toomuchtime said:
As for insurance companies getting ready to screw workers, get a clue. It's the employer, and sometimes the union, that decides what kind of coverage the worker gets and what it will cost him/her, not the insurance companies. Insurance companies compete for the sale by trying to give the employer what it wants at a price it is willing to pay.
All I know is what I hear, which doesn't look good for employees who don't stay right on top of their employer-sponsored health care.
CNN.com/transcripts -- House Call, 10/31/09:
GUPTA: We are back with HOUSE CALL. You know, for a lot of us with employer-sponsored health insurance, including myself, late fall is when we start to sign up for a new health insurance plan. But for some of us, the whole process is going to be different for 2010 and we got the best in the business, personal finance editor Gerri Willis to help talk us through it. And you know, I haven't been able to go to the meetings yet, describing, explaining some of this. I know you have, but it is confusing. What changes are we talking about here?
GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: Yes. Hey there, Sanjay.
We've been studying this for a couple of weeks now and big surprise: your costs are going to go up as employers ship more of the health care cost burden onto our shoulders. Next year, you can expect to pay 10 percent more, that's $4,000, including co-pays and premiums. About 10 percent of employers will drop you from their health care plan if you don't ...
GUPTA: Wow.
WILLIS: ...participate in open enrollment. Previously, if you didn't make a decision, they just simply default you into last year's option. But this year, if you don't choose, you're going to be penalized.
Another new trend this year: companies are increasingly doing away with co-pays and introducing co-insurance. Co-insurance is the percentage a patient pays for a medical service generally after a planned deductible is met and it can vary by plan. And this is a big deal, Sanjay. A co-pay may cost you 25 bucks, right, but the average doctor's appointment or emergency room visit could run you 500 bucks or more.
Now, if your plan is moving towards co-insurance, make sure you call your doctors and find out what the average visit costs you without insurance so that you can figure out how much money you're going to be on the hook for. Employers are increasingly auditing who you cover under your health insurance plan to make sure your health plan doesn't cover people who are ineligible. And if your spouse is on a health plan but has other insurance options available, you could be paying more in premiums.
So, not a lot of good news here, Sanjay.
GUPTA: I know. When my most recent child was born, I had to show a lot of documentation to make sure that I get her on our exiting plan. So, it's pretty frightening, this idea that people could be dropped as well if they don't sign up. I hope a lot of people paid attention to what you were say there.
What -- you're famous for your tips. So, what are some of the best choices that we could possibly make this year for open enrollment?
WILLIS: Well, here's how you come to your decision about what plan you're going to choose. Look at the coverage you had last year. How much did you spend on co-pays and out-of-pocket costs. Did you see any doctors that were out of network for your plan? How long did your flexible spending account last? Now, most companies, they offer actual tools online that can help you analyze your health claims from last year. Ask if your company has this kind of estimator and make sure you take advantage of flexible spending accounts. This lets employees set aside pretax wages for certain medical expenses not covered by insurance. You have to use the money in that year or you lose it.
So, make sure you follow the guidelines. Again, this is not an easy thing to go through. But if you do the comparisons and really find out how you lined up against last year's plan and what it means for this year, you'll go a long way to choosing the right plan.
GUPTA: It's probably worth the time, it sounds like you're saying, and trying to at least anticipate what some of your health issues might be in any given year.
WILLIS: That's right, Sanjay. You've really got to figure out what you're going to need next year. If you're going to have a baby, if you're having a big life-changing event of some kind. Pay double, triple attention to what you're doing this year because it's really going to matter.
