Another interesting healthcare article...dropping spouse coverage

[scrooks]

http://articles.marketwatch.com/2013-02-23/finance/37230097_1_spouses-health-coverage-health-insurance


This is kind of scary for SAHMs. It sounds like right now they are only targeting spouses who can get coverage from their own employer but they mention the prospect of them also cutting out those who don't work in 2014 when the health exchanges start opening up. Right now I work part time and I don't have coverage of my own and rely on Dh. It makes me nervous!

[o_mom]

DH's company has had the spousal surcharge for quite a few years - I want to say 5-7yrs? They haven't moved to dropping spouse coverage yet, but we will see. His company generally has very good benefits, so I don't see them doing that as it is a good recruiting and retention tool.

If your spouse can get coverage through their employer for less than a certain amount, you have to pay extra if you choose to keep them on your plan. It hasn't applied to us because I do not have that option, but when I was working it would have (it started a few years after I quit working).

[scrooks]

At DHs old job they had a surcharge for a spouse that was able to get their own coverage through their own employer and I ultimately don't have any problem with that (I was eligible and took my own coverage at the time). But now I haven't worked enough in the past 3 years to qualify for my employer's plan and am considering being SAH for awhile... I worry what kind of coverage I would be able to get if DHs employer dropped me....

[sophiesmom03]

DHs company only offers employee coverage. He can add me and dc but we are all billed full cost as individuals - there is no family plan. So DC and I are on a high deductible, restrictive plan while he is on an awesome, 0 deductible comprehensive plan but he works too much to ever use it.

[JBaxter]

DH works for a fairly large corp. We pay for a family plan. I might be wrong but I don't believe South Carolina is setting up any of the exchanges.
http://www.thestate.com/2012/11/09/2512806/with-election-over-sc-healthcare.html

[scrooks]

I think the states have the option of starting their own or waiting for the federal government to set one up they can use. It just seems like things are going to be such a mess as this law unfolds. I really like parts of the law but am afraid of the ramifications of other parts of it!

[niccig]

DH is fully covered at no cost to us through his employer, but we pay a lot for DS and I, more than the family plan at his previous employe. It's a smaller company. DH thinks they'll still have to offer health insurance to families to get the employees, it's been standard for some time that benefits are good in his industry and if they drop it they'll lose staff, but only if other companies don't drop family insurance too. I wonder with the exchanges, they'll stop offering it as there's an alternative. If enough companies stop offering it, employees won't have a choice.

[brittone2]

DH's employer is otherwise awesome, but to add our family on would be 11K per year. We have been on our own high deductible (6K per family) plan as a result, and then they kick back half of what they would have paid to insure DH to us (180/month). They put 1200 per year into our HRA, which helps with the non covered deductible expenses. We fund an HSA for our family as well. Our insurance company has lowered our deductible the last two years since we haven't met our deductible in previous years, so this year they kick in at 100% once we hit 3K. It is working okay for us right now, but I've read the higher deductible plans will likely be phased out when the new changes kick in.

If we buy on the exchange, it looks like we'd be paying more per year (something like just under 10K). DH's employer is trying to figure out what they are going to do for insurance this year. I don't know if they are going to be participating in an exchange or not.

I kind of hate the whole in limbo thing. We've been socking away extra $$ in case there are major changes to our cost this year. We aren't sure if we'll continue to buy on our own, jump into DH's employer plan, what the price will be if DH's employer's small business gets in on an exchange, etc.

We were really bummed about the insurance situation when DH got his job offer there, but there are so many other great things about his employer that we deal with it right now. DH used to work for a very large company that had fantastic coverage. It wasn't much to add me on back in the day pre-kids. We still have friends there, and their expected contribution toward insurance to add their family on has jumped dramatically over the last 10 years (definitely began well before Obamacare stuff). When we ran the #s, it really doesn't end up much different than our OOP #s. He has the opportunity to return there, but when we run the #s it just isn't worth it, especially since DH really enjoys his current company and everything else about working there.

[ahisma]

I think the states have the option of starting their own or waiting for the federal government to set one up they can use.

This is correct. The states can set up an exchange (that meets some minimum requirements). If the state chooses not to, the feds will set one up for them. Basically, the states have the option of controlling their own exchange or deferring to the feds.

