health insurance, work, fairness issue--what do you think

[blisstwins]

First, if you get your health insurance through you employer what do you pay for it if anything?
Do you have to pay more for the family plan?
____________

Here is my issue and I need to know whether or not I am off-base. I took a job and was told I would receive full benefits, including health insurance.
We currently buy health insurance privately because my husband is self employed. I expected to pay something toward insurance through my employer, but no where near what we pay buy it on my own.

My employer pays for me entirely--I contribute nothing. But if I want to cover my family I have to pay myself and it is just about the same as if I buy it privately. My co-workers said the employer believes it is unfair to single employees/childless families for them to provide a benefit to families.

I am a professional in a pink collar job. This is an employer that speaks a lot about our professionalism, glass ceilings, and other progressive workplace issues.

Am I offbase for feeling diasppointed or do many companies treat issurance this way these days?

[kijip]

IME, most smaller employers are only able to offer coverage for the employee. Larger employers are more likely to offer family benefits.

You mentioned that "This is an employer that speaks a lot about our professionalism, glass ceilings, and other progressive workplace issues. " Can i assume that you work for an advocacy group or non-profit of some sort? I work in non-profit and have not found full-coverage for families to be remotely common. It's a cost issue for smaller employers with smaller groups and thus higher rates.

[blisstwins]

It's a single sex school with 150 employees if that matters.

[niccig]

We're lucky in that DH's employer pays 100% of our premiums. DH was the 5th person hired 13 years ago, and at the time the owner believed in paying for health care, and we're grandfathered in. Later hires pay premiums.

If DH did pay out of his pay check, it would be the same amount as friends who self insure because they are self-employed. I know this as his company takes out the insurance premium from his pay, then reimburses us for that amount, and my friend has told me her insurance costs. BUT the coverage is much much higher/better on our employer plan. My friend has very high deductible and copays. Eg. her blood test to check thyroid levels is $450 out of pocket, mine is $15. My visit to the Dr. is $15, her visit is $50. We see the same Dr. and go to same lab for our blood word. She doesn't have dental or vision, we do have these benefits.

I would check the actual benefits and see what is covered. It may end up being the same premium, but your other costs might be much less, more is covered on the employer plan.

[egoldber]

Well, I work for the federal government, and we have a ton of options available. We currently pay $250 a month for very good family coverage. With DH's old job we were paying about $600 a month OOP for family coverage and our COBRA amount when he was laid off was $1400 a month.

Every place I or DH has ever worked has had different rates for employee only, employee and spouse and family coverage. I think that is typical. The amount that the employee (and the employer) paid was also going up significantly every year for less and less coverage.

I do think it was disingenuous of them not to outright tell you that the employer sponsored coverage was for the employee only. That seems like important information when considering a job offer!

[blisstwins]

It is a little better and I am not actually out of my mind about it, it's just that we are routinely told how important our work is, almost everyone has an advanced degree, and when I asked what people did for insurance (it's 12k a year out of a 60k salary for a family) I am told that most get it through their spouse/partner's insurance. It just seemed so contrary to the message that this is a professional job. This is the first time I have experienced/thought about this and I don't even know the norms anymore.

[almostamom]

DH works for the federal government as well. We pay to have the family covered. When I was originally hired by the school district (1991), 80% of the premiums for dependents was paid for by the school district. By the time I left (2004), the employee had to pay 100% of the premium for the dependents. For the past few years, the teachers have had to pay a percentage just to cover themselves.

Linda

ETA: This is in a very large public school district in Phoenix.

[kijip]

We don't have to pay a premium for my husband or the kids. My premium on his plan is really low, (I think they pay 1/2 or more of it, just not 100 like they do for the boys and my husband). We don't have any complaints but he works for a very large hospital and their health plan is kinda of their signature draw for attracting and retaining employees. I think the level of coverage we have is less and less common for sure though and that is one of the reasons I think employer based health insurance is on it's merits a defective system- it's bad for the employers (esp the smaller ones that can't afford it), people are getting less and less coverage for more and more cost, unemployed people lose their coverage etc. And why should my husband and I enjoy better coverage than most of the rest of the population just because he is lucky enough to work for a big employer with primo benefits? It's inherently unjust. So while I think you are right to be irritated by your employer's plan not meshing with the values they spout and certainly that they did not let you know before you accepted the offer, I think the real problem is that our insurance has to be through our employer in the first place.

[tiapam]

We pay $3000 per year for me and the kids to be covered on DH's employer's plan. I believe that is the whole premium. His coverage is free. I feel like it is high because at my old job (basically local government) it was much cheaper to cover a spouse and family. They have changed their plans and policies since I left my FT job, so I know it has gone downhill but would still probably be cheaper than what we pay. But it also employs more people than DH's firm.

