# Health insurance rates are way to much money.



## ScottySkis (Apr 23, 2014)

$200 increase in what I pay at my job per month wtf.:x


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## Hawkshot99 (Apr 23, 2014)

What happened to the affordable health care act?

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## skijay (Apr 23, 2014)

Zip Codes dictates premiums so those with "higher earners" will basically be subsidizing those Zip Codes with the "lower earners".  That part of the Act is working as designed.


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## ScottySkis (Apr 23, 2014)

I wirk in 10113 which is a high high end zip code but i dont make much money  by boss does. I was paying a lot less with more benfits with last years plan. Also boss was paying 80% of insurnace now he is paying 50%. April 15 was last enrollement in Affordale Act now i cant enroll in that. .


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## Puck it (Apr 23, 2014)

We lost our HMO Blue and have only two options now.  A HSA and PPO.  We went with the HSA with the lower monthly cost and a $2500 deductible before any kicks in.  And I work for a $19 billion company.  Thank you ACA.


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## Not Sure (Apr 23, 2014)

Don't get me started!!!! Self employed , went up 40% day after election. Following year went to a $4000.00 deductable to keep down to 
15% increase. Recently dropped it to go on Wifes ins. was $498.00 mo for just me.
"Have to pass it to see wats in it", "Stool sample"  as some AZ'er wrote


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## wa-loaf (Apr 23, 2014)

ScottySkis said:


> $200 increase in what I pay at my job per month wtf.:x





Puck it said:


> We lost our HMO Blue and have only two options now.  A HSA and PPO.  We went with the HSA with the lower monthly cost and a $2500 deductible before any kicks in.  And I work for a $19 billion company.  Thank you ACA.



Sounds like your companies are using using the law as an excuse to screw you. My insurance went up the usual couple of percent for the year.


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## Savemeasammy (Apr 23, 2014)

Puck it said:


> We lost our HMO Blue and have only two options now.  A HSA and PPO.  We went with the HSA with the lower monthly cost and a $2500 deductible before any kicks in.  And I work for a $19 billion company.  Thank you ACA.



My wife is a teacher.  I am waiting for something similar to happen to us in the future.  


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## Puck it (Apr 23, 2014)

wa-loaf said:


> Sounds like your companies are using using the law as an excuse to screw you. My insurance went up the usual couple of percent for the year.




The HMO Blue plan had a max not allowed under ACA and did give justification to screw us.


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## ScottySkis (Apr 23, 2014)

Up boss probably make who ever left pay 90% nedt yesr. So kooking for new job again. I ak for compay making profit bit as employy i need money for work other wise why be productive?


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## Puck it (Apr 23, 2014)

ScottySkis said:


> Up boss probably make who ever left pay 90% nedt yesr. So kooking for new job again. I ak for compay making profit bit as employy i need money for work other wise why be productive?




And a a phone that works.


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## deadheadskier (Apr 23, 2014)

I'm patient.  I think as participation continues to rise, costs will come down and better options and plans will open up.  I think the current pain is merely an over-reaction from the private insurance market as they adjust to the new normal of semi-public healthcare insurance. 

Feel free to flame me for that opinion.  I'll bump this thread in five years and I'll either be right or I'll eat crow.


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## hammer (Apr 23, 2014)

wa-loaf said:


> Sounds like your companies are using using the law as an excuse to screw you. My insurance went up the usual couple of percent for the year.


Had this as well but deductibles went up for specialist visits.

Over the past several years the insurance company has held my employer hostage...either put up with reductions in benefits or face double-digit percentage increases.  To my employer's credit, our cost share has remained fixed for several years...but our benefits have eroded to just that required under Mass. law.  This erosion of benefits has been going on long before ACA kicked in.  Now the claim is that ACA is the reason...right...

And I have had a $2000 individual and $4000 family deduction for several years now.  Really stings financially when a few family members get injured like last year...and other stuff happens like the year before...


