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Topic: Some Health Exchange Policies Cost More, But Provide More Coverage For Your Money< Next Oldest | Next Newest >
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PostIcon Posted on: Nov. 06 2013, 7:18 am  Skip to the next post in this topic. Ignore posts   QUOTE

Obamacare forces health insurance policies to provide coverage for many health care costs in order to be called "health insurance". Health insurance is required by every citizen after 2013. The new Obamacare mandates include coverage for drugs, hospitalization, etc and make any exclusions for such conditions as cancer, cardiovascular disease, AIDS, back pain, etc part of the BIG print in the policy.

As a result, health insurance is more likely to pay for treatment for illness or injury.

From Obamacare :

Consumer Reports offers the example of Judith Goss of Macomb, Mich. The 48-year-old was calmly going through life with a $65-a-month policy from Cigna's Starbridge plan. Then she was diagnosed with breast cancer.

Goss found herself facing a $30,000 hospital bill, with medical “coverage” limiting payments to $1,000 a year for outpatient treatment and $2,000 for hospital care. Frightened by the cost, the former Talbots saleswoman put off treatment until after her tumor had tripled in size.

So what was Goss getting for her $780-a-year premiums? If she'd had no insurance, at least she'd have known she wasn't covered for cancer. Depending on income, someone in her position might now qualify for subsidies to bring the premiums for good coverage way down. And yes, under Obamacare, an insurer can't turn anyone away because of a pre-existing condition.
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PostIcon Posted on: Nov. 06 2013, 7:33 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

There are thousands of self employed people in NY (where the vast majority of the ACA provisions have been in place for years) who will be forced in to poorer quality, more expensive plans. This applies specifically to Sole Proprieters or business's where two spouses are the only employee's within a company.
A 01/01/14 loss of coverage date with a web portal that was down for the vast majority of October. Completely ridiculous, and completely avoidable. So much for "if you like your coverage you can keep it".
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PostIcon Posted on: Nov. 06 2013, 7:44 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(ScotH @ Nov. 06 2013, 5:33 am)
QUOTE
There are thousands of self employed people in NY (where the vast majority of the ACA provisions have been in place for years) who will be forced in to poorer quality, more expensive plans. This applies specifically to Sole Proprieters or business's where two spouses are the only employee's within a company.

Do you have any documentation on that?  A link, a story, etc?  I'd be curious to see specifics, genuinely.

I'm fully aware the law has it's faults, and seeing the details of how it actually plays out goes a long way toward improving it.  But most the doomsday claims floating around the internet are more fiction than fact.  If you have specific info I'd love to read about it.


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PostIcon Posted on: Nov. 06 2013, 8:27 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

GBH, I am an Insurance Agency owner. I am witnessing what I referenced with clients every day. Every small business association medical plan that has a common renewal date, (such as January first) is non renewing the class of small business people that I spoke of. Chamber of Commerce administered Medical plans which have a disproportionately large amount of sole proproprieters(without employee's)utilizing them will lose their coverage upon the common expiration date of those plans. We have many clients that will lose coverage effective 3/01/14 and 7/01/14. They will be forced into the Individual Exchange and will not have access to the quality of coverage they had before. Almost all the options on the Individual Exchange in our NYS region are HMO's. Practically all of our clients are in PPO's or EPO's which have not only regional networks but national networks and don't require a referral from a Primary Care Physician. Additionally the Individual Exchange options have been consistently more expensive than their present plans. I have a client I will be speaking to today that will no longer be able to use his present cardiologist unless he wishes to pay him completely out of his pocket.
There are many positive things about the ACA, but there are a number of things that are horrible IMO. There are significant number of self employed people in NYS who will be very adversely effected.
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PostIcon Posted on: Nov. 06 2013, 8:58 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(ScotH @ Nov. 06 2013, 6:27 am)
QUOTE
Almost all the options on the Individual Exchange in our NYS region are HMO's. Practically all of our clients are in PPO's or EPO's which have not only regional networks but national networks and don't require a referral from a Primary Care Physician.

