Going Back to a Group Health Insurance Plan

[The White Coat Investor]

Crazy health insurance situation this year. I've been buying on the open individual market the last few years because it was cheaper than the group plan through my partnership. However, premiums went up 21% this year for a worse plan. Meanwhile, the group plan premiums didn't go up at all. So for about the same price, I now get a better plan through the group. Crazy! It pays to look around each year and see what you're eligible for.

I'm told many group plans didn't go up in price. Not sure how true it is.

[jpa]

I'm a healthy 26 year old male in med school, buying my own health insurance. In 2014, i was getting a high deductible plan for $97, now the cheapest available plan with a very high deductible is $270/month.  It's mind-boggling how the cost to insure me can change that much in two years.

[thomashackett]

I've been on a group plan, but this year also brought my wife and kids onto the group plan. The group plan we had with UHC went up by 4% this year, and I'm told the expected change for the group rates with Kaiser (our new carrier) from our 2016 rates to our 2017 rates may actually go down.

The flow chart in this NY Times article matches closely with my decisions making process for selecting a plan (both in the individual market and group - I own the business with the group plan): http://www.nytimes.com/2016/11/02/upshot/need-to-pick-an-insurance-plan-start-here.html. This year we actually broadened the choices in the group so that each employee can select a higher level of coverage if they want by paying for the buy-up. For most people the lower plan is selected, but for people like my wife with a medical condition (she has T1D), they can select the plan with higher coverage.

The other part I appreciate about having a HDHP for the kids and myself is we get to max out the family HSA, have my wife covered with a deluxe healthcare plan, and then cover the out of pocket expenses we do have for my wife from the HSA.

 

[Hatton]

The White Coat Investor wrote:

Crazy health insurance situation this year. I’ve been buying on the open individual market the last few years because it was cheaper than the group plan through my partnership. However, premiums went up 21% this year for a worse plan. Meanwhile, the group plan premiums didn’t go up at all. So for about the same price, I now get a better plan through the group. Crazy! It pays to look around each year and see what you’re eligible for.

I’m told many group plans didn’t go up in price. Not sure how true it is.

Click to expand...

I have been trying to tell you this for a while.  Even high net worth people are worried about this cost. My small business plan through the state medical society  is $550/month (age 59).  You need at least one employee to get this.  If I retired and went on the ACA exchange unsubsidized it is $650/mo with a $6000 deductible. (Bronze plan). My deductible is $500/year with state plan.  To get a mid silver plan the cost is $950/mo.  I am going to continue working 3 days per week for now.

[docnews]

hatton1 your numbers look good to me!

Late 20s with late 20s spouse with 1 child. Only 1 company in the exchange offering only one plan that has an HSA.

Premiums = ~$740/month (~$8,900/year) + deductible = out-of-pocket max = $13,100

So total cost if we have a bad health year = $22k!

Interestingly this wasn't a huge increase (~5%) in cost from last year but just less coverage (old plan/company ran away from the exchange).

Through a group of independent contractors I am offered insurance not on the exchange but it is MORE expensive (but I compare every year).

[Zaphod]

docnews wrote:

hatton1 your numbers look good to me!

Late 20s with late 20s spouse with 1 child. Only 1 company in the exchange offering only one plan that has an HSA.

Premiums = ~$740/month (~$8,900/year) + deductible = out-of-pocket max = $13,100

So total cost if we have a bad health year = $22k!

Interestingly this wasn’t a huge increase (~5%) in cost from last year but just less coverage (old plan/company ran away from the exchange).

Through a group of independent contractors I am offered insurance not on the exchange but it is MORE expensive (but I compare every year).

Click to expand...

This is almost exactly the same as my plan (and family).

[VagabondMD]

Our group plan stayed the same this year, but I opted out last year and joined my wife's company plan, heavily subsidized by the company. Better coverage, lower deductibles and copays, and we have used the heck out of it this year! The good news is that at age 55 (less than three years from now), she may retire and participate in the plan with family until age 65 (or maybe for life, not sure which but either bridges us to Medicare).

[PEDs Allowed]

Our group is having even larger increases to the tune of 40% hike!!!  We are currently shopping around as well as looking into becoming self insured.  Do any of your groups self insure or have any insight into it?

[Hatton]

docnews wrote:

hatton1 your numbers look good to me!

Late 20s with late 20s spouse with 1 child. Only 1 company in the exchange offering only one plan that has an HSA.

Premiums = ~$740/month (~$8,900/year) + deductible = out-of-pocket max = $13,100

So total cost if we have a bad health year = $22k!

Interestingly this wasn’t a huge increase (~5%) in cost from last year but just less coverage (old plan/company ran away from the exchange).

Through a group of independent contractors I am offered insurance not on the exchange but it is MORE expensive (but I compare every year).

Click to expand...

My husband is already on Medicare.  The premium I am quoting is for one person.

[Otodoc]

late 30's.  with spouse and 4 kids.  No group plan available.  Absolutely cheapest plan available to me is about $1250/month with $6,400 deductible per person.  And that is off exchange and doesn't include the pediatric dental stuff and not HSA eligible.

Cheapest HSA plan is 1400 per month with 6400 deductible.

very poor choices in this part of the state.

[triad]

my individual health insurance plan will be cancelled this summer so i was looking for plans on the obamacare exchange and found nothing but HMO's and EPOs.

Since I'd prefer a PPO plan and the only way to get it is with a group policy I need to figure out how much that would cost.  I found the SHOP plans on the exchange and the prices seemed reasonable (~400/month/participant) for a PPO/HSA plan.  As the employer am I required to pay the premium for all the employees or is cost sharing an option?  I'm meeting with my CPA next month so I'll be sure to ask him, but wanted to hear what some of my other fellow business owners do