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## wa-loaf (Apr 23, 2014)

hammer said:


> Had this as well but deductibles went up for specialist visits.
> 
> Over the past several years the insurance company has held my employer hostage...either put up with reductions in benefits or face double-digit percentage increases.  To my employer's credit, our cost share has remained fixed for several years...but our benefits have eroded to just that required under Mass. law.  This erosion of benefits has been going on long before ACA kicked in.  Now the claim is that ACA is the reason...right...
> 
> And I have had a $2000 individual and $4000 family deduction for several years now.  Really stings financially when a few family members get injured like last year...and other stuff happens like the year before...



I'm paying $500+ a month for a family plan (pre-tax). Company only offers a PPO, I think they save by only offering one plan. They pay 60% so it's a pricey plan. No deductible $25 copay, had surgery on my foot including and implant and it only cost me the $250 day surgery cost, hospitalization would cost $500. $25/40/55 prescription rates. I really like that I can go directly to a specialist instead of dealing with a primary care doc. I feel really lucky that our company takes care of us.


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## ctenidae (Apr 23, 2014)

wa-loaf said:


> Sounds like your companies are using using the law as an excuse to screw you. My insurance went up the usual couple of percent for the year.



I agree- I think there's a lot of this going on. My insurance stayed the same this year.
ACA can cause problems for self employed folks, though Not supposed to, but, well, it's a government run market.


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## Edd (Apr 23, 2014)

My company had a noticible reduction in coverage this year and sent out emails explaining that they, also, are responding to changes triggered by the ACA.  Ours falls under the definition of a Cadillac plan and they claim we need to avoid fees imposed on companies with such plans.  

However, I don't think those fees are active yet and they've also chipped away at coverage, in tiny increments, for several years, the ACA notwithstanding.  I agree that some companies are taking advantage of the situation but I'm not in a position to complain much.


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## bigbog (Apr 24, 2014)

Hawkshot99 said:


> What happened to the affordable health care act?



Good Intentions but seems a lot of deep thought went into it, much like the plans for the website design....lol.


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## hammer (Apr 24, 2014)

ScottySkis said:


> I wirk in 10113 which is a high high end zip code but i dont make much money  by boss does. I was paying a lot less with more benfits with last years plan. *Also boss was paying 80% of insurnace now he is paying 50%.* April 15 was last enrollement in Affordale Act now i cant enroll in that. .


Guessing that's the source of the increase right there...and do you really have a choice to go into the open market since in that case you would be on the hook for the entire premium.

I may get flamed for this but one of the problems with the current system is that it's still tied too much into employment.  If health care just wasn't offered as a employment benefit and everyone went on the insurance marketplace I'd hope there would be more choice and lower premiums.  Downsides of this change are that the current system for getting insurance is still FUBAR and that removing employers from the equation would result in a significant pay cut for many (doubt employers would be fair and increase wages/salaries to make up for not having to pay insurance premiums).  I also think this would be a hard sell for many since there are still a lot of people out there who benefit a lot from the current system.


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## Puck it (Apr 24, 2014)

deadheadskier said:


> I'm patient.  I think as participation continues to rise, costs will come down and better options and plans will open up.  I think the current pain is merely an over-reaction from the private insurance market as they adjust to the new normal of semi-public healthcare insurance.
> 
> Feel free to flame me for that opinion.  I'll bump this thread in five years and I'll either be right or I'll eat crow.



So next year the rates will rise because they did not get the healthy people to sign up like they expected.


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## snoseek (Apr 24, 2014)

Health insurance-must be nice....

I can't even wrap my head around what the fuck to do at this point. I move every six months and go from decent earning to very low earnings. Yeah, I'm stupid for playing risky I know.

Anything else I have to say will only awaken the old people on here so ill stop there


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## Puck it (Apr 24, 2014)

snoseek said:


> Anything else I have to say will only awaken the old people on here so ill stop there



Oh go ahead. We want you too.


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## deadheadskier (Apr 24, 2014)

Puck it said:


> So next year the rates will rise because they did not get the healthy people to sign up like they expected.