A few questions. Why didn't the PPO's get involved in the exchanges, to offer plans as part of the Exchange portal similarly to the way the HMO's did?  I ask this genuinely.  Also, why are the plans being canceled and not count as "insurance" anymore?  Was the coverage insufficient, or was it something else?  The ACA doesn't automatically force policies to cease existing... just if they want to be called "insurance" they need to meet a minimum threshold.  Did the PPO plans not meet that threshold in some specific way? If so, was it impossible to make adjustments to the plans to meet the thresholds?  So far it doesn't make any sense why insurance companies would shutter windows and close shop as a result of the ACA instead of making small adjustments to adapt (none of the actual provisions in the ACA would force that behavior) so without specifics I have to view such claims with a bit of incredulity.

Again, I ask these genuinely, not simply to argue. That's why I was curious about specifics. To judge whether a criticism is valid or complete conjured bullsheet, the devil is always in the details.


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PostIcon Posted on: Nov. 06 2013, 10:06 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I don't have the time right now to address all of your questions. I know that in NY all medical plans will have 14 "essential health benefits" where I believe but am not certain that the ACA requires 10 "essential health benefits".
Single person business entities are no longer able to purchase coverage through an Association or Chamber of Commerce and must purchase an on Exchange or off Exchange product that is for an individual. (Non Group product).
There are essential health benefits that NY plans were non compliant with. Pediatric dental coverage, child coverage to age 26, mandatory prescription coverage are examples that immediately come to mind.
I am not entirely certain of the why's that sole proprietors are being forced into individual products and why the On and Off Exchange options are almost completed restricted to HMO's. It would seem clearly a cost containment measure on the part of Insurance Companies to make sure this newly created actuarial pool is restricted to providers that they have contracted fee's with.
Hopefully in time if their experience is good they will expand their product offerings to EPO's and PPO's.
Whether the ACA mandated these things or not the net result is how the marketplace has been influenced. Prior to ACA the marketplace for this class of individuals was far more favorable.
Oddly enough in NYS the group plans outside the Exchange that have been most adversely effected have been the High Deductible plans. Obscene rate increases. The only people who are paying less for coverage in NYS are Individuals who were direct pay with medical insurance companies or Individuals who are receiving income based subsidies. The over whelming majority of people who already had coverage are or will be paying more.
I guess I had more time than I thought. Your questions are legitimate and I respect them. These things that I have mentioned could very well be the "unintended consequences" versus the specific legislation, to the people who are negatively effected it doesn't much matter.
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PostIcon Posted on: Nov. 06 2013, 1:50 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

"Whether the ACA mandated these things or not"

Devil is always in the details.

And whether it is mandated or not does matter in that a federal law mandate will be difficult to adjust (though the regulatory interpretation is open to both public comment and adjustment through the implementation period) while companies making independent decisions open the door for market forces to adjust and fill the needs.
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PostIcon Posted on: Nov. 06 2013, 3:29 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

The reality is that as a result of the implementation of this legislation there are thousands and perhaps tens of thousands of small business owners in NYS that will be paying more money for coverage that is inferior to what they had previously. They are unable to keep coverage they were content with. On top of that many of these people are faced with a 12/31/13 cut off date of their existing plans and are dealing with a web portal/system that still isn't working properly. As an example you have to go off the Exchange site to view the provider networks (because the Exchange site isn't working properly) and you are not certain that you are viewing the correct network because any one particular carrier could have 10 plus variations of their network. Then it is necessary to contact the carrier directly and wait on hold while you get passed around to multiple Customer Service Representatives who aren't really sure and will have to get back to you.
When was this legislation passed? 2010 right? Has there been enough time to get these things in order? Apparently not.
I am thrilled that individuals will have much greater availability to medical coverage and that people earning up to 400% of the Federal poverty level will receive subsidies. Let's not pretend though that there are some people who are not being very detrimentally effected. I am seeing it every day. People are shocked, like the gentleman I spoke to today who will no longer be able to see his Cardiologist. A very Successful 60 year old self employed gentleman who will no longer have a plan that enables him to go out of network. He is feeling very betrayed.
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PostIcon Posted on: Nov. 06 2013, 3:43 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Would have been so much easier, and more effective to just expand Medicare to everyone under single payer, neh?

