New insurance fee... am I missing something?

[Christine]

I'm sure this will happen to me soon!

My husband works for a private company with great insurance (we don't pay premiums and the whole family is covered). I am eligible for insurance through my employer, but I don't take it because who can beat FREE???

But I totally understand why it would be a good business decision for my husband's employer to drop me because I can be covered under my own employer.

 

[Happy Snowman]

I'm sure this will happen to me soon!

My husband works for a private company with great insurance (we don't pay premiums and the whole family is covered). I am eligible for insurance through my employer, but I don't take it because who can beat FREE???

But I totally understand why it would be a good business decision for my husband's employer to drop me because I can be covered under my own employer.

What will happen is that they won't be able to pay 100% for your premiums. They might not charge a surcharge on top of that but you will have to start paying something for them. The benefit can't exceed $12,700 in value and since a family plan or employee and spouse is usually in the $1200/month range give or take depending on your table rating...you will have to pay something or the company will be fined...a lot. Now, they can add intensives for healthy lifestyles and such, effectively reducing your net cost

 

[DebbieB]

My company is starting a $50 to $100 monthly surcharge if you have a spouse covered by our company and they work at a company of 100 or more employees, which means they could get coverage at their company. They are still contributing to the spouse's coverage, just not as much.

 

[BadgerGirl84]

"If you like your insurance, you can keep your insurance." For an extra $900 a year. I guess this was one of those things Ms. Pelosi was thinking of when she said they'd have to pass the ACA before they found out what was all in it.

 

[M5ward]

The Affordable Care Act hasn't turned out to be so affordable, has it? Wait until mid-November when the new premiums come out (historically Oct. 1 but nicely delayed because of the election.) I know people who are already having their coverage cancelled.

 

[DebbieB]

The Affordable Care Act hasn't turned out to be so affordable, has it? Wait until mid-November when the new premiums come out (historically Oct. 1 but nicely delayed because of the election.) I know people who are already having their coverage cancelled.

We got our 2015 rates last week, 3.5% increase in premium, no changes in benefits. I think a lot of companies are using ACA as an excuse to make employees contribute more or make a political statement.

 

[mom2rtk]

We got our 2015 rates last week, 3.5% increase in premium, no changes in benefits. I think a lot of companies are using ACA as an excuse to make employees contribute more or make a political statement.

My husband's plan is on a June 1st renewal. We had a 70% increase. That's a lot of political statement.

 

[3boymthr]

The Affordable Care Act hasn't turned out to be so affordable, has it? Wait until mid-November when the new premiums come out (historically Oct. 1 but nicely delayed because of the election.) I know people who are already having their coverage cancelled.

Just wait until 2018 when the Cadillac tax goes into effect. Then it really won't be affordable.

 

[Gracie09]

What will happen is that they won't be able to pay 100% for your premiums. They might not charge a surcharge on top of that but you will have to start paying something for them. The benefit can't exceed $12,700 in value and since a family plan or employee and spouse is usually in the $1200/month range give or take depending on your table rating...you will have to pay something or the company will be fined...a lot. Now, they can add intensives for healthy lifestyles and such, effectively reducing your net cost

Actually for family plans the number is a bit over $27,000. So there are probably very company plans that will be effected. My husbands company pay about 85% of the cost of insurance plans and has before and after Aca. Our cost hasn't gone up more than a few dollars a month. The idea that Aca is the cause of all these plans to increase is not necessarily grounded in the whole truth. Many companies are using it as an excuse to decrease their contribution and pass it along to the employees.

 

[kamik86]

It is a life event at both companies. He should go talk to HR now, tell them he is losing your coverage because of a surcharge and get the paperwork in motion to start his company plan in January when your surcharge starts. There is no reason to wait until March.

Yeah my husband was already told to get my the benefit info for his job and ask his HR rep today... Now I just have to hope he asks. He was telling me yesterday he is POSITIVE he can't change it in March (well until yesterday I was positive my company wouldn't let me drop him in March and I found out I was wrong so I still really want him to ask!).

The Affordable Care Act hasn't turned out to be so affordable, has it? Wait until mid-November when the new premiums come out (historically Oct. 1 but nicely delayed because of the election.) I know people who are already having their coverage cancelled.

Yeah our new premium info will be out in the next week or so as open enrollment starts. They have released some of the change info like how this fee has gone up to 1040 a year (so $80 a month just because my husband has the option of coverage somewhere else) and how one of the plans now has a much higher out of pocket max and deductible (but didn't mention the other plan, so either that is now the one they are trying to get everyone to take or that one is changing too and they just didn't tell us yet) They haven't told us the prices yet.