Didn't realize Health Insurance was only a privilege of the healthy people.  

Like I said, I'm patient.  It will take time, but I think the more people who end up in the pool both for ACA and private insurance, the more costs will drop.

http://www.pressherald.com/news/nat...lth_care_law_to_cost_less_than_expected_.html

The fact is that ultimately the most affordable system this country could go to is a single payer system.  We spend 17.7% of our GDP on Health Care.  Almost every other developed country in the world with a single payer system pays FAR less.  

Take Canada, they spend 11.2% of their GDP on Healthcare.  I've got plenty of friends from over the border.  I don't hear from them that their Health Care services suck because it's publicly financed.  In fact, most polls show a 70+% approval rating for their care and over 90% favor their system compared with a privatized system like the US has.

Speaking purely from a financial standpoint, I would think fiscal conservatives would be banging the drum the loudest on moving towards a single payer system.


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## bvibert (Apr 24, 2014)

ctenidae said:


> ACA can cause problems for self employed folks, though Not supposed to, but, well, it's a government run market.



My dad is self employed and actually saved a bunch of money for better coverage thanks to the ACA.


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## Puck it (Apr 24, 2014)

deadheadskier said:


> Didn't realize Health Insurance was only a privilege of the healthy people. QUOTE]
> 
> 
> Not my point. If only the people that need it sign up and the young healthy people do not. Then the cost has only one way to go.  Up. It is a very simplae actuarial science lesson.


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## wa-loaf (Apr 24, 2014)

bvibert said:


> My dad is self employed and actually saved a bunch of money for better coverage thanks to the ACA.



I think a lot of people if they take the time to investigate the options find this out. When things first kicked in the insurance companies sent out letters saying your insurance is canceled and here is the really expensive replacement policy. People took that as their only option, when the insurance company was just trying to trick you into paying more.



Puck it said:


> Not my point. If only the people that need it sign up and the young healthy people do not. Then the cost has only one way to go.  Up. It is a very simplae actuarial science lesson.



It sounds like they've met their targets for this go around.


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## Puck it (Apr 24, 2014)

wa-loaf said:


> It sounds like they've met their targets for this go around.



Not completely corrected.  The number has been adjusted a number times and there is still no real number for those that paid yet.


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## Warp Daddy (Apr 24, 2014)

OK heres my take :

Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5  will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .

Moreover the docs are also sharing the pain as the system adjusts under the push and pull , ying and yang of politicized systemic change . The game has shifted to the point where the industry MUST be able to make margin on the MEDICARE reimbursement rates . Most are unable to do this , ie that is why only very few hospitals make a positive margin .  The Insurance companies however will reap a windfall   IMHO . Incentives for many to consider becoming physicians are rapidly being affected .

Rural healthcare will remain seriously challenged as the competition for fewer doc and specialists impacts . This COUPLED with the values , work ethic and norms of the New Generation Workforce of Docs (more want to be employed not be independent businesspeople ) with regular hrs and extremely limited callbacks will be a GAMECHANGER .

So imagine greater demand for service ( from all the new enrollees , FEWER service providers i. E. Docs , severely constrained Margin. See previous commentery re making margin on Medicare AND more patient services delivered by mid levels ie PA,s Nurse practironers with huge demand for service . THIS is a daunting challenge .......BUT the insurance industries will continue to pay execs and proffer huge bonuses i would imagine 

So saddle up , hold the reins tightly, its gonna be a helluva ride till this thing smoothes out .......IF it does


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## Puck it (Apr 24, 2014)

Warp Daddy said:


> OK heres my take :
> 
> Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5 will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .
> 
> ...



Do you think the border hosipitals like Hepburn have seen an increase in Canadian patients since the socialization in Canada?  I have heard yes.


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## yeggous (Apr 24, 2014)

Most of the problems with the ACA are related to it being a watered down version of Romneycare. I can tell that you that (in general) people in Massachusetts are very happy with Romneycare. Yes, health insurance rates as a whole spiked, but this was largely related to the expansion of benefits due to the increase in minimum coverage.