You would support that, wouldn't you, rather than all this "efficiency" through the free market that has been ripping us off since WWII??

Just an enquiring mind!   :blush:


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PostIcon Posted on: Nov. 06 2013, 3:54 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(wwwest @ Nov. 06 2013, 12:43 pm)
QUOTE
Would have been so much easier, and more effective to just expand Medicare to everyone under single payer, neh?

You would support that, wouldn't you, rather than all this "efficiency" through the free market that has been ripping us off since WWII??

Just an enquiring mind!   :blush:

True: just build on The Framer's, John Adams, 1798 model. easy peaty.

Every medical care provider in the United States in a snappy Public Health Service uniform?

That could be interesting.
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PostIcon Posted on: Nov. 06 2013, 4:09 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

"You would support that, wouldn't you, rather than all this "efficiency" through the free market that has been ripping us off since WWII??"

So it is okay that so far the thing is a cluster ---- because we didn't go single payer? I am much more consumer driven than company driven and it is abundantly clear that many people in NY will be paying more and have an inferior Health Care product than what they had previously and that really is not fair to them. "If you like the plan you have you can keep it" Not even close to being true!
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PostIcon Posted on: Nov. 06 2013, 4:46 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(ScotH @ Nov. 06 2013, 3:29 pm)
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Let's not pretend though that there are some people who are not being very detrimentally effected. I am seeing it every day. People are shocked, like the gentleman I spoke to today who will no longer be able to see his Cardiologist. A very Successful 60 year old self employed gentleman who will no longer have a plan that enables him to go out of network. He is feeling very betrayed.

My spouse is peripherally associated with the medical industry (he re-sells medical imaging equipment) and he's been listening to non-stop whining from doctors and hospitals for months now, with similar stories like this.  He plays dumb and asks why the doctor or clinic doesn't then join the networks for these HMO's and, their answer?  Mostly that the networks are "cheap" and won't pay enough for the precedures they perform.

It's not the ACA law that's preventing patients from seeing the doctors they want.  It's the financial agreements between the insurance companies and the doctors that are the problem.  Neither side wants to give up any of the profits.

For what it's worth, my husband is self-employed and has his own health insurance.  We've gotten commitment that his premiums for 2014 will not be going up.  This will be the FIRST year that they haven't.


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PostIcon Posted on: Nov. 06 2013, 6:09 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

ScotH
QUOTE
I know that in NY all medical plans will have 14 "essential health benefits" where I believe but am not certain that the ACA requires 10 "essential health benefits".


Things must be radically different in NYS than in other parts of the country.

Where I live, and most people in the US live, health insurance policies that individuals purchase seldom cover the 10 "essential benefits" ( mandates ) that Obamacare requires before a policy can be called "medical insurance". Most company benefit managers are skilled at picking through the hundreds of pages of fine print in their group insurance policies and ferreting out the "exclusions" from coverage buried in the policy. So most employers who care for their employees manage to end up with a pretty good deal for their employees.

But sometimes, even employers miss some exclusion in the group health insurance policies that they obtain for employees. But not often. Employers have become very savvy about the tricky fine print. So I am thinking that Obamacare isn't affecting employers very much - except as you state in NYS. Employers that I am familiar have made sure that Obamacare's "mandates" are part of what they select for employees for years - even decades.

So I am mystified about the NYS situation. Perhaps health insurance executives in NYS are raising their prices on policies offering LESS coverage than before because they can use the new Obamacare law as an excuse. Some employers in my area are firing full-time employees and hiring them back at less money and hours as temps and blaming it on Obamacare. So that may be the case.

