ObamaCare Info

[kydisneyfans]

Welch Allyn, a company that manufactures medical diagnostic equipment in central New York, laid off 275 employees this year, and planned on dropping roughly 10% of their workforce over the next three years.

"Health care reform mandates" are to blame for up to 400 jobs being dropped at Orlando Health.

One of the biggest medical device manufacturers in the world, Stryker confirmed 1,000 jobs were lost due to Obamacare.

Wake Forest Baptist Medical Center cited "the challenges of health care reform" while announcing the elimination of 950 jobs.

The medical device tax also claimed positions at Boston Scientific. The company first announced in 2011 that they would be cutting between 1,200 and 1,400 positions. Then in January of this year, they announced further layoffs for up to 1,000 employees.

Smith & Nephew, a global medical technology firm, dropped 100 employees.

A Blue Cross/Blue Shield health insurance office was closed, resulting in another 100 or so employees hitting the unemployment lines. The reason? Complexities in federal regulations and mandates implemented by Obamacare.

In March of 2010, medical device maker Medtronic warned that Obamacare taxes could result in a reduction of precisely 1,000 jobs. That plan became reality when the company cut 500 positions, and scheduled another 500 by the end of the fourth quarter in 2013.

Reading Hospital announced layoffs for 210 workers, and the elimination of another 181 jobs through attrition, citing federal health care reform requirements.

Abbott Laboratories announced a series of layoffs that would result in approximately 1,900 people being out of work. The company cited "U.S. health-care reform and the challenging regulatory environment” as a reason for the job cuts, then proceeded to donate money to politicians wanting to change Obamacare.

Public employees in Virginia fell victim to Obamacare's rules for part-time workers. A minimum of 7,380 jobs were converted to less than 30 hours per week.

The nation's largest movie theater chain, Regal Entertainment, reduced the workweek for thousands of their employees.

Kroger, a grocery store chain, reduced the hours of their staff.

Taco Bell slashed employee hours.

As did Wendy's, and also Denny's.

An executive from White Castle pondered only hiring part-time workers in the future.

Subway chains, and Carl's Jr. stores reduced positions to part-time.

Clothing retail chain, Forever 21, conducted staffing audits which resulted in non-management positions being reduced to 29.5 hours weekly. Forever 21 has over 27,000 employees.

400 employees at the Community College of Allegheny County saw their hours reduced.

The Wall Street Journal reported that numerous universities were scaling back the number of hours worked per week by their adjunct professors, in an attempt to avoid the new Obamacare requirements.

Hours for over 100 people in the Fort Wayne Community School District in Indiana have been reduced, including substitutes and support staff.

Phone operators in Affordable Care Act call centers noted the irony in "working for a call center and trying to help people get health care" but only at a part-time rate ... in order to avoid having to provide health insurance.

Repeatedly blaming Obamacare in a staff memo, UPS announced that 15,000 employee spouses are being dropped from their health insurance coverage.

Erick Erikson reported via Twitter that he had obtained an internal memo from Delta Airlines. The memo stated that the company would have to totally revamp their health care plans, and had to eliminate a plan developed specifically for pilots due to it violating the Cadillac tax.

The University of Virginia is dropping coverage for spouses due to federal health reform costs and penalties.

The owner of Professional Finance Company indicated that he may have to drop coverage for his employee's families. The company employs 170 people.

Health insurance coverage is being reduced for school districts in Pennsylvania.

The United Methodist Church recently announced that "clergy and lay employees" would be losing their coverage.

Wegman's, who had previously provided coverage for employees that worked 20 or more hours, announced they were no longer offering health insurance to part-time workers thanks to ObamaCare.

The 8,000 number is correct, the anticipated number by year end is 15,000.

Kings Daughters Hospital in KY has laid off 150.
KY One is laying off around 40 in the Lexington area, my wife received notice of layoff but they have decided to keep her on board, her commute is now 140 miles a day starting January. That is just in billing/coding.
Baptist Health in Lexington has wage and OT freezes in place to attempt to avoid layoffs.

The safe employment field of healthcare isn't so safe anymore.

