PPACA "Obamacare" enrolees

[LTC8K6]

I have seen all sorts of reports of how many enrolees there are and the breakdowns of who enrolled in what, etc.

These reports seem to center on healthcare.gov and who has been there and enrolled, or created an account, or whatever.

I have a question that I haven't seen answered or discussed.

I don't qualify for a subsidy.

When I enrolled at the BCBSNC site on Nov 16th for an Obamacare compliant plan, I was asked if I wanted to try for a subsidy. If I clicked yes, I would be directed to healthcare.gov for that part of the enrollment.

I knew I did not qualify, so I declined, and therefore stayed at the BCBSNC site for the whole, very short and quick enrollment process.

I never went anywhere near healthcare.gov for my enrollment and payment.
Never gave any personal info to the gov't as far as I know, and gave very little personal info to BCBSNC, to boot.

I can download a tax form from the BCBSNC site that says I have purchased a compliant plan, to file with my taxes. I have confirmation of my plan and coverage for 2014.

My question is:

Who is counting enrolees such as myself, who did not need to use the gov't site at all?

Is the insurance company reporting these enrolees? If so, I have never seen a breakout of enrolees who did not get subsidies, or those who did not even use the gov't site.

Just wondering, because I haven't seen it mentioned.

News reports read as if everyone needs to register via healthcare.gov, but apparently a whole bunch of people don't even need the site at all.

 

[theeedude]

That is a good question. I would hope there is data about health care plans outside of the healthcare.gov marketplace.
I think you should still have gotten quotes through the healthcare.gov marketplace to compare with what BCBS was offering you. It may have been a better deal even without the subsidy.

 

[LTC8K6]

That is a good question. I would hope there is data about health care plans outside of the healthcare.gov marketplace.
I think you should still have gotten quotes through the healthcare.gov marketplace to compare with what BCBS was offering you. It may have been a better deal even without the subsidy.

This is a small business. The owners are discontinuing the employer sponsored coverage, and helping us all enroll via a rep. The company is going to reimburse us for the premiums and the deductible.

BCBS can only offer Obamacare compliant plans.

You don't need the heathcare.gov marketplace unless you have a subsidy as far as I know. It wouldn't make any sense to go there. You will only get directed to an insurance company site, if you don't qualify for a subsidy, I think.

The plans I was offered were exactly the same as the plans offered to the rest of the employees, all of whom qualified for subsidies and went through the government site.

We all chose from the same group of plans. I am the only employee who did not qualify for a subsidy. Some have the same plan that I have.

 

[theeedude]

This is a small business. The owners are discontinuing the employer sponsored coverage, and helping us all enroll via a rep. The company is going to reimburse us for the premiums and the deductible.

BCBS can only offer Obamacare compliant plans.

You don't need the heathcare.gov marketplace unless you have a subsidy as far as I know. It wouldn't make any sense to go there.

The plans I was offered were exactly the same as the plans offered to the rest of the employees, all of whom qualified for subsidies and went through the government site.

We all chose from the same group of plans. I am the only employee who did not qualify for a subsidy. Some have the same plan that I have.

So BCBS offering same rates outside of Healthcare.gov as those on the exchange? It's good if they are. Some companies are not, trying to take advantage of customers who follow the path of least resistance and don't shop around.

 

[LTC8K6]

There are only 2 insurance companies available in NC for an Obamacare plan anyway, and BCBS is the dominant one. BCBS is the only company covering the whole state. Coventry only covers a few of the big cities.

The vast majority of NC residents getting a quote are going to get a BCBS quote.

NC's exchange is federally run only. So we are all using the same exchange.

 

[theeedude]

You guys should get your own state exchange. In CA, it's at least BlueShield and Anthem everywhere, Kaiser in most areas, and local HMOs depending on where you live.

 

[werepossum]

I have seen all sorts of reports of how many enrolees there are and the breakdowns of who enrolled in what, etc.