Sadly, individuals tend to learn that their health insurance bought on the individual market is pretty much worthless whenever they get injured or sick and need it. The example in the OP link is typical:

Consumer Reports offers the example of Judith Goss of Macomb, Mich. The 48-year-old was calmly going through life with a $65-a-month policy from Cigna's Starbridge plan. Then she was diagnosed with breast cancer.

Goss found herself facing a $30,000 hospital bill, with medical “coverage” limiting payments to $1,000 a year for outpatient treatment and $2,000 for hospital care. Frightened by the cost, the former Talbots saleswoman put off treatment until after her tumor had tripled in size.

So what was Goss getting for her $780-a-year premiums? If she'd had no insurance, at least she'd have known she wasn't covered for cancer. Depending on income, someone in her position might now qualify for subsidies to bring the premiums for good coverage way down. And yes, under Obamacare, an insurer can't turn anyone away because of a pre-existing condition.


From the OP link of a previous thread - Keep Your Existing Insurance, Unless the Company Cancels It:
"The whole idea behind the Affordable Care Act was to discontinue an alarming trend of policies with gaps in coverage, sometimes to the surprise of policyholders,"

From your posts, it looks like NYS is experiencing the opposite of what people in the rest of the US are experiencing. The exchanges and Obamacare mandates have forced insurance companies to compete on a more level playing field - and that transparency has resulted in increased competition and LOWER costs to consumers.

It is sad that in NYS, health insurance companies are INCREASING rates for POORER quality insurance.
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PostIcon Posted on: Nov. 06 2013, 7:27 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Not really that unexpected.  Mandating coverage of previously uninsurable at the same rates as others would automatically mean cost for others would go up. (That the government helps them pay their premium does not change that) That these folks are grouped only with other single payers (at least this is what it sounds like) means less folks to bare this cost?  (Those who are in group plans offered by their employer are not effected? , aa long as their plan meets the minimums and isn't a "Cadillac" plan? At least that is what it sounds like.
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PostIcon Posted on: Nov. 06 2013, 7:27 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I am not well versed with what is taking place with the offerings in other states. Because of my profession I have been focused on our clients and how they will be effected. As I had mentioned previously, NY was already significantly more advanced from a compliance perspective than the majority of the country.
Our business has about 20 clients in one particular Association plan where they will all be terminated on 12/31/13. We administer a Chamber of Commerce plan that will terminate approximately 60 clients on 03/01/14 and 07/01/14. I have been assisting many clients out of graciousness as a number of the Exchange Options will not compensate Brokers for Individual/Family products. I don't object because without guidance many of these people would truly struggle trying to make sense of their options.
I have met with most of the 20 clients who are to be terminated as of 12/31/13. All of them will be working with a much more limited network of providers and everyone of them who does not qualify for a subsidy will be paying a higher premium. I know this is not what any of them envisioned.
I am happy to have a civil conversation with any and all here. I am just conveying my experience working within the midst of these things in NY.
My biggest concern now is that anyone who has a 12/31/13 cancellation can select a plan and get on board by 12/15/13 so they can realize a 01/01/14 effective date without any break in coverage. I met with a couple earlier this evening who are artists and bright people, they were very challenged in attempting to understand their options. Unfortunately the web portal is still not working properly.
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PostIcon Posted on: Nov. 06 2013, 8:22 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

ScotH, another legitimate question:  

How does the ACA impact the income of Insurance agencies such as yours?  

I clicked on one link that said it would be actually a boon for private agencies, but it didn't explain how.   

Another link indicated private agencies would suffer:   

"......The Patient Protection and Affordable Care Act dictates that health insurers must spend at least $0.80 of every $1.00 in premiums collected on health care in the individual and small group markets, and $0.85 in the large group market.

Insurance agents represented by National Association of Health Underwriters tried hard for the government to define their commissions as part of the medical expense and failed.  The argument by insurance agents was a senseless argument.
......".

