Hillary: People who refuse to buy health insurance may have wages garnished

[Trumplestiltskin 5,791]

Wow that's a heinous amount of money....

Through work I only pay about $220 a month for both me and the wife. That includes medical, dental and vision...

Of course we don't have / haven't had any health problems. If we do - no doubt that will go up...

Your premiums shouldn't. You pay a group rate, your rates will change when the group rate changes.

That's cool - we can still be "pre-existing conditioned" of course.

Not if you're currently healthy with no pre-existing conditions

I dunno - the Michael Moore movie had some interesting stuff on how Pre-existing conditions are determined. It can range from something as simple as disclosing that you have heartburn or back ache on an application form or health assessment.

[w¡n9Nµ7 §£@¥€r 123]

Wow that's a heinous amount of money....

Through work I only pay about $220 a month for both me and the wife. That includes medical, dental and vision...

Of course we don't have / haven't had any health problems. If we do - no doubt that will go up...

Your premiums shouldn't. You pay a group rate, your rates will change when the group rate changes.

That's cool - we can still be "pre-existing conditioned" of course.

Not if you're currently healthy with no pre-existing conditions

I dunno - the Michael Moore movie had some interesting stuff on how Pre-existing conditions are determined. It can range from something as simple as disclosing that you have heartburn or back ache on an application form or health assessment.

I hate to say this, but I've seen that a lot of it depends on the kind of relationship that exists between your insurance provider and your employer. Insurance providers have a lot of leeway in managing relationships with certain clients. If your employer cares about you guys, they'll nurture that relationship and, in turn, go to bat for you when your provider attempts to screw you. I've worked at a major dental insurance provider in the past and have seen this first hand. Certain 'accounts' get preferential treatment over others, and it's typically a function of two things - size and the quality of the account relationship management people on that account.

[w¡n9Nµ7 §£@¥€r 123]

ETA: On the subject of pre-existing conditions, many employers have negotiated contracts with the providers stating that no benefits will ever be withheld based on pre-existing conditions. My current employer is one of them, as was the one before.

[Trumplestiltskin 5,791]

Its a crooked business.

[w¡n9Nµ7 §£@¥€r 123]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

[Fandango 1,439]

Wow that's a heinous amount of money....

Through work I only pay about $220 a month for both me and the wife. That includes medical, dental and vision...

Of course we don't have / haven't had any health problems. If we do - no doubt that will go up...

Your premiums shouldn't. You pay a group rate, your rates will change when the group rate changes.

That's cool - we can still be "pre-existing conditioned" of course.

Not if you're currently healthy with no pre-existing conditions

I dunno - the Michael Moore movie had some interesting stuff on how Pre-existing conditions are determined. It can range from something as simple as disclosing that you have heartburn or back ache on an application form or health assessment.

MM makes his living bending the truth to induce hysteria, imo.

If you've already been covered for a year, you've not been to the docs, there is no pre-existing condition. Especially on a group plan...private insurance requires either a medical or medical questionnaire where you might have some cause to worry if something wasn't disclosed...but that's pvt ins and not a group plan where you're covered regardless of health.

You can check your member benefits policy to see how they address PEC.

[Trumplestiltskin 5,791]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

[w¡n9Nµ7 §£@¥€r 123]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

If by 'prospective customer', you mean the employee covered under an employers group plan, no. You can't find out. You find out the hard way.

If by 'prospective customer', you mean the sponsoring employee (in the insurance business, that is who we consider the customer, not you), then yes. There are hours and hours of contract negotiation to iron all those details out. Unless you're a small company and buy one of their 'packages' in which case you're likely going to get screwed. The best people tend to work on the large accounts.

[GaryC 7]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

I was given a book about 3/4 of an inch thick that explained everything in great detail. My insurance excludes pre-existing conditions for 1 year. After that it's all covered.

[Ban Hammer 13,360]

[Trumplestiltskin 5,791]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

I was given a book about 3/4 of an inch thick that explained everything in great detail. My insurance excludes pre-existing conditions for 1 year. After that it's all covered.

Of course a lot can happen in the course of that year.