These reports seem to center on healthcare.gov and who has been there and enrolled, or created an account, or whatever.

I have a question that I haven't seen answered or discussed.

I don't qualify for a subsidy.

When I enrolled at the BCBSNC site on Nov 16th for an Obamacare compliant plan, I was asked if I wanted to try for a subsidy. If I clicked yes, I would be directed to healthcare.gov for that part of the enrollment.

I knew I did not qualify, so I declined, and therefore stayed at the BCBSNC site for the whole, very short and quick enrollment process.

I never went anywhere near healthcare.gov for my enrollment and payment.
Never gave any personal info to the gov't as far as I know, and gave very little personal info to BCBSNC, to boot.

I can download a tax form from the BCBSNC site that says I have purchased a compliant plan, to file with my taxes. I have confirmation of my plan and coverage for 2014.

My question is:

Who is counting enrolees such as myself, who did not need to use the gov't site at all?

Is the insurance company reporting these enrolees? If so, I have never seen a breakout of enrolees who did not get subsidies, or those who did not even use the gov't site.

Just wondering, because I haven't seen it mentioned.

News reports read as if everyone needs to register via healthcare.gov, but apparently a whole bunch of people don't even need the site at all.

I don't know the answer to your question, but I suspect that these people are not being counted. Hard to tell any difference since ALL new health insurance plans must be compliant. At any rate, you'd be a net neutral, having lost your health insurance because of Obamacare.

Also, if memory serves anyone purchasing through the exchanges is seriously limited as to employer contribution. That was part of the big kerfuffle of Congress and its staffers getting a special interpretation allowing them to purchase insurance through the exchange yet still be heavily subsidized by their employer.

 

[LTC8K6]

I don't know the answer to your question, but I suspect that these people are not being counted. Hard to tell any difference since ALL new health insurance plans must be compliant. At any rate, you'd be a net neutral, having lost your health insurance because of Obamacare.

Also, if memory serves anyone purchasing through the exchanges is seriously limited as to employer contribution. That was part of the big kerfuffle of Congress and its staffers getting a special interpretation allowing them to purchase insurance through the exchange yet still be heavily subsidized by their employer.

We have essentially exactly the same arrangement as before, except we will get a bill from BCBS every month that we have to pay. Our employer is depositing 95% of our premiums into our bank accounts every month, so we can pay BCBS.

The only difference is that our employer is not managing the plan anymore and has no connection with our insurance other than "preimbursing" us for the premiums we have to pay.

We still have the same insurance rep to complain to as well, if we have problems.

It's pretty much just been a money shuffle for us as a small company. The only thing that has changed is the way the bills are paid. Instead of paying BCBS directly, our employer pays us and we pay BCBS.

Big deal...

 

[werepossum]

We have essentially exactly the same arrangement as before, except we will get a bill from BCBS every month that we have to pay. Our employer is depositing 95% of our premiums into our bank accounts every month, so we can pay BCBS.

The only difference is that our employer is not managing the plan anymore and has no connection with our insurance other than "preimbursing" us for the premiums we have to pay.

We still have the same insurance rep to complain to as well, if we have problems.

It's pretty much just been a money shuffle for us as a small company. The only thing that has changed is the way the bills are paid. Instead of paying BCBS directly, our employer pays us and we pay BCBS.

Big deal...

I actually think that's a superior system overall, but so many people are simply too irresponsible to handle their own health insurance. I do wonder how your fellow employees managed government subsidies as well as substantial employer subsidies as I thought it was either/or. But there's been so much FUD on both sides that I'm not terribly surprised. In any case, that's how it should work, especially given that Congress has granted itself and its staffers special exemptions. Any exemptions need to be available to everyone, and Obamacare should not prevent an employer from subsidizing a major portion of an employee's health insurance if they freely come to that agreement.

 

[theeedude]

We have essentially exactly the same arrangement as before, except we will get a bill from BCBS every month that we have to pay. Our employer is depositing 95% of our premiums into our bank accounts every month, so we can pay BCBS.