You're dealing with this first hand, do you think  the Insurance Companies make that .80/1.00 hurdle partly by cutting out private agencies, and still maintain their own overhead?

http://www.forbes.com/sites....-ruling


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PostIcon Posted on: Nov. 06 2013, 9:01 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I expect that our business specifically will lose income, at least in the short term. About 10 percent of our Agency's income comes from Health Insurance products. It would not surprise me to see that income percentage drop to 5 percent in this next year. This would be largely as a result of the loss of compensation in the sole proprietor marketplace. There will be some opportunity that arises as a result of some insurance companies compensating us for the sale of individual health insurance products where they hadn't previously. I really don't like not having a non HMO product to offer successful and sophisticated individuals/sole proprietors. That is a real negative.
We are not compensated particularly well on Health Insurance products. Most often 3 percent of premium, sometimes less. It is definitely not a provide it and forget it product either. It is incredibly service intensive and is re marketed on almost every renewal.
For many years we wrote more health insurance than I would have liked, we dug to find avenues that were more affordable and provided better coverage. Associations, chambers of Commerce etc. we did it for existing clients and people who other Agents wouldn't give the time of day to because the ROI was so poor. I felt it was the right thing to do and I don't regret it. I am not particularly thrilled right now with a deadline looming a significant amount of work to do and an Exchange portal that isn't sufficient. We will do the right thing, build good will and strengthen relationships. I dread February and June though!
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PostIcon Posted on: Nov. 06 2013, 9:06 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

ScotH, you sound like a good guy who wants to make a living AND provide service, good luck!

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PostIcon Posted on: Nov. 06 2013, 11:03 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Thank you Old Frank.
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PostIcon Posted on: Nov. 06 2013, 11:26 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I have met with most of the 20 clients who are to be terminated as of 12/31/13. All of them will be working with a much more limited network of providers and everyone of them who does not qualify for a subsidy will be paying a higher premium. I know this is not what any of them envisioned.


What is the range of income for the 20 clients you are talking about??


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PostIcon Posted on: Nov. 06 2013, 11:57 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(ScotH @ Nov. 06 2013, 9:01 pm)
QUOTE
I expect that our business specifically will lose income, at least in the short term. About 10 percent of our Agency's income comes from Health Insurance products. It would not surprise me to see that income percentage drop to 5 percent in this next year. This would be largely as a result of the loss of compensation in the sole proprietor marketplace. There will be some opportunity that arises as a result of some insurance companies compensating us for the sale of individual health insurance products where they hadn't previously. I really don't like not having a non HMO product to offer successful and sophisticated individuals/sole proprietors. That is a real negative.
We are not compensated particularly well on Health Insurance products. Most often 3 percent of premium, sometimes less. It is definitely not a provide it and forget it product either. It is incredibly service intensive and is re marketed on almost every renewal.
For many years we wrote more health insurance than I would have liked, we dug to find avenues that were more affordable and provided better coverage. Associations, chambers of Commerce etc. we did it for existing clients and people who other Agents wouldn't give the time of day to because the ROI was so poor. I felt it was the right thing to do and I don't regret it. I am not particularly thrilled right now with a deadline looming a significant amount of work to do and an Exchange portal that isn't sufficient. We will do the right thing, build good will and strengthen relationships. I dread February and June though!

How does your experience and analysis square with this report showing that NY state will enjoy an average reduction in premiums of 40%, the most of any state??

Forbes states that analysis covers those indviduals buying health insurance on their own.

Eight states will enjoy average premium reductions under Obamacare: New York (-40%), Colorado (-22%), Ohio (-21%), Massachusetts (-20%), New Jersey (-19%), New Hampshire (-18%), Rhode Island (-10%), and Indiana (-3%). Most, but not all, of these states had heavily-regulated individual insurance markets prior to Obamacare, and will therefore benefit from Obamacare’s subsidies, and especially its requirement that everyone purchase health insurance or pay a fine.

http://www.forbes.com/sites....elderly

You notice they say nothing about the quality of the coverage before ACA, and then what is covered after.  Pretty easy to have cheap insurance that covers nothing.

Here is the link to their interactive map:

http://www.forbes.com/special....ap.html

This smacks of sophistry to me.  Switch and bait.