 

[disney1990]

Oh wow, that fee seriously stinks if that is the case! I hate insurance! Ours was ridiculously overpriced and crappy before ACA and now it's even worse. I seriously don't know how some people do it.

Lots of companies do not allow a spouse to be covered. For years now, these fees have been added to cover a spouse that can get insurance elsewhere. It is not really a feel by the insurance company (even though they collect it). It is a fee by your employer.

 

[SC Minnie]

We have to pay an additional $100/month to cover a spouse that has coverage under and employer but opts out. This has been in place for several years.

 

[jerseygal]

So in our new health insurance information last year my company introduced a fee (over 900 a year) if you have your spouse on our insurance even though they have coverage through work (that is in addition to the increase in premiums to go from employee coverage to employee + spouse so I have to pay 900 more for the same coverage then a coworker whose spouse doesn't work)

I got stuck paying it all this year and now they are making the fee even larger.

Here is my problem on why I can't come up with any way to avoid it.

The solution would be have my husband have insurance through his job right? Except his open enrollment is in March. Mine is in November.

It is my understanding that he can't get insurance through work outside his annual enrollment just because we are no longer covering him on mine (if my work decided to just drop spouses he could as he wouldn't be eligible here but he still is, Just with insane fees)

If I cover him now he can't get his insurance in March and drop from mine either. As he still wouldn't' be starting a new job to have a qualifying event under my plan to drop him.

If the fee had been in place all along it would have been fine as we would have set it up separately when we started working but now it seems there is no way to split it.

We can't drop him from having insurance at all because then we get all the tax penalties and a huge risk of having no insurance until his kicks in.

And keeping him on mine and then picking up his would mean not only paying this insane fee for another year but adding on TOP of that his preimiums for redundant coverage.

Am I missing something? Is there some other option here?

Have heard many start to complain about this fee as well; will be almost "common" in most health plans for 2015!
THANK YOU, LOL, AFFORDABLE HEALTH CARE ACT!

 

[sam_gordon]

Just to give some alternate information...

Our rates went up 9% (after increasing <5% over the last couple years). My company offers three health plan options. All three have different rates if you're covering yourself, yourself and a spouse, yourself and children, or a family.

We were told our plans are "grandfathered" in (since they've been available for the last three years) and don't HAVE to follow all the ACA guidelines (two of the plans require copayments for wellness checkups).

It sounds like employers or insurance companies are blaming the ACA for increased costs when it was their choice on what to do with policies/costs.

According to our HR person, our company pays 75% of the insurance cost. Yes, I work for a pretty good company.

For the record, the premium costs for the family plans for the year range from $2470 (HSA Account) to $2938 (PPO "Core") to $4810 (PPO "Buy up").

 

[Cannot_Wait_4Disney]

THANK YOU, LOL, AFFORDABLE HEALTH CARE ACT!

The fee in question has nothing to do with the ACA or the insurance companies. Many employers subsidize health plans for their employees and families. Most of these fees come from employers who don't want to be subsidizing insurance plans for spouses that have their own plans they could buy at their own jobs. Some of em probably don't care but toss that fee in anyway because they can and they're jerks.

Originally Posted by M5ward
The Affordable Care Act hasn't turned out to be so affordable, has it? Wait until mid-November when the new premiums come out (historically Oct. 1 but nicely delayed because of the election.) I know people who are already having their coverage cancelled.

Uh lots of rates are already out. As of October 20th, 7 states and DC have approved all their submitted new rates according to Price Waterhouse Cooper. The average increase is 3.5% well below the 10% average seen before the ACA. 41 states have data out on what their new rates are going to be. The average including them is a 6 percent increase, again well below the 10% figure. But there are some states with some pretty large premium increases of over 10%. And 7 of the 11 of them have yet to expand medicaid. One more of them just did.
Even in these states though it pays to shop around. The range of rate changes in Indiana for example, runs from a drop of 3.4% to an increase of 24%.

 

[STLDisney_Freak]

My employer added the spousal fee last year (they are self insured). It is a $100 dollars additional to the premiums a month if your spouse can get coverage at their employer. DH and I weighed the pro and cons of it. In the end he ended up signing up with his employee insurance and I cover myself and the kids at my employer.

 

[AndyLL]

Just to give some alternate information...

Our rates went up 9% (after increasing <5% over the last couple years). My company offers three health plan options. All three have different rates if you're covering yourself, yourself and a spouse, yourself and children, or a family.

