Planned Change to Out-of-pocket Cap Calculations.

Sep 23, 2015

  1. Duaine
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    HealthCare.gov CEO Kevin Counihan has announced that the Obama administration will proceed with its planned change to out-of-pocket cap calculations. Under the guidance, the out-of-pocket cost for individuals enrolled in family plans would be capped at the individual limit of $6,850 per year, instead of the family limit of $13,700. Certain industry groups and employers argue that this change would increase prices and add administrative complexity to plan administration.


    Dag nab bit what is going on? :twitchy:
     
    Duaine, Sep 23, 2015
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  2. somarco
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    somarco GA Medicare Expert

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    Like comparing embedded deductible to aggregate deductible. Except in this case it is the OOP.
     
    somarco, Sep 23, 2015
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  3. AllenChicago
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    Hopefully any new HHS-mandated changes that increase the cost of providing coverage won't occur until 2017. Health Insurers have already set premiums and plan designs for 2016.
     
  4. somarco
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    somarco GA Medicare Expert

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    Memory problems?

    You seem to forget all the admin changes on birth control, extending open enrollment, etc that happened in 2013 and 14 after rates and benefits were set in stone.

    Even though Sebellius isn't around any more, they can and will do whatever is politically appealing to the (m)asses.
     
    somarco, Sep 23, 2015
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  5. AllenChicago
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    haha..(m)asses. Too funny!

    Yep..I remember the last minute and late changes that Sebelius/HHS mandated. None of them were as severe as changing the OOP though. A Birth Control Mandate is small potatoes compared to an OOP ceiling reduction, IMO.
     
  6. somarco
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    Yes, changing OOP is a much greater cost than birth control. Point was, this admin has no qualms about rewriting anything from bankruptcy rules (GM) to immigration to Obamacare.

    They do whatever they want with impunity. Why should this be any different?
     
    somarco, Sep 24, 2015
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  7. AllenChicago
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    Yes, they've violated the letter and spirit of the law many times, Somarco. But there are some lines they won't cross. For instance, HHS really wanted to make getting pregnant a SEP this year, like New York did. What stopped them? Something kicked in to make the Admin show some rare ACA common sense.
     
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