I think it is silly to say that it is unfair to single and childless employees when employers pay for all or some of family coverage. It sounds like something the employer has made up, I cannot believe anyone would actually complain about that. I bet those people don't feel it is unfair when they later get married or have kids!

[tiapam]

My friend has very high deductible and copays. Eg. her blood test to check thyroid levels is $450 out of pocket, mine is $15.

Nicci, is that $450 a typo? If it is just blood work, she might do better ordering the tests herself. There are some labs that do that. Here is more info, just in case:

http://thyroid.about.com/od/gettestedanddiagnosed/a/selftesting.htm

[caheinz]

My coverage is paid 100% for PPO. I could switch to HMO and have the difference applied toward other benefits.

Dependents are not covered. They can be added, but I would pay 100% of their cost on our group plan.

Fortunately, DH has a good plan at work, so he and the kids are on it, while mine is through my employer.

Oh, and I like the way DH's plan is structured. The way I understand it, the more an employee makes, the greater the percentage of their premium they're asked to pay. So, the employees at the bottom of the ladder pay less for the same plan compared to those at the top.

[blisstwins]

I do think it was disingenuous of them not to outright tell you that the employer sponsored coverage was for the employee only. That seems like important information when considering a job offer!


This was really this issue, Katie. I was so surprised by this policy, it took me off guard. Thankfully we can afford insurance, but if my husband made what I do and it cost $1200 a month for our family to be covered while we were both employed we would have a problem.

I don't know how to fix the system, but something is broken.

On the smaller point, I just feel a angry at my employers policy here. If I had known there is a good chance I would not have taken the job and I really do think schools should think about the values they operate by. Stuff like this makes me think stuff I don't like to think--like I don't want my children to follow in my footsteps because it is one thing to know you did not choose a job for the money, but it is quite another to feel like it is a profession in which you cannot get by. Without a spouse in a different field we would not be OK (in this area) and that makes me feel disappointed. On a more positive note, my emploers are generous in other areas.

[mommylamb]

I have employer sponsored health care (lucky). When it was just me on my insurance (DH also has employer sponsored through his work, but we are not currently on the same policy), my employer paid 80% and I paid 20%. When I added DS to my insurance, my employer began paying 60% for both of us. I think it's fair. However, DS and I are planning to move to DH's insurance during open enrollment because it will be a huge cost savings for us. His employer is more generous. I also work for a small non-profit and he works for the Australian government.

[KrisM]

We're insured through DH's job. We have 3 choices. We choose the PPO and we pay nothing monthly for our family to be insured. We do have a $3000 deductible though. We could move to a HMO plan and pay more. If I remember correctly, it's around $300/month for the family plan.

His employer offers 3 tiers:
employee
employee + one
employee + family

[wellyes]

My plan options are:

$92/mo for employee
$171/mo for employee + 1
$250/mo for a family

That's for the HMO, but for either the HMO or the PPO, family coverage is more than 2x individual coverage.

[lizzywednesday]

My health insurance is partially subsidized by the company.

They also partially subsidize dependents.

True, it costs more to cover employee + 2 (i.e.-spouse + child) but it's still covered. I don't recall what the coverage is ... we switched from my plan (roughly the same costs, but I make less and did not get a raise last year) to his plan (slightly better coverage, plus he makes more, got a raise AND a bonus last year) ... for both medical and dental coverage.

HOWEVER I get better (and cheaper) vision benefits at my job, so I pay for that. But it's something like $12/month for VERY good coverage!!! (Better than his - he has a "discount plan" which I intend on using for replacement eyeglasses soon, but I typically wear contacts because I see more clearly with them than with glasses. Also, it saves me $$ on sunglasses and time on switching from regular glasses to sunglasses and back.)

If the DH started wearing glasses, I would add him to my vision coverage (again, mine is much better than his,) but my monthly costs would STILL be under $20/month for both of us.

[Moneypenny]

I work for state government so the state contributes to both single or family premiums. My portion is higher for family coverage.

I have several friends who work in the private sector, however, and it isn't at all unusual that single coverage is provided by the employer while family coverage is not.

[vonfirmath]

Every place I have worked has had different policies on what is/is not covered.

The reason any company pays for medical is back back in President Franklin Roosevelt's day, the government capped what a company could pay a person. So, in order for a company to attract employees away from other companies, they started offering benefits. Medical was one of the benefits that they offered. So basically paying for health "insurance" is in lieu of putting more money into your paycheck. How much they pay, etc. Is up to how the company wants to apportion its money.

From this standpoint, it is "unfair" to a single person because the company does NOT put that extra money into the single's paycheck that they are paying for another's family premiums. But other companies choose to support families, instead. (or find that they can attract better employees by paying for family health insurance) so are willing to pay more to pay partial (or all) of the family premiums.

[JBaxter]

We pay 215/ month for our portion of the family plan. DH's company has wonderful isurance. One of perks of his company ( which is a fairly large company) is the isurance.