We were told our plans are "grandfathered" in (since they've been available for the last three years) and don't HAVE to follow all the ACA guidelines (two of the plans require copayments for wellness checkups).

It sounds like employers or insurance companies are blaming the ACA for increased costs when it was their choice on what to do with policies/costs.

According to our HR person, our company pays 75% of the insurance cost. Yes, I work for a pretty good company.

For the record, the premium costs for the family plans for the year range from $2470 (HSA Account) to $2938 (PPO "Core") to $4810 (PPO "Buy up").

Yep.

Companies faced double digit rate increases well before the ACA.

Before ACA my premiums increased, I had more co-pays, my co-pays went up.

Before ACA my company switched/dropped insurance providers twice meaning I lost my doctor.

Before ACA my company's insurance had wellness programs, covered pregnancy, mental health, prescriptions, and short term disability. The ACA mandates had little effect.

The ACA really didn't change anything for people that worked for medium and larger companies that already had typical insurance group policies.

But the ACA sure makes a convenient whipping boy when a company wants to save some money by taking away benefits.

My rates have stayed the same or have gone down for the last 3 years. That's for the CDHP plan. The standard POS plan has gone up. For quite some time they have changed extra for smoking and spouses that can get insurance elsewhere.

 

[mickeymedic]

Yep.

Companies faced double digit rate increases well before the ACA.

Before ACA my premiums increased, I had more co-pays, my co-pays went up.

Before ACA my company switched/dropped insurance providers twice meaning I lost my doctor.

Before ACA my company's insurance had wellness programs, covered pregnancy, mental health, prescriptions, and short term disability. The ACA mandates had little effect.

The ACA really didn't change anything for people that worked for medium and larger companies that already had typical insurance group policies.

But the ACA sure makes a convenient whipping boy when a company wants to save some money by taking away benefits.

My rates have stayed the same or have gone down for the last 3 years. That's for the CDHP plan. The standard POS plan has gone up. For quite some time they have changed extra for smoking and spouses that can get insurance elsewhere.

I guess everyone's experience is a little different. Before ACA I got a lot more coverage for my health premiums. Yes my health premiums went up 5-10% each year. But my copays stayed pretty much the same. So healthcare was affordable. Since the ACA, my premiums are still going up 5-10% each year, but in addition to copays, I have a large deductible along with co-insurance until I reach a potentially financially crippling out of pocket max. Insurance companies and/or employers don't offer co-pay only plans anymore. Those are somehow considered "cadillac plans." The only options include high deductibles and co-insurance. And those deductibles go up every year along with the premium hikes.

I am thankful, though, that I am covered under my husband's insurance. Because even with the faults I just listed, it's significantly better than the coverage available to me through my employer. If I were to take out the insurance where I work, I would have to pay more per month (than my husband's plan) for the privilege of paying the first $3500 per person out of pocket before the insurance would even kick in. And when the insurance does kick in, it doesn't cover everything. It covers NO prescriptions at all. And still carries a 20-30% co-insurance on pretty much everything else. How on earth is that considered to be affordable?

Several of my co-workers have opted to remain uninsured because they can't afford the high premiums plus having to pay 100% of the cost every time they go to the doctor (up to the first $3500 per person.)

And before anyone else says that it's the employers who are at fault for passing along too much of the cost to the employees, I used to work in HR and I know how much the companies I worked for were charged for insurance. They consistently paid the same percentage towards the plans from one year to another. But the insurance companies kept raising the rates. The employers aren't the evil ones in this equation. I'd like to blame the insurance companies, but I have no inside knowledge of how they work. So I don't know if it is fair to blame them, either. (It might be...perhaps someone who works in the industry can share their perspective.)

I do know that my healthcare was much more affordable before the ACA. Now I worry constantly that my husband's employer will change their policy and I will be stuck paying high prices for extremely crappy coverage. So yes, I blame the unaptly named ACA. I am happy for those of you who have been relatively unaffected by the passage of the ACA. Please consider yourself to be extremely lucky.

 

[Happy Snowman]

I guess everyone's experience is a little different. Before ACA I got a lot more coverage for my health premiums. Yes my health premiums went up 5-10% each year. But my copays stayed pretty much the same. So healthcare was affordable. Since the ACA, my premiums are still going up 5-10% each year, but in addition to copays, I have a large deductible along with co-insurance until I reach a potentially financially crippling out of pocket max. Insurance companies and/or employers don't offer co-pay only plans anymore. Those are somehow considered "cadillac plans." The only options include high deductibles and co-insurance. And those deductibles go up every year along with the premium hikes.