The only difference is that our employer is not managing the plan anymore and has no connection with our insurance other than "preimbursing" us for the premiums we have to pay.

We still have the same insurance rep to complain to as well, if we have problems.

It's pretty much just been a money shuffle for us as a small company. The only thing that has changed is the way the bills are paid. Instead of paying BCBS directly, our employer pays us and we pay BCBS.

Big deal...

Under the Republican definition, you have "lost" your health coverage. My sympathies.

 

[LTC8K6]

Under the Republican definition, you have "lost" your health coverage. My sympathies.

Well, I have. I liked the other plan. It had lower costs and better coverage. I can live with the new plan, though. Overall, to me, it's not a big deal. I can afford it.

The new plan has no vision coverage. BCBSNC says that it was too chaotic during the planning to factor in vision care, but they will add it next year.

I have not received any insurance cards, despite enrolling and paying in mid November, and I still cannot access a plan booklet or find out if my doctor is in my network. I am going to my old doctor regardless, though. I did manage to print out a temporary card online.

I do wonder what will happen when the lower ranks have to pay their deductibles or max out of pocket costs. They will still be liable for at least half of the deductible. Half of the current deductible is more than the old total deductible. I know for certain that a few of them live paycheck to paycheck.

 

[theeedude]

Well, I have. I liked the other plan. It had lower costs and better coverage. I can live with the new plan, though. Overall, to me, it's not a big deal. I can afford it.

The new plan has no vision coverage. BCBSNC says that it was too chaotic during the planning to factor in vision care, but they will add it next year.

I have not received any insurance cards, despite enrolling and paying in mid November, and I still cannot access a plan booklet or find out if my doctor is in my network. I am going to my old doctor regardless, though. I did manage to print out a temporary card online.

I do wonder what will happen when the lower ranks have to pay their deductibles or max out of pocket costs. They will still be liable for at least half of the deductible. Half of the current deductible is more than the old total deductible. I know for certain that a few of them live paycheck to paycheck.

Employer is saving money by having them get subsidized coverage on the exchange. It could contribute those savings to employee health savings accounts and more than make them whole for the deductible. My employer contributes to HSA for those on high deductible plans. Between that contribution, tax savings, and lower premium, it's a net win to go with a high deductible plan + HSA.

 

[werepossum]

Employer is saving money by having them get subsidized coverage on the exchange. It could contribute those savings to employee health savings accounts and more than make them whole for the deductible. My employer contributes to HSA for those on high deductible plans. Between that contribution, tax savings, and lower premium, it's a net win to go with a high deductible plan + HSA.

Odd, Obamacare raised my HSA deductible by $1000 because it was too good for the likes of me (though of course much worse than the health insurance I help fund for Obama and Congress) and now it's been canceled due to Obamacare requirements.

 

[theeedude]

Odd, Obamacare raised my HSA deductible by $1000 because it was too good for the likes of me (though of course much worse than the health insurance I help fund for Obama and Congress) and now it's been canceled due to Obamacare requirements.

HSA deductible?

 

[Fern]

There are only 2 insurance companies available in NC for an Obamacare plan anyway, and BCBS is the dominant one. BCBS is the only company covering the whole state. Coventry only covers a few of the big cities.

The vast majority of NC residents getting a quote are going to get a BCBS quote.

NC's exchange is federally run only. So we are all using the same exchange.

Coventry is owned by BCBS.

Fern

 

[werepossum]

HSA deductible?

Yup, my out-of-pocket before insurance pays anything.

 

[theeedude]

Yup, my out-of-pocket before insurance pays anything.

So they raised your deductible on existing plan or they cancelled the existing plan and the new one has a higher deductible?

 

[werepossum]

So they raised your deductible on existing plan or they cancelled the existing plan and the new one has a higher deductible?