[Sillygirl]

It is a little better and I am not actually out of my mind about it, it's just that we are routinely told how important our work is, almost everyone has an advanced degree, and when I asked what people did for insurance (it's 12k a year out of a 60k salary for a family) I am told that most get it through their spouse/partner's insurance. It just seemed so contrary to the message that this is a professional job. This is the first time I have experienced/thought about this and I don't even know the norms anymore.

To me, this is another example of how the current system undermines what the right calls "family values." If you want to teach children and have a family of your own, you better have a spouse that also works full time to make sure your children have benefits? Yeah, that supports families for sure.

[truly scrumptious]

It is a little better and I am not actually out of my mind about it, it's just that we are routinely told how important our work is, almost everyone has an advanced degree, and when I asked what people did for insurance (it's 12k a year out of a 60k salary for a family) I am told that most get it through their spouse/partner's insurance. It just seemed so contrary to the message that this is a professional job. This is the first time I have experienced/thought about this and I don't even know the norms anymore.

BTW, if most employees get their insurance through a spouse/partner, that could drive up your employer's premium because of the small size of the group they are now insuring, especially once age is factored in.
I work for a small company that requests combined bids with our sister company for health insurance to keep rates down (individually, my company has 15 employees, but combined with the sister company we have 60, which gives the company slightly more bargaining power with the insurer.)
I am one of the younger employees on the company plan (we pay about $4,000 a year for a family plan, which is 30% of the cost, with the employer picking up the other 70%) and I know that if I were drop out of the plan the cost would go up significantly because it would bring the average age up.

[jenmcadams]

My DH started his own small software company a few years ago -- this is his 3rd small company he's run and he's always paid 100% of the premium for his employees and families. We current have very good PPO coverage and his company's cost for our family is $1200+/month. The current company only has 8-10 employees, but he decided it was worth it from a recruiting perspective to make it a fully covered benefit. I'm not sure if the company pays all of the dental or now, but they definitely pay 100% of Health.

This is definitely not typical. I think your situation is far more typical -- I know in public education, often only the employee is covered and the amount employers are willing to pay for spouse/family premiums is low.

[niccig]

Nicci, is that $450 a typo? If it is just blood work, she might do better ordering the tests herself. There are some labs that do that. Here is more info, just in case:

http://thyroid.about.com/od/gettestedanddiagnosed/a/selftesting.htm

Pam, it's not a typo. I and several other friends have told them to compare other insurance plans. I"ll send her the link about self testing...anything cheaper than $450 would be better.

[rlu]

Generally I've worked for public tech companies in Silicon Valley and I have always paid a premium and it goes up the number of dependents you add.

I agree with pp that the co should have disclosed to op that family would cost.

eta: when my co was bought-out by an East Coast company our health benefit costs went up and coverage down. Not sure if that was a regional thing, this specific company, or industry trend.

[AnnieW625]

We have health insurance through my husband's employer (same employer as me, State of California, but DH's union negotiated better rates than mine did in our last contract) and we have the family plan. We pay about $250 month for our family (I don't think there is a limit, so a family of 3 pays the same as a family of 6). If I wanted insurance on my own it would cost about $50-$75 a month, but I don't really need my own policy. We have Kaiser Permanente for our insurance and we pay $5 for most generic prescriptions and I think the most I have paid is $45 for other brand names, but that is not usual. Our dr. visit co pays are $15 and I don't think I have had to pay a separate co pay for blood work and such. All maternity and baby well visits are covered so that is a huge plus. We had no co pay to see the audiologist, but had to pay $15 to see the speech therapist. The HMO paid 100% of everything else. I have been lucky and not had an issue. When we had an 80%/20% PPO plan the ER paid for 80% of the service (after we paid the $20 co pay) and we paid the remaining 20% until we met the deductable of $1500 per person, which we never did. I have never had a single billing issue with Kaiser and I am extremely happy about that.

[codex57]

Sounds extremely typical.

We have insurance thru DW. She works for Kaiser. Awesome medical benefits obviously. She's part time, and I think we only pay like $60/pay period for the whole family. So like $120/mo? $5 copay. Like $20/pay period for single people.

If you're full time, I think you don't pay squat and there's no copay either. Gotta double check on that, but I know for sure there's no copay.

For certain employees, they get a gold member card that's supposed to help them get seen faster so that they can get back to work faster and make more money for Kaiser. But Kaiser wants their employees to have health insurance so they stay healthy and don't take off work as much. Healthy employees are also cheaper to treat.

That's how the national health plan should go. It needs to follow Kaiser's example. Can't be a "treat the symptom as it comes up" as is how our medical field basically operates. Need to be more proactive. I know many Japanese companies (not sure if it's under gov't directive) have fitness goals with penalties attached. We need to follow that model, tax the hell out of junk food and soft drinks (sorta like we do with cigarettes) so people have less incentive to go there, and yank the subsidies to farmers of favored industries like corn and apply it to more useful and healthy crops.

