21% paycut on Monday.

[nsx2tall]

BCBS unfortunately for the patients, feel "reasonable" is 30% of a typical out of network bill.

I appreciate both your courtesy to your associates and your willingness to discount out of network charges. If you are in the network because they are, I'd be interested in knowing why they are in the BCBS network as it doesn't seem as if they would be treated any different than you.

Personally, I haven't yet found a doctor in Illinois who is not in the BCBS network. That reason alone mitigates my employee's risk of having to eat excessive out of network charges. I'm sorry that they don't pay you what you feel you deserve, but given that 15% of my payroll is health insurance (8 years ago it was less than half that cost with 30% more employees on the plan), I gladly accept the help of an insurance company who can negotiate such disadvantageous rates and still have such a vast network. If I apply that same logic to the 12% I pay for FICA and Medicare, I don't really see the difference between the Government dictating rates and BCBS dictating rates. Someone on my behalf needs to apply downward price pressure since I'm too small to negotiate anything with providers on my own.

As for UHC, I had 5 employees go to collection because UnitedHealth took more than 120 days to pay their (UHC) portion of covered in-network expenses. You must have had different experiences than I had.

 

[SilverStone05]

I've never seen a plan for a family of three, I've seen yourself, you and spouse, or 'entire family' which could be 3 or 30. I have BCBS $1000 deductible per person with max of $2000 per family per year. $20 copay (specializes and PCP), and prescriptions are $10/$30/$50. My company is paying $980/month for medical, $150/month for dental. When I had to pay for myself, as I mentioned I joined a small business group to get the benefits of pooled pricing, and used Neighborhood Health (the same company MA welfare people get, only with a different name), and I ran into many doctors that wouldn't take it because they had difficulty getting paid. I'd have to go back and check but I believe I was paying around $1200/month. I had to have it as my wife was pregnant during that period, then once I had a kid have to carry insurance. If I was younger and it was just myself or myself and wife, I'd pay out of pocket, but MA now requires you to carry health, I have kids and we're now at the age where things are starting to fall apart. Fun!

Raise your deductibles. Pay more of the doctor costs out of pocket. Let insurance pay for the nasty stuff that MAY happen.

Think about it...let's say you each go to the doctor once a month. A Dr's visit costs about 100/per visit. That is still only 400/m....800 less than your premium. And you can usually negotiate a non insurance pay price beforehand. Let's say they knock it down 10% to 90 per person...that is still only $360/month.

Isn't that better than HAVING to piss away $1200/month?

Insurance is for a "what if" scenario. It's not a catch all that people want it as today. Think life/auto/property casualty insurance.

I'd rather pay very little as my "no choice scenario" and have to cover myself up to 5k IF.....IF the unthinkable happens.

With a low deductible plan, you are soaked whether or not you actually use the plan. If your actual health/dental costs are ~$14,000per year, every year, I'd be surprised. And if they exceed that, you really shouldn't be complaining because the insurance company is covering the excess and LOSING money on you.

We are overusing our insurance and that is why the costs keep rocketing up.

One BIG way to cut costs is to switch to high deductible plans, and start covering costs out of pocket and NEGOTIATING.

Only when people are shouldering the costs themselves will they start considering the costs when seeking medical care.

A bunch of Dr's fielding calls where clients are trying to negotiate rates will really put some competition into the mix.

 

[robr]

As for UHC, I had 5 employees go to collection because UnitedHealth took more than 120 days to pay their (UHC) portion of covered in-network expenses. You must have had different experiences than I had.

When I had UHC, I was told by more than one office that this was the very reason they no longer accepted UHC.

 

[docjohn]

I appreciate both your courtesy to your associates and your willingness to discount out of network charges. If you are in the network because they are, I'd be interested in knowing why they are in the BCBS network as it doesn't seem as if they would be treated any different than you.

Personally, I haven't yet found a doctor in Illinois who is not in the BCBS network. That reason alone mitigates my employee's risk of having to eat excessive out of network charges. I'm sorry that they don't pay you what you feel you deserve, but given that 15% of my payroll is health insurance (8 years ago it was less than half that cost with 30% more employees on the plan), I gladly accept the help of an insurance company who can negotiate such disadvantageous rates and still have such a vast network. If I apply that same logic to the 12% I pay for FICA and Medicare, I don't really see the difference between the Government dictating rates and BCBS dictating rates. Someone on my behalf needs to apply downward price pressure since I'm too small to negotiate anything with providers on my own.

As for UHC, I had 5 employees go to collection because UnitedHealth took more than 120 days to pay their (UHC) portion of covered in-network expenses. You must have had different experiences than I had.

The bigger crux of the matter however is what does the ins co. do with thier surplus net income.Imagine how wack it is that the ins co can dictate how much it pays the doctor and how much you the insured pays in premiums...In our area the blues have amassed a vast "war" chest of cash...Do they pass thier saving on to you

 

[robr]

Raise your deductibles. Pay more of the doctor costs out of pocket. Let insurance pay for the nasty stuff that MAY happen.

I agree, but as I'm no longer self employed, I have to take what my company offers. It's not like they pay me the money instead if I decline, and they subsidize the costs. Right now I'm not complaining, just discussing.