At our early renewal BCBS increased our deductible by $1,000 to make it compatible with Obamacare requirements, as $3,700 is now the lowest deductible allowed in an HSA. That change bought us one year. However, BCBS is not extending these policies a second year because of the cost and complexity of running two sets of small business health insurance plans with mutually conflicting legal requirements. So every small business in Tennessee with BCBS health insurance (which is most of them) just lost its health insurance, effective whenever their policy runs out. We have until the end of June to either find another small business policy with the new mandated provisions or kick everyone out into the federal exchange and pay the extra tax penalty. (Actually we may be too small to pay a tax penalty.)

Every plan I looked at on the exchange without more than doubling my cost has a much higher deductible, so I'm assuming that I'll have to pay a much higher premium AND have a much higher deductible. But it's really too soon to know yet, could be a much smaller hit depending on how the demographic weighting changes offset the additional mandates and freebies. Freakin' regulations are being changed daily so it doesn't make much sense to look for deals six months out. And if I get kicked into the exchanges I've already decided that I'm one with this new fundamental transformation of America. I qualify for a subsidy, and I'm gonna latch on to Uncle Sugar's biggest teat with a death grip that would make a welfare mother blush.

On the plus side, one of our guys just retired at 62. He's morbidly obese and probably won't live to retire at 70, but without Obamacare subsidizing his insurance he could not have afforded to retire until 65. And as a cancer survivor, if something happened and I had to buy my own health insurance I'd likely pay less. The Messiah giveth and the Messiah taketh away, blessed be the name of the Messiah.

 

[IGBT]

http://www.cnsnews.com/news/article...h-spiral-economist-warns#sthash.gI6TyRZI.dpuf


“Remember, everybody is facing the wrong price. And sick people are facing a price that’s well below the cost of their care. Young healthy people are being overcharged. And so they need lots of young healthy people to join so they can get the money to pay the bills for the sick people. And the younger people just aren’t buying it.

 

[werepossum]

http://www.cnsnews.com/news/article...h-spiral-economist-warns#sthash.gI6TyRZI.dpuf


“Remember, everybody is facing the wrong price. And sick people are facing a price that’s well below the cost of their care. Young healthy people are being overcharged. And so they need lots of young healthy people to join so they can get the money to pay the bills for the sick people. And the younger people just aren’t buying it.

I think he's wrong, for a few reasons. First, bailouts to insurers to cover losses are already part of Obamacare. Maybe they will be larger than expected, but that just means less time before our regular spats over raising the debt ceiling and bigger loans from Uncle Mao/more Fed created money which can be loaned to Uncle Sam. Neither will stop Dems from proclaiming Obamacare's incredible success.

Second, young healthy people who do not qualify for a subsidy would be foolish to purchase through the exchange, if only for the lack of modern security. I do not think these people are being counted now. However, their premiums will still reduce the level of government bailout required. We won't really understand Obamacare's success or failure until we have a handle on total percentage of uninsured versus cost including bailouts.

Third, the cost of health insurance must always be less than the cost of treatment for sick people and more than the cost of treatment for healthy people. Otherwise health insurance would be impractical for us on the first point and impractical for insurance companies on the second point.

And as this economist points out, the individual market has largely been destroyed and the small group market is not far behind. When/if Obamacare fails, the only practical alternative for most of us will be to turn over all health care to the same people unable to run a damned health insurance web site, as the cost of health insurance will have been driven far higher than most individuals and small businesses can afford. This is not accidental.

 

[theeedude]

http://www.cnsnews.com/news/article...h-spiral-economist-warns#sthash.gI6TyRZI.dpuf


“Remember, everybody is facing the wrong price. And sick people are facing a price that’s well below the cost of their care. Young healthy people are being overcharged. And so they need lots of young healthy people to join so they can get the money to pay the bills for the sick people. And the younger people just aren’t buying it.

NCPA is a Koch funded think tank.

 

[IGBT]

NCPA is a Koch funded think tank.

..and if it was a George Soros collusion you'd be happy about that.