Course, it'll be a cold day in hell before all the special interest groups allow that to happen. I cynically believe any national health plan is gonna fail miserably cuz needed steps aren't gonna be taken.

[cindys]

I work for a telecommunications company..Been with them 28yrs...

We are union and have never paid a health insurance premium for myself or my family...We do have a $20 co-pay and thats all..

But, we just negotiated a new contract and we are now going to have to pay $75 per month premium for a family($35 for single person) with no deductibles...We have known the day was coming when we were going to have to pay a premium.

Cindy
Mama to 3 boys...18, 3 & 10mos:love-retry::love-retry::love-retry:

[GaPeach_in_Ca]

I switched to a new health plan this year and the cost to me as the employer is $0 for myself and as many family members as I have.

The catch is that it's a HDHP and there's a very large deductible. Well-baby and annual checkups are covered, however. I contribute to a HSA that rolls over and the amount I contribute is less than or about what I was paying in premiums, yet enough to cover the deductible. Next year, I will likely contribute less as I will hopefully only use a small amount of that money this year.

My company is interesting in that they self insure. Every dollar that an employee spends on health care comes out of the bottom line. They do contract with insurance companies for the administation. The company itself is paying for my doctor's visits (well, in my case, once I hit the deductible :)).

[BabyMine]

We are insured through DH's job. He pays $106 per month. It is a PPO plan and has a $250 deductable/ family max of $600. Out of pocket max is $1250 with a family max of $2400. Copays are $15.

The plans are

employee
employee + one
employee and family
domestic partner

[jent]

From this standpoint, it is "unfair" to a single person because the company does NOT put that extra money into the single's paycheck that they are paying for another's family premiums. But other companies choose to support families, instead. (or find that they can attract better employees by paying for family health insurance) so are willing to pay more to pay partial (or all) of the family premiums.

Exactly. My current employer, which pays a percentage of our insurance premium, has always been very transparent about what their costs are each year for the premiums. They have really skyrocketed over the past few years, and the difference between a single vs family premium has become more dramatic.

Think about it from the employer's point of view. They need to hire a new person; the new hire will cost them salary+benefits. It would be completely their decision whether they would like to offer full benefits whether the employee has a family or not (thus attracting a larger pool of candidates) or decide that they can only spend a certain amount on their new employee and the extra benefit would be paid by their employee. In the current job market, where the pool of candidates is large, and the cost of premiums is increasing with no ceiling in sight, I can understand offering limited benefits. Especially for smaller companies, who have less bargaining power with insurance companies, so their premiums are higher.

When you are job searching, it is up to you to evaluate benefits package being offered as well as the salary before you accept the offer.

I agree that it is just completely crazy that our insurance system is tied to our employers. Should our bosses also be worrying about our health habits?

[stefani]

http://www.windsorpeak.com/vbulletin/showthread.php?t=328474

I was declined because my urine had blood (hematuria). My doctor wrote a letter that I had my period then, I did not complain of any urinary issues, no culture was taken, and no referral to a urologist was made. Therefore it should not be a cause of concern/ denial. No go.

At that time, it would cost almost $800 to cover me and our son on my husband's insurance. Thankfully, they recently changed it, and now it would cost $300 to cover me and our son. We decided that our son will stay with his private insurance, which costs $93/month, but I will be on DH's insurance for $150/month. I applied to 4 different insurance companies for me, and 2 for DS. It took a lot of time, and it was frustrating.

I don't know what the answer is to the whole health insurance issue, but unless you are very very healthy, health insurance is not easy to get, and /or can be very expensive.

[blisstwins]

If you want to teach children and have a family of your own, you better have a spouse that also works full time to make sure your children have benefits? Yeah, that supports families for sure.


Right. This is what bothers me and makes me feel like less than a respected professional or valued community member.


When you are job searching, it is up to you to evaluate benefits package being offered as well as the salary before you accept the offer.


Yep. Live and learn. I was told that I would get full benefits and I had worked for this company a decade ago. I should not have taken for granted what the exact medical benefits would be. I had said that my husband is self-employed so benefits were important. I honestly thought it was going to be $600 a month or so--not $1200. But it was absolutely my fault for not inquiring and I will never make a mistake like that again.

I find all these costs staggering, though I am jealous of a few of you. We really spend a fortune on health care. Last year we paid something like $1400 a month with a 3K deductable that we had to pay because of a hopitalization. It was brutal.

[tiapam]

The cynic in me thinks any money an employer "saves" by not paying some/all for spouse and/or family is not being put into the average worker's salary. Somebody is benefiting from this system. And it is not the person at the bottom of the hierarchy.