At the end of the day, however, there will be an exchange in every state.

I think we're going to see a lot of transitions. For profit insurance companies are starting to buy hospitals. There are lots of non profits out there working to create alternate solutions that will provide for comprehensive, affordable care. We all know that change has to happen, the current system isn't working well at all. Hopefully we can get through this without too many growing pains.

[BayGirl2]

I have access to coverage through my job but we are all on DH's company plan because we prefer his provider options and its cheaper. So it sounds like this would apply to me. But splitting me off would mean I would be on a PPO plan while DH and kids stay on Kaiser NorCal. Which means I'd have to have a baby outside of the Kaiser system then switch them into the system after birth. annoying. Personally I'd probably pay for an individual Kaiser plan before going to my employer's PPO, I just like Kaiser that much more in my area.

I like the exchange concept in theory, although I admit I have net delved into the details yet. I don't believe HC should be tied to your employer or job. It's just not an appropriate model for our modern economy.

[scrooks]

Wow! It's interesting to see many people already have private insurance vs employer provided coverage. In theory I like the idea of the exchanges but I am nervous that the care options they will offer will be crappy and $$$. I am definitely spoiled by DHs coverage. I guess it will be interesting to see how it all plays out over the next few years.... Interesting but a bit scary!

[KrisM]

DH's employer is otherwise awesome, but to add our family on would be 11K per year. We have been on our own high deductible (6K per family) plan as a result, and then they kick back half of what they would have paid to insure DH to us (180/month). They put 1200 per year into our HRA, which helps with the non covered deductible expenses. We fund an HSA for our family as well. Our insurance company has lowered our deductible the last two years since we haven't met our deductible in previous years, so this year they kick in at 100% once we hit 3K. It is working okay for us right now, but I've read the higher deductible plans will likely be phased out when the new changes kick in.

.

How does the HSA with the HRA work? I thought you couldn't do the HSA if you had an HRA.

This site: http://www.irs.gov/publications/p969/ar02.html#d0e264

This quote: Other employee health plans. An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses generally cannot make contributions to an HSA. Health FSAs and HRAs are discussed later.

DH has great insurance. We don't have a monthly payment and it covers the 5 of us. We get $1000 in an HRA and we have a $3500 family deductible. The past 2 years, we have carried over leftover HRA money, so we're slowly building that up.

[brittone2]

How does the HSA with the HRA work? I thought you couldn't do the HSA if you had an HRA.

This site: http://www.irs.gov/publications/p969/ar02.html#d0e264

This quote: Other employee health plans. An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses generally cannot make contributions to an HSA. Health FSAs and HRAs are discussed later.

DH has great insurance. We don't have a monthly payment and it covers the 5 of us. We get $1000 in an HRA and we have a $3500 family deductible. The past 2 years, we have carried over leftover HRA money, so we're slowly building that up.
We buy our higher deductible plan on our own. DH's employer's coverage is not a high deductible plan. HDHP and HSA we have on our own. Our deductible on our health plan is less than the HRA contribution from DH's employer. eta: HRA is set up as a limited purpose HRA.

[essnce629]

DBF and I aren't married so I'm not able to get coverage from his work health insurance. I now have my own private health insurance plan. DBF said that even if we were married it would still be cheaper to to just pay for my own private plan than to add me to his work insurance. I'm just glad that private insurance covers maternity care now, since that was one of my big issues with it before (no private plans covered maternity in the past, but they all do now). So I'm ok with my private plan now-- I have a plan through Cigna and DBF's work insurance is through Cigna as well.

[KrisM]

We buy our higher deductible plan on our own. DH's employer's coverage is not a high deductible plan. HDHP and HSA we have on our own. Our deductible on our health plan is less than the HRA contribution from DH's employer. eta: HRA is set up as a limited purpose HRA.

Darn. I was hoping it was something we could do :). thanks for the clarification!

[brittone2]

Darn. I was hoping it was something we could do :). thanks for the clarification!
Well, if it is any consolation, I'm envious of your family's plan, believe me. It is the one thing that we really dislike about Dh's job. We're a little stressed about what they'll be offering this year, whether they'll benefit from the small business exchanges, etc.