Health Care Thread

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a_skeleton_03

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Draegan_sl said:
Everyone in my company paid the exact same amount for insurance depending on size of the plan. I.e. 2 kids, 1 kid, 1 spouse etc. That's how groups work.
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My wife's plan the pool is the same but you pay more if you are female etc.

Not all pools are created equal.

You have a pool of $1000.

You have 10 men at $50/mo. and 5 women at $100/mo.

Nothing wrong with that old plan. Now it will be illegal. Like I said, we shall see if that is the best option in the long run. I do not think it will be the best.
 
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a_skeleton_03

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Draegan_sl said:
That's why the individual market was shit.
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You can have that opinion but a person paying for just what they will use/need is preferable to a blanket set of EHB's that all people have to pay for regardless.

They could have started out the ACA without that portion of mandatory EHB's and making it illegal to adjust the options and I think it would have gained a little more traction and less animosity.
 
Vaclav

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a_skeleton_03_sl said:
My wife's plan the pool is the same but you pay more if you are female etc.

Not all pools are created equal.

You have a pool of $1000.

You have 10 men at $50/mo. and 5 women at $100/mo.

Nothing wrong with that old plan. Now it will be illegal. Like I said, we shall see if that is the best option in the long run. I do not think it will be the best.
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The men are in a separate pool if that's true - its illegal to vary rates by gender within a pool unless something happened to undo the 85ish reforms... Don't even think grandfathering was allowed.
 
TrollfaceDeux

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Vaclav_sl said:
The men are in a separate pool if that's true - its illegal to vary rates by gender within a pool unless something happened to undo the 85ish reforms... Don't even think grandfathering was allowed.
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Women Still Pay More for Health Insurance, Data Shows - NYTimes.com

The new health care law will prohibit such "gender rating,"starting in 2014.But gaps persist in most states, with no evidence that insurers have taken steps to reduce them.

The rating rules have not been directly challenged in the court case. In that case, 26 states attack the law's requirement for most Americans to carry health insurance.
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A

a_skeleton_03

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Vaclav_sl said:
The men are in a separate pool if that's true - its illegal to vary rates by gender within a pool unless something happened to undo the 85ish reforms... Don't even think grandfathering was allowed.
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Yeah you are wrong. You often are. You take your anecdotal evidence based on that one year where you worked for a living and spew it out as undeniable fact. The rest of us are actually willing to be wrong. You aren't. You already double down on stupidity with your 9 to 1 comment etc...
 
chaos

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I can't imagine how that wasn't illegal, pre-ACA even. Everywhere I have ever worked had group plans and you paid the offset of what the company didn't pay, period. It was the same cost for everyone for each plan option and did not vary according to anything, much less gender.
 
Vaclav

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a_skeleton_03_sl said:
Yeah you are wrong. You often are. You take your anecdotal evidence based on that one year where you worked for a living and spew it out as undeniable fact. The rest of us are actually willing to be wrong. You aren't. You already double down on stupidity with your 9 to 1 comment etc...
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Human Resource Management, 13th Edition: Robert L. Mathis, John H. Jackson: 9780538453158: Amazon.com: Books

Although 11th edition quotes explicitly otherwise on page 124 halfway down the page, if you'd care to find a copy you could see it yourself. (Specifically within the chapter on selecting health benefits)

This is not to say women don't make the entire pool tick up a bit in cost, but within the same pool static costs are the law in the private sector. However note if your wife is getting hers through the Fed, Fed guidelines are incredibly bizarre and random. (I.e. Federal workers and SSI - it was possible for them over some years to have to pay in to SSI while being exempt from drawing it - fun times)

Our men's only pool might be an outlier I'll acknowledge that, but circa 1985 healthcare law you can't charge extra within a pool outside a few select conditions - sex is not one - extra charges for other criteria must go to the entire pool.

But hey, what do I know only shopped for three plans to offer every year for 15 years with 200-650 employees depending on the timeframe - and not once with plenty of women were they charged differently. (And note technically it was 4 plans a year, but the management one was not available for the majority to select)
 
Vaclav

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Neat.. So in a corner case of small (non-HR most likely) employers in what looks to be 12 states with tons of stipulations it rarely could occur before.

Its interesting some states flipped it though, must've been explicit to contradict Fed law if the text isn't off in how its presented, would be quite curious to see a full legal timeline. Nothing in the text within that section states its not applicable in small employers.

Edit: Oh never mind, I missed a huge caveat there... Supplemental plans... I'm talking primary insurance - supplemental insurance has always been the Wild West to follow legally.

Got any evidence it exists for primary plans?
 
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Vaclav_sl said:
Human Resource Management, 13th Edition: Robert L. Mathis, John H. Jackson: 9780538453158: Amazon.com: Books

Although 11th edition quotes explicitly otherwise on page 124 halfway down the page, if you'd care to find a copy you could see it yourself. (Specifically within the chapter on selecting health benefits)

This is not to say women don't make the entire pool tick up a bit in cost, but within the same pool static costs are the law in the private sector. However note if your wife is getting hers through the Fed, Fed guidelines are incredibly bizarre and random. (I.e. Federal workers and SSI - it was possible for them over some years to have to pay in to SSI while being exempt from drawing it - fun times)

Our men's only pool might be an outlier I'll acknowledge that, but circa 1985 healthcare law you can't charge extra within a pool outside a few select conditions - sex is not one - extra charges for other criteria must go to the entire pool.

But hey, what do I know only shopped for three plans to offer every year for 15 years with 200-650 employees depending on the timeframe - and not once with plenty of women were they charged differently. (And note technically it was 4 plans a year, but the management one was not available for the majority to select)
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That wiki page only says that it is legal/practical for insurers to charge more based upon gender or pre-existing conditions in an individual sense. It says nothing about buying policies as a group. But that's kind of the point, the larger the pool of people being insured, the lower the risk of them all getting sick at once. Thusly, the lower the risk of massive costs being incurred by the insurance company, and therefore, the lower the overall average cost of premiums. Its the basic idea behind national healthcare, and the reason that businesses pay less for premiums, when buying in bulk, than individuals do.
 
Kreugen

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So she can get insurance where she was denied before, but she makes too much money to get a subsidy? Tiny violins, etc?
 
Synj

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Kreugen_sl said:
So she can get insurance where she was denied before, but she makes too much money to get a subsidy? Tiny violins, etc?
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Where does it mention that she was denied before? I thought the reason she couldn't get coverage was due to cost and she cannot get coverage now due to cost?

I thought the whole point of the Affordable Care Act was to make it affordable, why is this lady who was applauded by Obama now all of a sudden not worthy of empathy? She got misled by the state websites (shocker) and she's still back at square one...thanks Obamacare?
 
Hoss

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Synj_sl said:
I thought the whole point of the Affordable Care Act was to make it affordable,
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LOL you're so naive. Generally speaking, the only thing you can tell from the official name of an act is what it will not do.
 
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