Home Forums Discussions General Discussion Health insurance

I need some advice about health insurance. If you don't mind, can you tell me what type of numbers or formula you use to arrive at what you pay and what your staff pays?

If you don't feel comfortable here, you can PM me.

Wow, you can afford to pay your staff health insurance? I have enough trouble paying for my own. I used to pay 100% of a single policy. Over the last 10 years it then dropped to 75%, then to 50%, then to 25%, then to "Sorry but if you want me to pay your health insurance I will have to let 2 employees go. You all decide what you want and if it is health insurance then pick straws to see who goes." During the interview for the last employee I hired I barely asked about her skills (I could teach her what she needed to know). The big question was "Do you need health insurance or are you covered on someone else's plan". Pretty sad.

I had to take a 10k deductible plan in order to get our employees a 2500 deductible...8 docs and 60 covered lives or so....176k is our premium...10 years ago it was 60k...employees are paying about 20 percent of the cost at present, but that will change

So when Obama said "If you like your health plan, you can keep your health plan". He forgot to add "If you can still buy it or even find it after I screw with it".

Todd

What are the rates (if I can ask) for family and single? We just switched to Blue Care Network and we have a $1000/$2000 plan.

Bert,
our insurance broker told us that most physicians pay 80% or less of their employees contribution , but we have staff who refused even this and wanted us to pay 100% !
so this became unaffordable and we had to buy individual policies which have many exclusions .
Bala

Bert,

We pay 75% of our employees premium which is roughly 300 dollars per month, and they have a 500 dollar deductible.
We do get about 200 dollars per employee tax incentive "break" for providing our employees with health insurance. It is costly, but has I think cut down on employee turnover.

Ben
I would tell you the rate, but each employee/family got rated separately, so they are not all the same...it is just too high.

Really that is interesting...for us they just gave one rate for everyone based on family size.

I should clarify the 300 dollars per month per employee is our cost and the 200 dollar tax incentive break is per employee per year--

JIMMIE!

Where and what insurance do you have?? The premium cost for us is over $960 for a family!

Thanks!

blue cross/blue shield great falls montana and these are family plans, and thankfully some of our employees have insurance through their spouse-- yes I am even more blue after hearing your cost!!http://amazingcharts.com/ub/images/graemlins/default/whistle.gif

And I pay $14,500 for my family but hey its tax deductible--can't go without it--i better go make some $$$

Thanks everyone. So, I will try to just give the facts, but I don't understand it,

First, right now I am the only one with health insurance. I pay around $740 for $2500 deductible and the usual pharmacy, etc. This is the government insurance here through Harvard Pilgrim.

Now, with a group plan, I would I would then pay $1250 monthly. The two employees would pay $225.00 a month pre-tax meaning I would only pay $800 a month. Plus the insurance is better. So, they would end up paying around $30 weekly. Sounds a bit too good to be true.

Here is the issue. Let's say the $30 post tax coming out of their paycheck is doable for one. One of our staff REALLY wants this plan. And, she really needs it,

The other, being young and carefree, REALLY doesn't want to pay for the insurance. Sounds silly, but I do recall what it was like when I was 24. I wouldn't have even sat down with a health insurance company. Carefree, nothing can happen to me attitude. And, understandable.

This has, of course, caused some friction between the two. Wow. Hard to believe that health insurance could cause issues and be complicated.

Bert,

We have an United Healthcare HSA plan for every employee in our office who wants to participate. Our PA pays half of the cost: a health savings account for the first $2,000, and the insurance premium (for the policy that covers 80% of expenses above $2,000).

Single premiums for our staff run from $500/mo (around age 35-45) to $900/mo (at age 60).

Some of our employees don't pay anything toward the initial $2,000 HSA -- they still get $1,000 from us, which rolls over to next year.

We will add family members but they have to pay full cost.