 

[johde]

My brother owns insurance agencies. The new healthcare is hiring navigators. This will impact his business negatively as it will thousands of other agencies throughout the country. He might have to let some of his staff go.

If he hasn't already, your brother should become an exchange approve agent. With the number of people expected to sign up, this is a huge potential market for your brother. People can sign up online on their own, use a navigator, or use an approved insurance agent. It is my understanding that there is money for insurance agents signing people up for the exchange like there is in the individual market today. This new law is complex and if he advertises that he can provide a service the navigators or self serve website doesn't he could possible generate additional business. For example, where I live, there are a huge variety of plans to choose from provided by 3 insurance companies. The 2 cheaper insurance companies have extremely limited networks in our area. So, money vs. network size is a real decision as people look at the network plans. Studying and being about to help people decide between these type of plans, or to even buy a plan outside the exchange, is a service people need. I have been looking and trying to get all the information I can, and I'm still looking at working with an insurance broker to make sure I'm picking the plan best for me.

 

[Robbi]

If he hasn't already, your brother should become an exchange approve agent. With the number of people expected to sign up, this is a huge potential market for your brother. People can sign up online on their own, use a navigator, or use an approved insurance agent. It is my understanding that there is money for insurance agents signing people up for the exchange like there is in the individual market today. This new law is complex and if he advertises that he can provide a service the navigators or self serve website doesn't he could possible generate additional business. For example, where I live, there are a huge variety of plans to choose from provided by 3 insurance companies. The 2 cheaper insurance companies have extremely limited networks in our area. So, money vs. network size is a real decision as people look at the network plans. Studying and being about to help people decide between these type of plans, or to even buy a plan outside the exchange, is a service people need. I have been looking and trying to get all the information I can, and I'm still looking at working with an insurance broker to make sure I'm picking the plan best for me.

He and his staff are approved agents. The problem is the naviagtors will still take potential business. He and a lot of other brokers are upset that navigators don't carry errors and emissions insurance and most importantly, the navigators are not required to be licensed or fingerprinted. Why is this important? In order to get an insurance license, a person has to pass a background check. Felons cannot be health insurance agents because they can't give out healthcare advice however navigators can be felons and are allowed to to enroll people in obamacare. These navigators will have access to SSNs and other information ripe for identity thieves. There has already been 1 publicized case of a navigator in Kansas who has outstanding warrants for check fraud.

The licensing and errors and omissions insurance are fees that agents/brokers have to pay and navigators don't.

 

[johde]

He and his staff are approved agents. The problem is the naviagtors will still take potential business. He and a lot of other brokers are upset that navigators don't carry errors and emissions insurance and most importantly, the navigators are not required to be licensed or fingerprinted. Why is this important? In order to get an insurance license, a person has to pass a background check. Felons cannot be health insurance agents because they can't give out healthcare advice however navigators can be felons and are allowed to to enroll people in obamacare. These navigators will have access to SSNs and other information ripe for identity thieves. There has already been 1 publicized case of a navigator in Kansas who has outstanding warrants for check fraud.

The licensing and errors and omissions insurance are fees that agents/brokers have to pay and navigators don't.

I don't disagree with what you're saying. My point is your brother, and the insurance industry as a whole need to figure out a way to convince the general public that these things are important. And that using an insurance agent gives them extra benefits that the navigators and website don't give them at no additional cost. The biggest benefit I see of using an agent is advice. Navigator are only supposed to help people through the system of signing up and remain unbiased. The website just provides information and requires you do the legwork to try and figure out the best plan for you.

It's not unlike when WalMart comes into town. Local business need to convince people to shop with them instead of WalMart. The difference here is that the price to the customer is the same no matter where you buy.

 

[atyose]

Deleted.

 

[Robbi]

I don't disagree with what you're saying. My point is your brother, and the insurance industry as a whole need to figure out a way to convince the general public that these things are important. And that using an insurance agent gives them extra benefits that the navigators and website don't give them at no additional cost. The biggest benefit I see of using an agent is advice. Navigator are only supposed to help people through the system of signing up and remain unbiased. The website just provides information and requires you do the legwork to try and figure out the best plan for you.