I am thankful, though, that I am covered under my husband's insurance. Because even with the faults I just listed, it's significantly better than the coverage available to me through my employer. If I were to take out the insurance where I work, I would have to pay more per month (than my husband's plan) for the privilege of paying the first $3500 per person out of pocket before the insurance would even kick in. And when the insurance does kick in, it doesn't cover everything. It covers NO prescriptions at all. And still carries a 20-30% co-insurance on pretty much everything else. How on earth is that considered to be affordable?

Several of my co-workers have opted to remain uninsured because they can't afford the high premiums plus having to pay 100% of the cost every time they go to the doctor (up to the first $3500 per person.)

And before anyone else says that it's the employers who are at fault for passing along too much of the cost to the employees, I used to work in HR and I know how much the companies I worked for were charged for insurance. They consistently paid the same percentage towards the plans from one year to another. But the insurance companies kept raising the rates. The employers aren't the evil ones in this equation. I'd like to blame the insurance companies, but I have no inside knowledge of how they work. So I don't know if it is fair to blame them, either. (It might be...perhaps someone who works in the industry can share their perspective.)

I do know that my healthcare was much more affordable before the ACA. Now I worry constantly that my husband's employer will change their policy and I will be stuck paying high prices for extremely crappy coverage. So yes, I blame the unaptly named ACA. I am happy for those of you who have been relatively unaffected by the passage of the ACA. Please consider yourself to be extremely lucky.

That is not true at all. Sounds like you have a tax qualified high deductible plan at your company and if that is the case, you also qualify for a Health Savings Account and the fantastic tax savings that go along with that. Deductibles and co-insurance have been around for decades. That is not new with the ACA at all. There is still an out of pocket max with co-insurance. The most a non-grandfathered plan can cost out of pocket for deductibles/co-insurance, etc. is $12,700. Yes, that is a lot of money but not all plans are that much. $6000 max out of pocket is very common. As for your premiums, define "high".

Insurance rates are based on usage. If employees are using their plans wisely, rates stay fairly stable. Most companies are self-insured, meaning what they collect in premiums pays claims. If what they collect in premiums is not enough to pay claims, rates go up. If your co-workers are running to the doctor every time they cough, well, yes, they will pay more for health insurance premiums. Your plan and coverages are decided by your employer and it's likely that the insurance company just administers the plan.

Health insurance plans have to cover prescriptions--yes, they are subject to the deductible and co-insurance but that doesn't mean they are not covered. Lack of understanding how insurance works is generally the cause of most of the frustration.

 

[Gracie09]

I guess everyone's experience is a little different. Before ACA I got a lot more coverage for my health premiums. Yes my health premiums went up 5-10% each year. But my copays stayed pretty much the same. So healthcare was affordable. Since the ACA, my premiums are still going up 5-10% each year, but in addition to copays, I have a large deductible along with co-insurance until I reach a potentially financially crippling out of pocket max. Insurance companies and/or employers don't offer co-pay only plans anymore. Those are somehow considered "cadillac plans." The only options include high deductibles and co-insurance. And those deductibles go up every year along with the premium hikes. I am thankful, though, that I am covered under my husband's insurance. Because even with the faults I just listed, it's significantly better than the coverage available to me through my employer. If I were to take out the insurance where I work, I would have to pay more per month (than my husband's plan) for the privilege of paying the first $3500 per person out of pocket before the insurance would even kick in. And when the insurance does kick in, it doesn't cover everything. It covers NO prescriptions at all. And still carries a 20-30% co-insurance on pretty much everything else. How on earth is that considered to be affordable? Several of my co-workers have opted to remain uninsured because they can't afford the high premiums plus having to pay 100% of the cost every time they go to the doctor (up to the first $3500 per person.) And before anyone else says that it's the employers who are at fault for passing along too much of the cost to the employees, I used to work in HR and I know how much the companies I worked for were charged for insurance. They consistently paid the same percentage towards the plans from one year to another. But the insurance companies kept raising the rates. The employers aren't the evil ones in this equation. I'd like to blame the insurance companies, but I have no inside knowledge of how they work. So I don't know if it is fair to blame them, either. (It might be...perhaps someone who works in the industry can share their perspective.) I do know that my healthcare was much more affordable before the ACA. Now I worry constantly that my husband's employer will change their policy and I will be stuck paying high prices for extremely crappy coverage. So yes, I blame the unaptly named ACA. I am happy for those of you who have been relatively unaffected by the passage of the ACA. Please consider yourself to be extremely lucky.

I have a co-pay only plan. It's not considered Cadillac. It basically the same plan we had pre Aca.