Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search

Kber

(5,043 posts)
Fri Sep 27, 2013, 03:31 PM Sep 2013

Thinking of opting out of my company's health insurance plan

Some background:

My plan isn't actually all that bad. No deductible if you stay in network and $2000 if you go out. All preventative care and doctors visits covered 100% in network, and 80% out and the deductible doesn't apply. (Only need to worry about it for hospital stays and out-patient surgery.) My company picks up 65% of the premium, so it's heavily subsidized. We elect family coverage that covers my husband, me and the kids.

My husband owns his own small company (5 employees including himself). He offers health insurance, but it's expensive and less comprehensive, since his small company's buying power is so much less than where I work.

That said, it's looking like the prices he can get through the exchanges as a small employer are pretty equivalent to what my company can negotiate. He is going to be able to offer a second plan to his tiny workforce that is similar to what I get and he'll be able to offer lower premiums all around. (The average annual salary he offers is too high to qualify for tax credits, so this price reduction is completely based on the buying power he gets through the exchanges.)

So here's the debate at home around the dinner table...

If we can get comparable insurance coverage, we'd pay more for it ourselves because we lose my company's subsidy. However, we'd pick up a lot more flexibility and at least our health coverage is in our hands. I won't have to worry that losing my job means losing my insurance. I really like the idea of taking insurance out of the employment equation all together for a few reasons. It takes one tool of control away from the company, which gives me more freedom to act. On a less ideological front, it means that I have more control over my plan, my network and my doctors than I did previously. I don't have to worry about switching my gynecologist because my company decided to switch from Aetna to Oxford or some such.

And the fact that we are even having this discussion leads me to hope that more people will get a taste of freedom and want to decouple insurance and employment once and for all. it makes the idea of single payer a lot less scary.

I think we will probably keep my insurance because it is cheaper, but it's nice knowing there is a very viable alternative. If I lose my job it's considered a "life event" and we can switch onto our own plan. And I suspect if that happens we may not switch back.

6 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
Thinking of opting out of my company's health insurance plan (Original Post) Kber Sep 2013 OP
This is an interesting new perspective. Wait Wut Sep 2013 #1
The options he will offer employees will be less expensive than what he currently has Kber Sep 2013 #3
My brother is in a similar situation to yours Kber Sep 2013 #4
I'm so glad to hear your brother will be able to get the care he needs. Wait Wut Sep 2013 #6
make sure obama/dems don't cave on ACA before you do anything drastic nt msongs Sep 2013 #2
I will! Kber Sep 2013 #5

Wait Wut

(8,492 posts)
1. This is an interesting new perspective.
Fri Sep 27, 2013, 03:40 PM
Sep 2013

I've been uninsured with several preexistings for 12 years. My story is all over the place, with different names.

Yours show the potential appeal to the 'other side' of the coin. You explain the 'what ifs' and how the ACA will protect you from the unforeseen.

I agree with what looks like the option you've chosen. If you have decent coverage and it doesn't appear to be changing, stick with it. You can always change your mind later.

Will there be more affordable options for your husband's company with ACA?

Kber

(5,043 posts)
3. The options he will offer employees will be less expensive than what he currently has
Fri Sep 27, 2013, 03:56 PM
Sep 2013

It looks like my larger employer's premiums will go up next , but probably by about the same percentage that they have every year for the past 4, so I really don't think that increase can be linked to "Obamacare".

My DH's premiums will actually go down. The real change is that, with only 5 employees and only 3 of them opting to take his insurance, he could only offer 1 plan, and it is very basic. He's still working through it and won't really nail it down for a few days, but it looks like he can offer much more choice and at the same or lower rates.

As a small employer, it puts him on equal footing with larger competitors who can negotiate better rates. He could compete on salary, because he is profitable and a dollar from him is worth the same as a dollar from anyone. However, being a tiny company meant he essentially paid a "small business tax" in the form of larger insurance premiums and that made it difficult for him to compete for top talent.

Another side effect of ACA is that self employed and small businesses can better compete with their big competitors for talent which I think is a good thing.

I think the ACA might actually shift the balance of power a little towards employees for the first time in a very long time.

Kber

(5,043 posts)
4. My brother is in a similar situation to yours
Fri Sep 27, 2013, 04:00 PM
Sep 2013

He's a bartender and a musician and neither profession really has a great health insurance plan.

He also has a few pre-existing conditions. The frustrating thing is that both of his issues are so much easier and cheaper to manage early, but, if they get out of hand, can be expensive and even life threatening.

He pays the bare minimum for health care because 100% of it comes out of pocket (or sometimes out of our mom's pocket when times are leaner than usual) but I am really hopeful that he can start to get his health issues under control next year with a real treatment program.

ACA my actually save my brother's life.

Wait Wut

(8,492 posts)
6. I'm so glad to hear your brother will be able to get the care he needs.
Fri Sep 27, 2013, 05:28 PM
Sep 2013

It's a little terrifying to have a preexisting that needs follow-up care and not get it. Those little things can definitely get out of hand. I'm on the 'scared to death' side of that discussion.

Good news about your husband's company, as well! I wish the small business owners in this town were as optimistic. They're whiny as hell here. Of course, not one of them has bothered to put in the effort to learn about the ACA. All that effort is reserved for tantrums.

Latest Discussions»General Discussion»Thinking of opting out of...