handles renewals, or cancellations for yearly updates.

 

It's a big headache.  Every July I get to revisit it, I think next July will be my biggest adventure yet.

[Larry]

Earlier we touched on HSA's reducing income before the selfemployment tax(Larry referred to it as FICA tax)

 

 

 

This is, perhaps, because it is the FICA tax. 

 

The "employer's contribution" of the FICA tax. 

 

(See, for every dollar if FICA that most people's employers take out of their paycheck, the employer is required to "contribute" another dollar.  The self employment tax exists because, when someone is self employed, then he is both the employer and the employee.  And, therefore, is on the hook for both halves of the tax.) 

 

Larry chose to let the topic drop, because Larry knew it was a distraction from the topic of the thread, and wasn't relevent to the question Larry asked.  (Whether HSA contributions actually reduced said tax.) 

[twa]

Oh it's getting just as ugly for me.

My HSA eligible plans never provided any extended out of network coverage.  You had to remain in network, that concept is new to me.

This is why I have been saying you wont be able to determine much of anything from those spreadsheet comparison charts they give you on the healthcare website.  I have an insurance broker and representatives from BC/BS, Cigna, etc laying out all of the differences.  I can't figure them out on my own

 

 

this was  marketplace plans that appear identical except the HSA plan was about twice as high and allowed reduced benefit out of network.

 

I agree the spreadsheets leave much to be desired....as does the BCBS website

[Larry]

Oh it's getting just as ugly for me.

My HSA eligible plans never provided any extended out of network coverage.  You had to remain in network, that concept is new to me.

This is why I have been saying you wont be able to determine much of anything from those spreadsheet comparison charts they give you on the healthcare website.  I have an insurance broker and representatives from BC/BS, Cigna, etc laying out all of the differences.  I can't figure them out on my own

 

One of the great things about competition. 

 

Want to find out what's bad about an insurance plan?  Just let his competitor tell you. 

 

one of the advantages you have, compared to a whole lot of people.  Yeah, you no doubt get slanted information.  But often, slanted information from multiple, competing, sources, beats the heck out of no information at all.  (Which is what almost everyone else is stuck with.) 

[twa]

This is, perhaps, because it is the FICA tax. 

 

 

The FICA equivalent, but not actually the FICA tax

 

http://sherayzenlaw.com/difference-between-self-employment-tax-and-fica-tax/

 

Difference between Self-Employment Tax and FICA tax - Sherayzen Law Office

• You are here:
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• Difference between Self-Employment Tax and FICA tax - Sherayzen Law Office

The best way to understand the difference between the Self-Employment tax (“SE tax”) and the FICA (Federal Insurance Contributions Act) tax is by contrasting self-employment versus regular salary employment. In essence, the SE tax is a Social Security and Medicare tax imposed on individuals who for themselves, while FICA tax is paid in equal portions by employees and employers

 

In an effort to apparent eliminate tax discrimination between employees (who pay full SE tax) and self-employed individuals (who pay one-half of FICA tax), the federal government created significant differences between the SE tax and the FICA tax. Two of them stand out and deserve special mention in this essay. First, unlike the FICA tax, the SE tax is imposed only on net earnings. Therefore, if you are self-employed, you are able to deduct your business expenses from your self-employment gross income and calculate your SE tax on your net self-employment income. Second, in calculating his adjusted gross income, a self-employed individual is able to deduct a half of his SE tax from his total gross income, further reducing his income tax burden. - See more at: http://sherayzenlaw.com/difference-between-self-employment-tax-and-fica-tax/#sthash.K1KfP468.dpuf

 

add

 

What matters here is the AGI and the subsidies are linked....even more so once you add in a HSA ded impact.

Edited December 8, 2013 by twa

[Larry]

Unfortunately, the "you can deduct half of your SE tax from your income", for example, doesn;t make the SE tax different from FICA.  It makes it the same. 

 

Joe Employee earns $1,000. 

1) He pays FICA on $1000. (call it $70)

2) He pays income tax on $1000.

3) His employer pays FICA on $1000.  (Call it another $70)

 

His employment actually cost the employer $1070.  But his taxes, both FICA and income, are based on only $1000. 

 

The money that goes to pay #3 does not count as part of his income, for purposes of FICA or income tax, because (as far as the government's concerned), he never "made" that money.  His employer paid it before he gave the employee $1000.  The "employer's contribution" never counts as money which he ever received.  (Whereas, the "employee's contribution", the part that actually shows up on his paycheck?  That money which he pays, gets counted as income.) 

 

The self employed guy gets to deduce his "employer's contribution" from his income, because non-self-employed people don't pay income taxes on the "employer's contribution", either.  (Non-self-employed people don't get to deduct it, because it never got counted as part of their income, to begin with.) 

[twa]

yes the ded is equivalent but the adjusted income is not...the AGI or MAGI is what matters here

 

add

if you want to understand the difference on S/E and FICA

http://en.wikipedia.org/wiki/Federal_Insurance_Contributions_Act_tax#Self-employed_people

This tax is imposed not by the Federal Insurance Contributions Act but instead by the Self-Employment Contributions Act of 1954, which is codified as Chapter 2 of Subtitle A of the Internal Revenue Code, 26 U.S.C. § 1401 through 26 U.S.C. § 1403 (the "SE Tax Act").

Edited December 8, 2013 by twa

[chipwhich]

One of the great things about competition. 