 

[SilverStone05]

I agree, but as I'm no longer self employed, I have to take what my company offers. It's not like they pay me the money instead if I decline, and they subsidize the costs. Right now I'm not complaining, just discussing.

But you don't.

Go shop a family plan on a health exchange. Call a provider. See a broker. Do something.

You CAN get a lower rate than what you are getting as a subsidized employee.

 

[robr]

But you don't.

Go shop a family plan on a health exchange. Call a provider. Do something.

You CAN get a lower rate than what you are getting as a subsidized employee.

How can you say that without knowing how much I'm being subsidized?

 

[SilverStone05]

My company is paying $980/month for medical, $150/month for dental.

Isn't this what you said?

And either way, i'm not trying to argue with you, i'm trying to help.

I've said it before, cute kids.

 

[nsx2tall]

The bigger crux of the matter however is what does the ins co. do with thier surplus net income.Imagine how wack it is that the ins co can dictate how much it pays the doctor and how much you the insured pays in premiums...In our area the blues have amassed a vast "war" chest of cash...Do they pass thier saving on to you

The BCBS war chest in Illinois was partly refunded back as premium discounts or it went towards building really nice buildings just like the war chests of many [formerly] non-profit hospital groups.

 

[robr]

Isn't this what you said?

And either way, i'm not trying to argue with you, i'm trying to help.

I've said it before, cute kids.

What I was trying to say was the costs I listed were how much my company is being charged by the insurance company in total. I only pay a percentage of that. I'm not actually sure what it is, it was just changed last month and I honestly haven't looked. And I certainly appreciate the help, I'm not trying to give you a hard time, I was just confused but now I understand I confused you first .

 

[docjohn]

The BCBS war chest in Illinois was partly refunded back as premium discounts or it went towards building really nice buildings just like the war chests of many [formerly] non-profit hospital groups.

Nice to hear,I fear that in our area the money will be used to buy/influence hospitals..

 

[Understudy]

I agree, but as I'm no longer self employed, I have to take what my company offers. It's not like they pay me the money instead if I decline, and they subsidize the costs. Right now I'm not complaining, just discussing.

You can check into this further actually if your company is operating under a Section 125 (cafeteria plan). While I'm not a tax professional my understanding is that under the cafeteria plan guidelines employers must offer participants a choice of at least one taxable benefit (cash) or a qualified benefit (pre-tax choices such as health care, DCA, HSA, etc.). So if you're interested you could potentially receive cash in lieu of your health insurance benefit provided by the employer but it would be subject to taxes. That's my understanding anyway but for some it could be worth looking into.

 

[nsxotic911]

Has anybody mentioned this, work for the government**!

http://www.usatoday.com/news/nation/2010-03-04-federal-pay_N.htm

Note that salary is not indicative of full compensation...

"These salary figures do not include the value of health, pension and other benefits, which averaged $40,785 per federal employee in 2008 vs. $9,882 per private worker, according to the Bureau of Economic Analysis."

The federal government spends about $125 billion annually on compensation for about 2 million civilian employees. "

+ the benefits of unionization to your job security can not be understated.

Job Federal Private Difference
Airline pilot, copilot, flight engineer $93,690 $120,012 -$26,322
Broadcast technician $90,310 $49,265 $41,045
Budget analyst $73,140 $65,532 $7,608

Chemist $98,060 $72,120 $25,940
Civil engineer $85,970 $76,184 $9,786
Clergy $70,460 $39,247 $31,213
Computer, information systems manager $122,020 $115,705 $6,315
Computer support specialist $45,830 $54,875 -$9,045
Cook $38,400 $23,279 $15,121
Crane, tower operator $54,900 $44,044 $10,856
Dental assistant $36,170 $32,069 $4,101
Economist $101,020 $91,065 $9,955
Editors $42,210 $54,803 -$12,593
Electrical engineer $86,400 $84,653 $1,747
Financial analysts $87,400 $81,232 $6,168
Graphic designer $70,820 $46,565 $24,255
Highway maintenance worker $42,720 $31,376 $11,344
Janitor $30,110 $24,188 $5,922
Landscape architects $80,830 $58,380 $22,450
Laundry, dry-cleaning worker $33,100 $19,945 $13,155
Lawyer $123,660 $126,763 -$3,103
Librarian $76,110 $63,284 $12,826
ocomotive engineer $48,440 $63,125 -$14,685
Machinist $51,530 $44,315 $7,215
Mechanical engineer $88,690 $77,554 $11,136
Office clerk $34,260 $29,863 $4,397
Optometrist $61,530 $106,665 -$45,135
Paralegals $60,340 $48,890 $11,450
Pest control worker $48,670 $33,675 $14,995
Physicians, surgeons $176,050 $177,102 -$1,052
Physician assistant $77,770 $87,783 -$10,013
Procurement clerk $40,640 $34,082 $6,558
Public relations manager $132,410 $88,241 $44,169
Recreation worker $43,630 $21,671 $21,959
Registered nurse $74,460 $63,780 $10,680
Respiratory therapist $46,740 $50,443 -$3,703
Secretary $44,500 $33,829 $10,671
Sheet metal worker $49,700 $43,725 $5,975
Statistician $88,520 $78,065 $10,455
Surveyor $78,710 $67,336 $11,374​

**I think I shot most of my chances to ever work for the government, especially in this political climate, <sigh>