Bert,

To be or not to be that is the question, but my philosophy of a practice is to be like a lichen. The staff being the algae reducing the atmospheric CO2 to carbon sugar--feeding me patients/collection & billing. Doctors being the fungus by retaining the water/capturing nutrients--so anything I can do to help this symbiotic relationship by providing health insurance (even though it is quite costly), providing a healthy retirement fund, etc.. means more to me than working in a fancy office or owning a building.
I am unhappy if any category of my monthly statement has a higher percentage of overhead cost than my staff's salary/perks. If that changes, the lichen has trouble surviving on a rock or tombstone (Obamacare, monopolistic ACO activity, HMO's and all the like) and as long as I keep my nose to the grindstone, and my AC/Updox is working , I can survive the future--I would be happy to compare my overhead costs or my staff turnover to any group in my community-and yes the office looks like you are in the time warp of the 60's but patient don't seem to complain about their bill paying without too many frills about.
So even though your young employee doesn't want health insurance, I wouldn't give her the option and provide it for her. She may be glad you started when in 20 years she is thanking you for providing it for her.
Now that is my philosophy and I know it wasn't asked for and it is outdated, and I may be kicking myself in the pants for beholding to this principle but it has worked for the past 18 years, and I am getting too old to change.

So, I suppose lichen or no lichen, I am then to provide free insurance to my other employee as well?

I would provide insurance to both employess--
Its not free it is costing YOU dearly.
I know it sounds counterintuitive but I would argue that over time you will maintain lower overhead costs by having happier/satisfied employees and improved efficiency without the staff turnover.
But lichen I said before --its my opinion and like..#%%&*(*^.. everyone has one.

Does anyone know the laws on health insurance? I would like to offer a program where we pay the employees to go get there own health insurance.

DO you have to pay just one flat amount to each employee? Can you vary it based on single vs family coverage? Or hourly vs salaried? Can We just pay for it or do we have to give them a set amount of money a dn they buy there own?

I just do not know what we can or cant do.

Thanks!

Ben

Not many Federal laws for small employers (used to be 50, now maybe 25??)
State laws??? That is really a good question.
Our local medical society is a good resource for us.

There is no requirement in my state (Florida) for any employer the size of a small medical practice (below 50 employees) to provide health insurance to employees. I would doubt that this is required in any state.

While it sounds good to give money to your workers for their own policies, individual policies are usually more expensive than group plans, and may be hard to find.

You can however either have a standard plan for all employees or offer each employee the same amount of dollar benefits and permit the employee to select desired benefits from a ?menu? of options offered by the insuring company. In Florida, if the company offers insurance, all workers must be eligible. However, an employer may offer different insurance plans to different groups of employees, such as staff versus physician employees. You can also set a weekly work hour threshold for eligibility for insurance.

There are some tax credits available to defer the costs of providing employee health insurance.

We might go with the HRA plan. Put set money in account and employees buy there own insurance.

Anyone else have experience with HRA's?

Thanks!

Ben

I don't know much about it (which is why I started this thread). Here in Maine, it is a set number of hours and 75% of your employees. Of course, that so far, has made for some bad feelings. One employee wants it, another does, which means the employee who wants it can't get it. You could decrease the pay, but the employee who doesn't want it may not like that. Plus, we get audited by the insurance company.

I think paying for the insurance, besides the group plans (which are huge discounts -- $750 to $490), it is also cheaper as they can purchase pre-tax. It would also seem, but I can't know, that employees getting insurance free or for very little would more likely stay knowing they may not get insurance at another office.

We have an accountant and free legal counsel from our state medical association. It seems that a lot of the stuff my practice consultant comes to me with would not be possible without an accountant.

Bert,

I just re-read my coffee induced rant, whew!! sorry-
Also just spoke to my office manager and I did not realize this but at least in Montana if you have a group plan, and depending on the # in your group, individuals may sign a waiver and opt out--so that may be a direction for you.

Thanks, you can't opt out unless it leaves at least 75%. Probably similar. Thanks.

It is too good to be true. As a Practice Manager of a solo Practice, Dr. originally paid 100% of employee 80% of the family coverage. He also supplied the Dental and Vision Policy. Over the last 17 yrs we have chipped away at these benefits, with every outrageous renewal. At this point we now only offer health at 50% for the employee. Those(me..only one left) that were on the older plans were Grandfathered until they left. In addition we have also had to go to individual rather than group plans since we are such a small office. Our ded has gone from what was once 500 to now 2700.00 ind or 5400 family. It is such a double whammy because as providers, we have seen that our reimbursement has in no way grown to reflect these higher premiums, if anything reimbursement is down while bureaucracy is up.