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PostIcon Posted on: Nov. 07 2013, 7:01 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Among these 20 people I refer to there are artists, contractors,writers,therapists, a pilates studio owner, store owners etc. Most of their earnings are $50,000 plus. Some of them qualify for subsidies if their earnings are $44,000 or less. The subsidy consideration doesn't address the quality of coverage issue.

I haven't read the Forbes piece. (I don't need to) I am immersed in this, there is nothing that can be written that will supersede my direct experience.
In NYS there is a dramatic average rate reduction for individuals with no availability of coverage through employment and who aren't self employed with employees. The make up of this group of people would be the unemployed and spouse situations where one spouse is Medicare eligible and has a younger mate who is not Medicare eligible. This pool of insureds was very small relatively and was horrendous actuarilly. These people only avenue previously was what was called direct pay with the insurance carriers and was extremely expensive. A single rate could be from $1800 to $2200 a month.
So yes in this small segment of the market place there are dramatic reductions in expense. It is not representative at all to the market at large. The people most harmed are the sole propriters who are now forced into individual products or the individual Exchanges.Premiums are higher and they have lost the ability to have access to PPO's and EPO's. In the small group market premiums are up considerably on high deductible plans and fairly flat on other group plans.
NYS plans have been very good for close to two decades, that has not been an issue in any way.
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PostIcon Posted on: Nov. 07 2013, 7:26 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

ScotH
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My biggest concern now is that anyone who has a 12/31/13 cancellation can select a plan and get on board by 12/15/13 so they can realize a 01/01/14 effective date without any break in coverage.


That is a VERY sad situation! NYS must have much stricter rules than other states. Or else the insurance companies themselves are precipitating this crisis by cancelling everyone's policies on 12/31/13 and blaming it on Obamacare.

Even in Tennessee, one of the states with very lax insurance regulation, health insurance policies that were in affect before 1/1/14 that do not meet Obamacare's "mandates" are allowed to stay in affect until their renewal. And IF that policy was in affect before 3/31/10 AND there have been no significant changes in the plan - that plan is "grandfathered" and will allowed to be in affect until "significant changes" are made. Note that there are almost NO health insurance plans that qualify to be "grandfathered" because almost ALL health insurance companies have made "significant changes" since 3/31/10.

So in most states, there is no crisis hitting policyholders on 1/1/14. BUT, most people will have to obtain an "Obamacare approved" policy when their renewal date comes up - or else pay the tax penalty for not having insurance if they purchase a policy that does not meet Obamacare standards. That means that most policyholders will have time to shop around for a health insurance policy that meets the Obamacare standards sometime in 2014 - or to just purchase on the exchanges.
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PostIcon Posted on: Nov. 07 2013, 8:45 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

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That is a VERY sad situation! NYS must have much stricter rules than other states.


At least one other state is having this happen:

http://www.okcfox.com/story....surance


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Or else the insurance companies themselves are precipitating this crisis by cancelling everyone's policies on 12/31/13 and blaming it on Obamacare.


It could be the chamber's plan did not meet the minimum requirements, and rather than change to the same as other individual plans they offer they (the chamber or the insurance companies) cancelled it?
Or are u saying they did this just to make Obamacare look bad?

I think Blue cross is doing the same thing here with individual plans, one is being forced into PPOs

If the chambers plan did not meet minimum requirements that would explain another part of the increase, also individual  plans usually have much greater sales commissions, but this is sort of an individual group plan so I am not sure that is the case.


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PostIcon Posted on: Nov. 07 2013, 10:22 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

If your are self employed without employees, your are considered an individual, under ACA.

So you have to be charged the same as other individuals, except for age, location, type of coverage above the minimums,etc.