It's not unlike when WalMart comes into town. Local business need to convince people to shop with them instead of WalMart. The difference here is that the price to the customer is the same no matter where you buy.

They've been interviewed on the news and are getting the word via ads.

 

[manning]

An excerpt from a tribune editorial

http://my.chicagotribune.com/#section/530/article/p2p-77808576/



Wait. It gets worse. Those who have managed to browse the marketplace have often been hit by sticker shock. Take Adam Weldzius, a nurse practitioner and single father from Carpentersville. He sought the same level of coverage on the exchange as he and his 7-year-old daughter have now, with the same insurer and the same network of doctors and hospitals. At best, Weldzius found, his monthly premium of $233 would more than double. If he chose a plan priced at the same level, the annual deductible would be $12,700, more than three times his current $3,500 deductible.

"I believe everybody should be able to have health insurance, but at the same time, I'm being penalized. And for what?" Weldzius told the Tribune's Peter Frost. "For someone who's always had insurance, who's always taken care of myself, now I have to change my plan?"

• Illinois officials boasted that insurance premiums here would be lower than expected. But the Tribune reported Sunday that 21 of the 22 lowest-priced plans offered for Cook County residents have whopping annual deductibles of more than $4,000 for an individual and $8,000 for family coverage. That's much more than many families can afford to pay.

There are more problems. People who have individual insurance coverage are finding that oft-repeated promise — "if you like your health care plan, you can keep your health care plan" — is just not true. They are being told by insurers that their existing plans expire on Dec. 31 and they must choose new coverage. They're learning that insurers managed to offer lower-cost plans by narrowing the networks of hospitals and doctors that are available or by upping the out-of-pocket expenses. Unless people are careful in selecting coverage, they may be surprised to find they have to pay much more for out-of-network care to go to their doctors or get treated at the best hospitals.

 

[johde]

They're learning that insurers managed to offer lower-cost plans by narrowing the networks of hospitals and doctors that are available or by upping the out-of-pocket expenses. Unless people are careful in selecting coverage, they may be surprised to find they have to pay much more for out-of-network care to go to their doctors or get treated at the best hospitals.

As someone who has purchased individual health insurance for years, looking at provider network is something I know to look at. I couple of years ago I switched insurance companies because of a dispute between the company and the doctors at the local hospital. The hospital was in network but none of the Dr. inside were. It took them 2 years to settle. I switched companies after 6 months.

After doing extensive searching, it seems like a large number of blue cross/blue shield affiliates are using this strategy. Here in Ohio, Anthem has contracted with 1 hospital chain in each metropolital area for the individual markets. So, The Ohio State University Wexner Medical Center and The Cleveland Clinic, two of the most respected hospitals in the nation, are going to be out of network for all new individual policies whether in the exchange or not. And where I live in a small rural city, the nearest in network hospitals are 25 miles away and nearly a 45 minute drive.

 

[j's m]

They're learning that insurers managed to offer lower-cost plans by narrowing the networks of hospitals and doctors that are available or by upping the out-of-pocket expenses. Unless people are careful in selecting coverage, they may be surprised to find they have to pay much more for out-of-network care to go to their doctors or get treated at the best hospitals.

The majority of plans offered on the individual market in NJ are EPOs with limited doctor and hospital coverage AND there is NO out of network coverage. So anything out of network is paid for by the insured.

I just hope everyone buying insurance now really reads the coverage and check hospitals, doctors, labs, radiology, etc. What sound like a cheap policy will come back and bite you and bankrupt you if you're not careful.

 

[Judyat]

To j"S M - Check out Health Republic available in NY and NJ. It's a co op that has a great network of doctors, labs, hospitals, PT etc through magnacare. Sll of the doctors, labs, pt and radiology that we have ever used are in their network and you don't need permission to see a specialist like the HMOs that I would never want. I'm shopping for my daughter and have found them to really have their act together. Yes I would prefer a PPO which my husband and I have but this looks good and reasonable. I'm looking at the platinum plan that runs around $515 here in NY. To keep her on our plan would cost $936 a month since she turns 26 the end of this month.

