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Consultant said:
I don't know how you can say it's safer other than an employee now has the incentive to leave the company when he wants because he/she already has coverage. I understand the portability of it - but to a business owner this would be a negative. They want them to stay for whatever reason.

I think you are comparing apples to oranges. Again, better coverage for less money. I think this is a misnomer at least in California. What individual Blue Cross plan can you get a 500 deduct/4,000 OOP for a 40 year old under $250?

A higher deductible plan is where the IFP's starts to become somewhat cost effective versus Group. (i.e. 1,500-2,000).

Two most affordable IFP's w/ low Deducts in CA. (40 yr. ex.)

Aenta 1,500 $233
Nationwide Health plans 1,750 $215

I think dollar for dollar the BC is better. Your group is internal making less turnover (a huge problem for most businesses - usually the 2nd reason to buy group) and no medical questions. Sorry Jimmy, you have diabetes type 2 - better luck next time.

Again, this is apple to oranges and don't forget the statistic that groups stay on the books longer, almost twice as long as IFP.

I know most of us can sell ice to Eskimo's - so however you want to get an appointment is up to you.
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If the only reason the business owner has for offering a group health insurance plan is to try to tether the employee to the business, then yes I agree. He is paying a terrible premium (30-50% more) to do it though.

It's better and safer for the employee in many more ways than just 'portability'. Here's just a couple:

Ever get a re-rate on a group the year after a huge claim? I have. Chances are the employer is going to have to cost shift more to the employee...and if people are paying 100% of the dependent cost...LOOK OUT!

Individual/family plans (here in FL anyway) can never have their premiums increased because of a claim - nor can they be cancelled on an individual basis.

Let's talk about "medical bankruptcy" for a minute. Fully 75% of these are folks who had group health insurance when they got sick or hurt! They lost their job...and ability to pay their premium (COBRA, conversion, whatever).

If they had been wise enough to get an HDHP, and opened and funded an HSA account...they would have the $$$$ to pay, or help pay the premium while they are unemployed.
 
Moon, I agree with you that it is always more adventageous to have an Ind / Fam plan than an employer plan, because of employee termination and long term disability situations.

Do you put these individual plans on a "list bill," or a payroll deduct?
 
moonlightandmargaritas said:
If the only reason the business owner has for offering a group health insurance plan is to try to tether the employee to the business, then yes I agree. He is paying a terrible premium (30-50% more) to do it though.
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You say that an IFP that's 200% of standard rate beats group in Florida
I'm not in Florida - please understand that.
I just showed you that it's barely 5% greater for group with the type of benefits because IFP's are generally HDHP.

moonlightandmargaritas said:
It's better and safer for the employee in many more ways than just 'portability'. Here's just a couple:

Ever get a re-rate on a group the year after a huge claim? I have. Chances are the employer is going to have to cost shift more to the employee...and if people are paying 100% of the dependent cost...LOOK OUT!

Individual/family plans (here in FL anyway) can never have their premiums increased because of a claim - nor can they be cancelled on an individual basis.
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You said you are "cancelling" group coverage to get them on HIPAA. So if doing that is bad, then why are you doing it? ? ?

Have you ever done this on a medium sized group 50 plus? Then I would understand the RAF increase of .10 for example. However, you are probably dealing with groups that are rated at max 1.10 because they are under 10 like you said. So they can't increase in premium due to health conditions.

In California, if you're on a IFP plan over 5 years, insurance companies totally raise them just because, they don't need a reason - just location and age.

They know that the healthy people will switch their plan and the sick people are now paying their weight. It's the SICK truth in California.

That being said, if someone was sick on a IFP plan, after 10 or, wow, 15 years? The plan would be twice maybe three times the cost of other like plans. (Omitted from the HSA handbook)

If I was in Florida, sounds like it may be better to do IFP. In CA - group is a God sent.

moonlightandmargaritas said:
Let's talk about "medical bankruptcy" for a minute. Fully 75% of these are folks who had group health insurance when they got sick or hurt! They lost their job...and ability to pay their premium (COBRA, conversion, whatever).

If they had been wise enough to get an HDHP, and opened and funded an HSA account...they would have the $$$$ to pay, or help pay the premium while they are unemployed.
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This, I agree. Most owners; however, only care about the bottom line (retention, retention, retention) Maybe Walmart & Star Bucks will start to do it too because they say they care for their employees, right?

1. Do you retrofit groups to IFP's even if someone has a Pre-exist? If so, why?

2. What's the average RAF when you cancel the group?

It's funny because I've had groups call me down the road saying someone tried switching them to IFP's but my group quote was still a better deal. I do show the full market search that includes the spill about HSA's and everyone has agreed that it's worth a few more bucks in CA to get a more comprehensive plan that makes the employee turnover virtually non-existent.

Groups are so cherished in California I have many individuals wishing they could start groups and I find ways for it to make it happen.

I read the HSA handbook and I still don't think its the answer.

I think I will agree to disagree with you. I know many other people on this board believe that HSA's are the answer, I don't. Not for the majority of groups.
 
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wildcat said:
Moon, I agree with you that it is always more adventageous to have an Ind / Fam plan than an employer plan, because of employee termination and long term disability situations.

Do you put these individual plans on a "list bill," or a payroll deduct?
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Neither.

One of the major advantages to the employer is being out of the business of health insurance purchasing and administration.

I don't want to take the chance of a screwed up list bill or P/R deduction situation - so I just do them on regular old bank draft. I do however work with pretty decent employers with well-compensated employees. Want to make sure the money is there!
 
This must be a state by state thing. As Consultant said, in California, the group plans are much more feature rich and much simpler for people. I take people off of IFP's and put them in small group when possible / practical.

Young, healthy individuals tend to save money on IFP's because they can have a plan that they won't use much. Someone with a child will want the group coverage so they can go see the doctor for $10.

Of course, it helps that in California, small group is guaranteed issue, and can't be above 1.10 raf. No IFP in California has the same protections.

Dan
 
Moon you scared me for a minute there. If you did that in Georgia you would surely be facing a lawsuit. In GA individual coverage is not gurantee issue. I can understand why you would do that in FL
 
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