Thread: Affordable Care Act

Most PPO plans are considered "cadillac" plans b/c the total premium is super expensive.

Originally Posted by Jessica80

Most PPO plans are considered "cadillac" plans b/c the total premium is super expensive.

It's not just that, it's based on the plan structure. We have a self-insured plan, we pay all of our claims out of company assets, therefore we don't have a "total premium", but we would still be considered a cadillac plan because our employees essentially don't pay enough for their health care in the eyes of PPACA. Which is sad for a company that wants to provide it's employees and their families with a valuable and inexpensive health plan, but will no longer be able to.

I have to say, as a non-American I feel sick about what some of you guys are faced with paying for healthcare. That said, I just.don't.get why the US has such difficulty providing the healthcare afforded to people in other countries. Is it a sales/income tax thing? Is it the potential premium involved? IDK. I really, really have no idea why it's so hard to figure out. $1200/year deducted from my salary gets my whole family extended benefits like chiro, podiatry, massage, eye exams and glasses, orthodontics (a portion of), 100% prescription payment, orthotic supplies, private hospital rooms, physiotherapy, 100% basic dental plus 80% extended dental like root canals, crowns, etc., plus many other services I can't even recall right now. My basic healthcare premium is paid 100% by the province. There used to be a $132/quarter premium for a FAMILY that we had to pay but the province did away with that a few years ago. I just can't wrap my brain around upwards of $20K per year. That is effed up.

Last year we paid $15K out of pocket for healthcare through an employer sponsored plan-- so I think it probably will cost at least $12K/year for a family. We have a good plan, but our contribution is $974/month for the premium, then 10% in network for a $2500/family member max. We always max out my DH's bc of his chronic health condition coupled with my non-in network homebirth last year= ouch!

$12K seems reasonable to me though, simply bc it is worth it. One trip to the ER can cost so much, it is a better investment than going bankrupt over unforeseen medical bills (which the rest of us end up paying anyways.....)

IMO Americans suck at taking care of themselves and preventative healthcare. I'm hoping having some coverage helps bring those costs down...time will tell.

Originally Posted by SID081108

It's not just that, it's based on the plan structure. We have a self-insured plan, we pay all of our claims out of company assets, therefore we don't have a "total premium", but we would still be considered a cadillac plan because our employees essentially don't pay enough for their health care in the eyes of PPACA. Which is sad for a company that wants to provide it's employees and their families with a valuable and inexpensive health plan, but will no longer be able to.

I am very concerned that the plan we are on will be considered the same way because it is also a self-insured plan. I don't know enough about it to know what category it falls into. So much for "If you like your health plan you can keep it"

Originally Posted by boilermaker

$12K seems reasonable to me though, simply bc it is worth it. One trip to the ER can cost so much, it is a better investment than going bankrupt over unforeseen medical bills (which the rest of us end up paying anyways.....)

$12K is not reasonable to me. I feel you would be much better off putting $12K in the bank each year then paying your own medical expenses. Especially if that did not count co-pays and deductibles. How would anyone possibly making just over the poverty level pay that and meet the rest of their basic needs?

12000 into the bank every year? Do you know what one extended stay at a hospital costs without insurance? (think about saving for 10 years +)

Originally Posted by AlyssaEimers

$12K is not reasonable to me. I feel you would be much better off putting $12K in the bank each year then paying your own medical expenses. Especially if that did not count co-pays and deductibles. How would anyone possibly making just over the poverty level pay that and meet the rest of their basic needs?

Somebody just over the poverty line would have state or federal insurance (just like they do now....) This is for families that can AFFORD to pay the premium.

Maybe your healthcare costs are really different from ours, but $12K won't get us far if something happens. My son just had his tonsils and adenoids removed last month-- $12K would just start to cover the whole procedure. We'd be done for the whole year? Not likely.

Another example of people losing their healthcare plans because of Obamacare.

Shocker: Universal Orlando To Drop Part Time Health Coverage Because of ObamaCare | Independent Journal Review

And since they only work part time...they surely probably don't get a living wage as we have pointed out in the last debate...probably minimum wage...correct? They will be eligible for other means of coverage.