 

[j's m]

Judyat, I already looked at Health Republic. They only offer EPOs and no out of network coverage. My DS is at an out of state college and we need coverage for him, so we need either a PPO or an insurer with out of network coverage.

 

[Judyat]

To - J" S M - How about checking what the out of state college offers for healthcare insurance. They are usually very reasonable or check the state exchange for the state your DS will be in.

 

[j's m]

Can't do the state exchange because he's home summers and a long winter break. The college insurance needs to meet ACA requirements and we have no idea how expensive that will be on top of our regular insurance. This year the insurance was almost 1500 but that was non compliant for the year.

The part I hate most about no out of network insurance is that any time we travel out of state, we will not be covered. How can I enjoy a Disney trip knowing any real emergencies aren't really covered if one of us has to be admitted to a hospital and pay full coverage? Not worth the risk.

 

[Judyat]

From what I have read in the exchange plans it says if someone is admitted to an out of network hospital it says that if the charges are more than the amount allowed you may have to pay the difference. I take that to mean that they will pay what they would normally pay in network and you will pay the difference if they are out of network. I have always had a PPO for this reason but at least they will pay what they allow. My daughter just graduated and her coverage was for a year September through August so summer wasn't a problem.

 

[mom2rtk]

From what I have read in the exchange plans it says if someone is admitted to an out of network hospital it says that if the charges are more than the amount allowed you may have to pay the difference. I take that to mean that they will pay what they would normally pay in network and you will pay the difference if they are out of network. I have always had a PPO for this reason but at least they will pay what they allow. My daughter just graduated and her coverage was for a year September through August so summer wasn't a problem.

Just so you know though, those charges above what they would pay in-network could be SUBSTANTIAL. I worked for an HMO for over a decade, and the discounts we had negotiated in-network could be up to 50% off. That out of network hospital would have no negotiated rates. Full price in this arena can be quite scary.

 

[j's m]

From what I have read in the exchange plans it says if someone is admitted to an out of network hospital it says that if the charges are more than the amount allowed you may have to pay the difference. I take that to mean that they will pay what they would normally pay in network and you will pay the difference if they are out of network. I have always had a PPO for this reason but at least they will pay what they allow. My daughter just graduated and her coverage was for a year September through August so summer wasn't a problem.

Almost all of the EPO plans say emergency room charges for out of network, no out of network ambulance and no out of network hospital. I've read the actual plans at the insurance company's site and I'm not taking a chance. That's the difference from EPO and PPO where you can have out of network which is what we've always had. That difference severely limits our choices of plans. A college policy won't help me for out of network, anyway.

 

[blanq]

He and his staff are approved agents. The problem is the naviagtors will still take potential business. He and a lot of other brokers are upset that navigators don't carry errors and emissions insurance and most importantly, the navigators are not required to be licensed or fingerprinted. Why is this important? In order to get an insurance license, a person has to pass a background check. Felons cannot be health insurance agents because they can't give out healthcare advice however navigators can be felons and are allowed to to enroll people in obamacare. These navigators will have access to SSNs and other information ripe for identity thieves. There has already been 1 publicized case of a navigator in Kansas who has outstanding warrants for check fraud.

The licensing and errors and omissions insurance are fees that agents/brokers have to pay and navigators don't.

I think there is a misunderstanding of the various roles of brokers and consumer assistance partners (navigators and in-person assisters) under the ACA. Navigators and IAPs assist applicants with the application process (maintain expertise in eligibility and enrollment, conduct public education activities, provide information and facilitate enrollment) They cannot provide recommendations on the type of insurance an applicant should choose. They cannot provide healthcare provider advice. They don't need to carry errors and emmisions insurance because they are not insurance agents. Under the ACA, brokers continue to receive their income from insurance companies; they CAN be biased and not neutral. Per CFR, title 45, section 155.210 (d)(4), consumer assistance partners must not receive any compensation directly or indirectly from any health insurance carrier in connection with the enrollment in a health plan. Consumer assistance partners must adhere to appropriate conflict of interest standards. In MN, they do go through a BCA (Bureau of Criminal Apprehension) background check. Entities that typically will serve as consumer assistors are non-profit groups, religious organizations, tribal organizations, state or local human service agencies, etc.