 

Want to find out what's bad about an insurance plan?  Just let his competitor tell you. 

 

one of the advantages you have, compared to a whole lot of people.  Yeah, you no doubt get slanted information.  But often, slanted information from multiple, competing, sources, beats the heck out of no information at all.  (Which is what almost everyone else is stuck with.) 

 

Well in Maryland there is BC/BS and everyone else.  Pretty much every doctor takes BC/BS because they are the least pain in the ass to deal with and get paid.  If you talk to doctors, they don't want to deal with many of these companies because of headaches of getting paid and dealing with incompetence.

Competition is going to have to be on more than just cost if this thing is going to work.

 

I know one thing, I will never lose the chance to hire an employee in a competitive marketplace if I tell them I offer BC/BS.  Some other insurance companies are an immediate turnoff to prospective job searchers (in a competitive industry).

[twa]

Obamacare leaves N.J. small employers scrambling around high premiums, hard choices

http://www.nj.com/business/index.ssf/2013/12/obamacare_changes_leaves_nj_sm.html

 

An example of how this plays out is in the renewal notice that John J. Toohey, a real estate firm in Roxbury, received at the beginning of November.

For a high-deductible plan set to renew in January, one family was quoted a 22 percent increase in its premium, while another would see a 63 percent increase, according to the company’s insurance broker, Karen Leonard.

The only apparent difference between the families is that the employee getting the higher rate is a couple years older and has one additional child, she said.

“The discrepancy between the two, it’s just astronomical,” said Tom Toohey, a member of the firm. “Now you’re being penalized for having a family.”

Families with older children, especially those taking advantage of the law’s provision allowing people to stay on a parent’s plan until they are 26, are facing higher charges, said Leonard, of Leonard Financial Group in Hackettstown.

[chipwhich]

Obamacare leaves N.J. small employers scrambling around high premiums, hard choices

http://www.nj.com/business/index.ssf/2013/12/obamacare_changes_leaves_nj_sm.html

 

An example of how this plays out is in the renewal notice that John J. Toohey, a real estate firm in Roxbury, received at the beginning of November.

For a high-deductible plan set to renew in January, one family was quoted a 22 percent increase in its premium, while another would see a 63 percent increase, according to the company’s insurance broker, Karen Leonard.

The only apparent difference between the families is that the employee getting the higher rate is a couple years older and has one additional child, she said.

“The discrepancy between the two, it’s just astronomical,” said Tom Toohey, a member of the firm. “Now you’re being penalized for having a family.”

Families with older children, especially those taking advantage of the law’s provision allowing people to stay on a parent’s plan until they are 26, are facing higher charges, said Leonard, of Leonard Financial Group in Hackettstown.

 

 

My insurance broker warned me last renewal that instead of Single, Couple, Family pricing, we will be priced individually for every member of the family.  So each member will have their own pricing and it would cause rates to skyrocket.

<sigh>

[twa]

more choice:rolleyes:

[chipwhich]

more choice:rolleyes:

 

So if you want to keep your doctor you can pay for BC/BS and pay handsomely.  If you want some random practitioner that's cheap and doesn't have much of a practice and generally can't keep patients, well you got it.

 

It's all playing out much as I suspected with the exception of the age brackets and smokers.  I can't believe they included those two doozies.

[twa]

well they have a cure for that Chipwhich

http://washingtonexaminer.com/examiner-editorial-obamacare-will-end-up-forcing-doctors-to-take-patients/article/2540341

 

 

down to a week for me to choose between a new out of marketplace or Obamacare

 

any word on keeping your old plan?....none from my provider aside from the new and improved(and higher) ACA compliant BS

 

If I said what I think I would be on even more watchlists.

 

I think the quote about hunting them with dogs in 14 sounds about right though.

[chipwhich]

well they have a cure for that Chipwhich

http://washingtonexaminer.com/examiner-editorial-obamacare-will-end-up-forcing-doctors-to-take-patients/article/2540341

 

 

down to a week for me to choose between a new out of marketplace or Obamacare

 

Better choose an out of marketplace....until you can get your own doctor by force

[sacase]

Why does it seem like "the more we find out what's in it" the worse it gets. It seems like Obamacare is really hosing over people and their covereages. When is enough bad stuff enough?

[nonniey]

well they have a cure for that Chipwhich

http://washingtonexaminer.com/examiner-editorial-obamacare-will-end-up-forcing-doctors-to-take-patients/article/2540341

 

 

down to a week for me to choose between a new out of marketplace or Obamacare

 

any word on keeping your old plan?....none from my provider aside from the new and improved(and higher) ACA compliant BS

 

If I said what I think I would be on even more watchlists.

 

I think the quote about hunting them with dogs in 14 sounds about right though.

Don't forget your other two choices.

#3) Not get Insurance and pay the fine.

or

#4)Not pay the insurance and not pay the fine (Many don't realize the latter is a viable option - just make sure you don't overpay your taxes and then there is nothing the IRS can get from you).

[chipwhich]

Well they are figuring out a way to fix prescription drug issues.  I wonder how easy it is to discover this through the marketplace spreadsheet

 

http://www.washingtonpost.com/national/health-science/aids-advocates-say-drug-coverage-in-some-marketplace-plans-is-inadequate/2013/12/09/0fca0fd0-5d18-11e3-95c2-13623eb2b0e1_story.html?hpid=z1