[GaryC 7]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

I was given a book about 3/4 of an inch thick that explained everything in great detail. My insurance excludes pre-existing conditions for 1 year. After that it's all covered.

Of course a lot can happen in the course of that year.

Thats where my medical savings account comes into play.

[one...two...tree 2,762]

Barack Obama's Plan

Quality, Affordable and Portable Coverage for All

• Obama's Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress. The Obama plan will have the following features:
  1. Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.
  2. Comprehensive benefits. The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have. The plan will cover all essential medical services, including preventive, maternity and mental health care.
  3. Affordable premiums, co-pays and deductibles.
  4. Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
  5. Simplified paperwork and reined in health costs.
  6. Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.
  7. Portability and choice. Participants in the new public plan and the National Health Insurance Exchange (see below) will be able to move from job to job without changing or jeopardizing their health care coverage.
  8. Quality and efficiency. Participating insurance companies in the new public program will be required to report data to ensure that standards for quality, health information technology and administration are being met.

National Health Insurance Exchange: The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public.Employer Contribution: Employers that do not offer or make a meaningful contribution to the cost of quality health coverage for their employees will be required to contribute a percentage of payroll toward the costs of the national plan. Small employers that meet certain revenue thresholds will be exempt.Mandatory Coverage of Children: Obama will require that all children have health care coverage. Obama will expand the number of options for young adults to get coverage, including allowing young people up to age 25 to continue coverage through their parents' plans.Expansion Of Medicaid and SCHIP: Obama will expand eligibility for the Medicaid and SCHIP programs and ensure that these programs continue to serve their critical safety net function.Flexibility for State Plans: Due to federal inaction, some states have taken the lead in health care reform. The Obama plan builds on these efforts and does not replace what states are doing. States can continue to experiment, provided they meet the minimum standards of the national plan. <a name="lower-costs">

Lower Costs by Modernizing The U.S. Health Care System

• Reducing Costs of Catastrophic Illnesses for Employers and Their Employees: Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums.
• Helping Patients:
  1. Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease and high blood pressure. Obama will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs. This will improve quality of care, give doctors better information and lower costs.
  2. Coordinate and integrate care. Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. Obama will support implementation of programs and encourage team care that will improve coordination and integration of care of those with chronic conditions.
  3. Require full transparency about quality and costs. Obama will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care. Health plans will also be required to disclose the percentage of premiums that go to patient care as opposed to administrative costs.

http://www.barackobama.com/issues/healthcare/#coverage-for-all

[Trumplestiltskin 5,791]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

I was given a book about 3/4 of an inch thick that explained everything in great detail. My insurance excludes pre-existing conditions for 1 year. After that it's all covered.

Of course a lot can happen in the course of that year.

Thats where my medical savings account comes into play.

True - but from what I've seen a lot of those accounts are pretty bad value. First, can a person save enough money in the short term to cover anything major during the 'qualifying period', and second, with a lot of those you actually lose the money if you don't use it within a given time period.

[w¡n9Nµ7 §£@¥€r 123]

Its a crooked business.

No, not crooked. Just terribly inconsistent across accounts and very very political.

But is there any realistic way that a prospective customer can find out about this before they sign up to an employer sponsored health program?

Or do you only find out the hard way when things start getting denied?

I was given a book about 3/4 of an inch thick that explained everything in great detail. My insurance excludes pre-existing conditions for 1 year. After that it's all covered.

Of course a lot can happen in the course of that year.

Thats where my medical savings account comes into play.

True - but from what I've seen a lot of those accounts are pretty bad value. First, can a person save enough money in the short term to cover anything major during the 'qualifying period', and second, with a lot of those you actually lose the money if you don't use it within a given time period.

Actually, there are two types of accounts. One type comes as a supplement to a traditional insurance plan (hmp, ppo or pos) and that does have 'use it or lose it' funds. The other type of savings account is a (usually mandatory) supplement to a high-deductible plan. This account is not a use it or lose it plan, it serves as a savings account for medical needs. In addition, at retirement age (65) you can withdraw any monies accumulated as you would from a 401k, even for non-medical reasons.