The work consumer assistance partners do cannot negatively impact (via taking away business from) the work of insurance agents because their roles are distinct and different. I think what will and can impact the need for agents (brokers under the ACA) are the marketplaces themselves. What used to be difficult for individuals to navigate on their own, because there was no one comprehensive place to do so, will increasingly become easier for them to do absent help with health care marketplaces. They will have one place they can go to compare insurance plans and choose what is best for them without perhaps needing an agent/broker. This entire process reminds me of what has happened with travel agencies and how travel agents have become more obsolete...what a travel agent used to do for me I can now do myself by going to Kayak, Travelocity, Priceline, etc and getting it all laid out for me in one tidy package.

 

[Colleen27]

After doing extensive searching, it seems like a large number of blue cross/blue shield affiliates are using this strategy. Here in Ohio, Anthem has contracted with 1 hospital chain in each metropolital area for the individual markets. So, The Ohio State University Wexner Medical Center and The Cleveland Clinic, two of the most respected hospitals in the nation, are going to be out of network for all new individual policies whether in the exchange or not. And where I live in a small rural city, the nearest in network hospitals are 25 miles away and nearly a 45 minute drive.

BCBS here seems to be doing the same thing; they have a few plans on their website that offer out of network care but if you indicate you are/might be subsidy eligible those plans don't come up in the search results. They do come up on the generic (not logged in) exchange site, so I have to assume they're compatible. And I will gladly pay a little more for a PPO with out-of-network coverage rather than an HMO without; we do too much traveling to only have coverage when we're at home.

I'm still not sure what direction we're going with this. We're low enough income for cost-sharing to come into play as well as the premium subsidy, which is something I didn't expect, so I need to re-do my calculations. I had pretty well settled on a bronze level HSA compatible plan, but cost-sharing requires a silver or higher plan and disqualifies you from HSA eligibility. What I'm not clear on is if I can get around the HSA exclusion by choosing a non-qualifying plan and thereby making myself cost-sharing ineligible, or if income alone rules out the HSA in which case I may as well choose the silver plan. I am increasingly glad we have a couple months to figure everything out because this is more complex than I'd anticipated.

 

[mikek]

Thanks! But doesn't that mean that BCBS can't offer that plan anywhere? I would think that they would adjust their plans to meet the requirements.

on the 'due to ACA we CANNOT renew your plan' issue.

From my best understanding- they regulations (I posted links above if i recall)- state that an employer cannot raise the percentage of premiums that he asks his employees to pay and keep his plan "grandfathered" so he may continue to offer it.

Typically the insurers have no idea at all what a small business asks it's employees to pay. The Small business works our what it will with it's employees and deducts from the employees paychecks whatever is agreed upon (be it zero dollars or 1500, zero percent or 100 percent) and then the employer cuts one check for all the health insurance from all the employees and sends it to the insurance company. So the insurance company has no way at all to know if they small group has asked their employees for more money or not. So they cannot renew the policy.

The government could have written the regulation to say any plan in existence from march 2010 is OK. But that's not what they did and so all the small groups are getting slaughtered.

 

[mikek]

This is my worst fear in all of this mess.

I am like some people here - my current individual plan is being cancelled and I have to pick an Obamacare plan. I currently have NJ Horizon Blue and they only have in-network plans to choose from. I realize that it doesn't matter if I pick bronze, silver, gold - if there are no protections from the costs of an out-of-network doctor or medical service, then you are just a bankruptcy waiting to happen. Or at least, a lifetime of massive debt and collection calls and destroyed credit.
...

I give up. There are no solutions to this except be one of the lucky ones to work for the state/municipal/government or a large wonderful company, since they tend to have the best benefits.

Amerihealth has some options apparently in NJ. Some are listed in the exchange docs but looks like they also choose to offer some others (POS/HMO) outside of the exchanges direct via their website.

The rates are still likely to be much more as they have to follow all the new rules, but there is an option. I suspect in the end if my spouse can't land a full time government job than we'll go with amerihealth and pay the THOUSANDS more for something approximating our current BCBS 'direct access' plan through my small business.