For and individual, depending on age the cost is between 180 and 405 per mnth, our age ranges are mid 20s to mid 50s.

Then on top of that, they find a way to not pay.

Bert,
Our office as well use to pay 100% back in the day for the employee. Currently we pay about 50% of the employee premium ($270 a month). We also pay all employees as a "medical benefit" whether they want the medical offered at the clinic or choose to opt out or get their own policy the same amount. Doing the "medical benefit" makes it fair for everyone. Family is paid by employee and always has been that way at our office.

How does a medical benefit work? We are struggling with insurance costs so I am looking for ideas.

Thanks!

Ben

Basically every full-time employee who is eligible for benefits (medical/dental/ vacation/401K) are paid a benefit each payday. If they choose to have medical/dental etc. then the benefit is applied to that as a "health benefit" as a non-taxable company item.. If they choose to opt out of medical/dental they receive the benefit as earned income as "benefit". They have to pay taxes on it as it is income but haven't had anyone complain.

Robynne,

Thanks for the tip. I guess if everything were equal across the board, and I gave, a certain amount per week as a benefit that was intended for insurance or an HSA, and they spent it on golf clubs, I would just be frustrated. I suppose if that were the understanding and the mindset in advance.

Thanks.

We still provide very generously for insurance. At least partly, this is because one of our older, long-term employees has had health problems and would be hard pressed to get her own insurance. With Obamacare, we will be tempted to drop it and just let everyone get their policies, since preexisting illness will go away. In general, we have found that benefits are much under appreciated by employees. The vast majority would rather get an extra $300/month in spending money than the 15% of their wages it costs us in 401K and insurance. Which then brings up a slight ethical dilemma; realizing that a lot of younger employees would just take the $$$ for toys and not buy insurance, penalty or not, will we then still provide it, having much more experience than they about what medical costs really are? Do I want it on my conscience that young Jane found her breast lump two weeks after having spent her salary increase on a 4-wheeler?

I have to second David's remark about employees rather taking the money we spend on them for insurance and run. We contribute only 75% of the $2,000 HSA amount for our employees; they are expected to designate what part of the remaining 25% comes from their paychecks. The younger ones put nothing in, and as age and number of dependents increase, so does the contribution. I understand this, since we are a consumer culture with a gadget addiction. But I don't think it is smart either.

David and John,
You are absolutely right; people would much rather spend their money on other things rather than health care. This is especially true for the young and healthy. Unfortunately, when they become ill, the employers, the more responsible employees, and the rest of society end up holding the bag. Perhaps you should require a contribution from the less conscientious as well. You could mandate this contribution. Of course that would put you at a disadvantage compared to other employers, so maybe a mandate for everyone would be more appropriate. What do you think?

I think we will most likely go back to paying 90% of their HSA contribution, we would get a lot of pushback against mandatory deductions. Unfortunately, this will require us to choose a plan with less benefits and higher deductibles to keep health insurance costs under control.

I am trying to figure out if this is one of those rare occasions where John doesn't pick-up on my sarcasm. I was relating your practices to the national situation, and hoping it might help you to appreciate the value of the ACA mandate...

Of course he might have gotten the reference, and is saying that it will lead to fewer benefits for all. Hmmm....

That's not fair. I am not addicted to gadgets.

A political nuance! How unusual in this campaign season of attack ads. What could be next, polite discourse? Give it up, Jon, it won't get you elected.

I actually am at peace with the mandate. I am now obsessing about the IPAB.

Wow. When JBS and ryanjo go out using their full cynism and sarcastic abilities, it's fun to watch. I will just sit back with a Heineken and try to pick up on the humor!

I offer Worker's Comp insurance, and use a pay-as-you-go plan through Intuit Payroll because my employee's hours are quite variable. Intuit sends my employee's hours for each paycheck to the WC company, which then deducts something like $30/mo (varies with the hours worked) for the WC insurance. And Intuit gets $5.00/mo to facilitate that.

While it's not a full-on health plan, it is gratifying to know I am insuring my employee, deductible-free, for all potential job-related health issues (paper cuts, untoward staple injuries, toxic toner spatters, etc.).