Feeling backed into a corner

This year was shaping up to be a pretty good one for us. We both got promotions at work, the boy is finally out of daycare and life has been fairly sweet as of late...until yesterday.

I get a call from H.R. seems it's open enrollment time and she has not received my paperwork. I explain I've not received any paperwork and she emails it to me, supposed to be in by today but she gives me till the end of the week so I can review it. Because of my promotion I am not eligible for the same plan I have been on. The plan I have now is a limited plan which is going away under the new laws. I was expecting it to be more expensive but was not ready for a 700% increase in premiums for the family plan.

That's correct, the family plan is going to cost me over half my income.

My wife's work offers health care but it's only slightly less expensive for her and the boy. Either one of these options are going to basically bankrupt us. All of our plans that we have been working on for the last few years are in jeopardy. She was speaking to her boss's husband who is a health insurance agent about getting private insurance. The way she described the situation to me is this. The new laws say that because both of our employers offer health care we are not able to purchase private health insurance and we are not eligible for the state run health exchange (or whatever they call it). So unless we choose one of the available options from our employer we have no other options. Well, I guess we could opt to not have insurance, in which case we will be "penalized" by the government at a rate of $98.50 per person per month or 1% of our income whichever is greater.

I'm seriously at a loss here. I have no idea what I should do.

I'm hoping I am getting some wrong information and there is another option for us.

Please try and keep this non political I would love some solid advice. I'm not trying to start one of those threads.

What can I do?

Holy crap. That's all I got at the moment.

Do you both need coverage? Like your personal coverage septuples, and hers does too, because spouses and children are not covered?

Not sure if that's clear. Can one of you drop your coverage, and be covered by the others policy, thereby making it a 350% increase? That would be muuuuch better.

Note to self: Don't bitch about this years Revenue Canada bill.

Both assume individual coverage with one of you taking on the kiddo?

It's either we are all on mine or, I have my own and her and my son are on hers, or we all are on hers. None of the options are affordable, and by affordable I'm not saying a little uncomfortable for us I'm saying we will be living under a bridge.

This can't be correct. Please tell me there's something someone overlooked. If this is 100% correct, how do I defect to Canada?

How can you not be allowed to purchase private insurance? That makes no sense.

Yes, this is scary.

What kind of premiums are you talking. Care to share any more details? Its hard to formulate an opinion without knowing what 700% increase is.

Beer Baron wrote: How can you not be allowed to purchase private insurance? That makes no sense.

^ this.

Go talk to another health insurance agent.

There was an article today on Yahoo Finance addressing this. Basically, many folks will soon be harmed as a result of their employers offering qualified health insurance as it takes options off the plate and they make too much to qualify for the exchanges. IIRC, the number is set at total household income of 98K (4X the official poverty level) where many are about to see astronomical increases.

Look, we’re about to add tones of people that contribute very little if any and we’re going to add a huge amount of cost in the form of governmental involvement. They can spin the numbers anyway they want but the bottom line is if you’re middle class, you’re about to carry a whole lot more weight than just your own.

Come on, “we” decided to do this…ignorance of fundamental, immutable, economic laws is no excuse. You can't say...but, but, but, we were promised...it is what it is.

Beer Baron wrote: How can you not be allowed to purchase private insurance? That makes no sense.

Me either, that's what I was told second hand from someone in the industry.

I just got an email from H.R. saying they will allow me to stay on the current plan until it goes away Dec. 31st so that buy's me some time to sort out fact from fiction.

http://www.medicoverage.com/health-insurance-blog/news/employees-cannot-purchase-individual-obamacare-plans

and this: http://kff.org/interactive/subsidy-calculator

I filled this out and chose "yes" if employer offer insurance and it said the same thing as the first article I posted. Oh yeah, better stop using tobacco.

In reply to nocones:

I was paying likely a lot less than most. However the coverage wasn't the best. The new coverage is much better and is not an astronomical amount based on what I've heard most other people pay. However we have been accustomed to this for many years. A slow gradual increase would have been a hell of a lot easier to take versus this situation.

I believe the relevant passage from Fletch1's first article is this:

"Individuals Who May Purchase on the Exchange Even if Their Employer Offers Insurance

If an employer based insurance plan exceeds 9.5% of your household income"

Note that this is only for buying it on the healthcare exchange; can't comment on buying an individual policy directly from one of the usual suspects.

You aren't by any chance a CostCo member?

Fletch1 wrote: http://www.medicoverage.com/health-insurance-blog/news/employees-cannot-purchase-individual-obamacare-plans

According to this article you should be ok, unless I am not understanding correctly:

"Individuals Who May Purchase on the Exchange Even if Their Employer Offers Insurance

If an employer based insurance plan exceeds 9.5% of your household income"

Wow. As a single dad who's pulling that whole load by himself, I need to check into this.

I'm so sorry to hear that you are in this situation. My previous employer started to implement the plans specified under the Affordable Care Act in 2010 to get ahead of the coming regulatory regime (read push the cost off on to us as soon as possible). We saw our premiums stay roughly the same, got forced into the new HSA accounts (of which the company did some contributions based on taking certain "courses", proving you made improvements, and doing biometric screenings) and the plans were changed to having $3000/yr individual/$6000/yr family total deductables on top of co-insurance.

We had a minor medical issues at the start of the year (typical sick visits, youngest needed some hearing tests/tubes, etc.). We ended up paying over $500 extra per month JUST on copays/co-insurance for 6-7 months.

According to the following infographic:

http://kff.org/infographic/the-requirement-to-buy-coverage-under-the-affordable-care-act/

For 2014 - The fee for non-compliance with purchasing a plan is $95 per adult, 47.50/child up to a max of $285 or 1% of income which ever is greater

For 2015 - It increases to $325/$162.50/$975 or 2.0% of income which ever is greater

For 2016 and beyond, it is $695/$347.50/$2085 or 2.5% of income.

You may eligible for an exemption from the mandate if the lowest cost plans provided to you exceed 8% of an individual's income

http://kaiserfamilyfoundation.files.wordpress.com/2011/04/8061-021.pdf

Just thought this might help.

I guess I'll just have to find out at my own enrollment, which I think is in November. I might take a tube of KY that day

Sending you a PM - I have a social worker who works for me. One of her priorities is to help people figure out their options to maintain their healthcare. She actually knows the language of the legislation and may be able to help you figure out your options.

Thanks oldtin.

Unless my numbers are wrong it looks like we'll be paying around 24% household income. I think the company is going to have to come up with something different before then because the penalty per employee for not offering coverage under 9.5% is $3000.

I know nothing about any of this, except....

I'm on our town board, and we were just discussing the annual healthcare plan for the village employees last night. Our insurance agent mentioned something about "open market" and subsidies to help pay for healthcare? He didn't go into details(and I didn't ask because, fortunately, we somehow only ended up with a 4% increase for the employees), but I believe he stated that a family of 4 could earn up to $90+k/year and still receive some subsidies???

Might be worth looking into?

I don't know how the hell you're gonna keep this one from getting political. The jump in rates is not a coincidence. Just be happy you get to keep your 40+ hrs a week...or, even better, you're on salary. Good luck.

Also: Obviously not a fan of Obamacare, but your "per person, PER MONTH" thing is way off. If a couple hundred bucks a year is going to "bankrupt" you, I'd definitely look into medicaid. You're obviously paying in. Get your money back.

700$ a month is what my wife and I are looking at, and that isn't even decent insurance. Hell the worst part is not understanding half of what you read when it comes to looking at plans.