QUOTE
   Insurance companies will be required to cover all applicants and offer the same rates regardless of pre-existing conditions, age or gender.


http://www.huffingtonpost.com/veer-gi....50.html


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" before you make assertions about numbers, look at the numbers."   Krugman
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PostIcon Posted on: Nov. 07 2013, 11:25 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(ScotH @ Nov. 07 2013, 7:01 am)
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These people only avenue previously was what was called direct pay with the insurance carriers and was extremely expensive. A single rate could be from $1800 to $2200 a month.
So yes in this small segment of the market place there are dramatic reductions in expense. It is not representative at all to the market at large. The people most harmed are the sole propriters who are now forced into individual products or the individual Exchanges.Premiums are higher and they have lost the ability to have access to PPO's and EPO's. In the small group market premiums are up considerably on high deductible plans and fairly flat on other group plans.
NYS plans have been very good for close to two decades, that has not been an issue in any way.

I really just don't understand how this can be the norm.  My husband is in his 50's, is self-employed, and has an individual PPO plan direct from a major insurance company.  No groups or agents involved.  He has a moderately high deductible ($1,000).  Monthly premium is $330.  We got quotes from a few companies before choosing this plan, including Blue Cross, and we chose it for a combination of factors but it wasn't radically cheaper than the others.

I was talking to our neighbor yesterday, who is also self-employed.  He also has a direct plan, but with a different insurance company, and it's for his whole family.  He told me his premium is going to be $1,800 per month for 2014, which may sound high but is comparable to most group rates through an employer.  I suspect that most employees don't realize how much their employer contributes to their health insurance premiums.

I'm hearing a lot of "horror" stories from doctors, insurance brokers, politicians, HR staffers, etc. but no real evidence from policy-holders themselves.  Some sort of disconnect somewhere...


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PostIcon Posted on: Nov. 07 2013, 11:47 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Change is hard to do, and the people who have been reaping the rewards of the most expensive health care in the world don't want to let that cash cow go, certainly not without a fight to the finish.

This whole dynamic is what will push us finally into a single payer system, like every other rational, first world country.


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PostIcon Posted on: Nov. 07 2013, 12:32 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(TigerFan @ Nov. 07 2013, 9:25 am)
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I'm hearing a lot of "horror" stories from doctors, insurance brokers, politicians, HR staffers, etc. but no real evidence from policy-holders themselves.  Some sort of disconnect somewhere...

There's been an incredible amount of this.


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PostIcon Posted on: Nov. 07 2013, 12:40 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Tech leading the way once again: F.U.D. has been a popular game in the tech world for a while.


That's Fear, Uncertainty, Doubt.
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PostIcon Posted on: Nov. 07 2013, 1:19 pm Skip to the previous post in this topic.  Ignore posts   QUOTE

Here is an interesting, and to me, encouraging, poll showing that interest and approval of Obamacare is growing, even while the media sh!tstorm decrying its failure rages around us.

Maybe this is just one more example showing that any constant publicity is good publicity, no matter how negative it attempts to be??  LOL

The poll's findings are good news for Obamacare supporters who worry the problems and bad press could dissuade people from signing up, particularly the young and healthy who are crucial to diversifying the pool of insured and keeping premiums down.

The uninsured view the 2010 Patient Protection and Affordable Care Act, commonly known as Obamacare, more favorably since online marketplaces opened - 44 percent compared with 37 percent in September, according to the Reuters/Ipsos poll. It found that 56 percent oppose the program compared with 63 percent in September.

A higher proportion of the uninsured also said they are interested in buying insurance on the exchanges, with 42 percent in October, saying they were likely to enroll compared with 37 percent in September. The results have a credibility interval, a measure of accuracy, of plus or minus 3.2 percentage points.

The online poll of nearly 12,000 people was conducted in October. Some 1,100 of the respondents identified themselves as uninsured.

Among the general public, support for the law rose from nearly 44 percent to 47 percent, with a credibility interval of 1 percentage point, according to the poll.

The non-partisan Congressional Budget Office estimates that up to 7 million people are likely to sign up for coverage on the private exchanges for 2014, but that number has been called into question due to HealthCare.gov's problems. The Obama administration has said it is working around the clock to fix the website by the end of November


http://www.reuters.com/article....0131106


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