In my household there is a dramatic difference between the coverage offered by my job in Massachusetts and my significant others' job in New Hampshire, even though she works as a healthcare provider. Her employer is able to offer her crappier coverage just because she works on one side of the state line. The plan that she is offered meets the ACA requirements but would be illegal in Massachusetts. I think the biggest thing that sets Massachusetts apart is that we have a government option (Mass Health) which provides a baseline minimum coverage and price point.

As for enrollment, the total enrollment numbers are a red herring. It does not matter how many people enroll as long as the mix is good. Health care reform should decrease total costs to society by moving people out of the emergency rooms (where their costs become baked into our fees for services) and into cheaper primary care. The results will be an increase in the burden on men, young people, and the well, in order to pay for the higher usage of the older, women, and chronically ill -- that is just what insurance is.

What we had without universal insurance was _not_ the free market. Did anyone have the ability to compare costs from multiple providers for a given procedure? How did I know what Hospital A and B charged for a MRI? There was no way to know what anything cost until the bill came. Romneycare / Obamacare / the Heritage Foundation plan is the free market solution. You go and buy a product from a number of competing vendors. There is a single location to compare price and coverage so you can make an informed decision.

The biggest gains that I see from health care reform:
- guaranteed minimum coverage that employers must offer
- moves people from the ER to primary care
- _individuals_ have access to group health insurance (pre-existing conditions, reasonable rates, etc)
- direct accounting for the cost of caring for the uninsured (no more baking these costs into everyones rates)
- a way to compare costs between providers


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## Warp Daddy (Apr 24, 2014)

Puck it said:


> Do you think the border hosipitals like Hepburn have seen an increase in Canadian patients since the socialization in Canada?  I have heard yes.



Puck : we do significant outreach in the capitol region especially thru the US Embassy to garner their employees who have Decent coverage as far as the general Canadian Citizen it peaked several yrs ago . We target marketed toward those who were SELF payers that had the means to pay the freight for elective procedures , surgeries or other procedures that were caught up in a Queuing problem  in the Canadian system .

As i said that book of business peaked has pretty much dried up  was always very modest but still when margins are tight we look for any and all sustainable revenue streams .The current stream is Embassy employees and their dependents.


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## Glenn (Apr 24, 2014)

Part of my job is employee benefits. For 2014 plan renewals, there was about an average of a 4% increase due to ACA compliance and mandated coverage. This is in the private sector for CT based employers. 

I could write a lot about this and have certain opinions. But it boils down to it's far more complicated than it needs to be. They probably could have accomplished just the same by requiring insurance companies to cover pre-existing conditions. 

Insurance is the business of financing risk. You need a diverse pool in order for the system to remain viable.


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## Puck it (Apr 24, 2014)

Glenn said:


> You need a diverse pool in order for the system to remain viable.




Completely agree.  We do not know the make up of the 7 million that signed up.  They were hoping for ~17 million to sign up originally from the ~39 million of uninsured.  
So who actually makes up this 7 million?

How many have actually paid?  Most of the states are reporting from 50% to 70% from data that I have seen.
How many had insurance and were cancelled?
How many had pre exisitng conditions?  Which in most states is against the law to deny all ready.
How many are in the healthy demographic 26-35?
How many went back to their parent's plan <26?
How many were unisured before?

I would to see these numbers but there is no central location to get these actual numbers.


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## bvibert (Apr 24, 2014)

wa-loaf said:


> I think a lot of people if they take the time to investigate the options find this out. When things first kicked in the insurance companies sent out letters saying your insurance is canceled and here is the really expensive replacement policy. People took that as their only option, when the insurance company was just trying to trick you into paying more.



That's exactly what he did.  He got a notice that his existing insurance at the time was going to go way up.  He went to his insurance agent to see what his options were and they were able to get him signed up for a better plan at a rate that was lower than what he had been paying.


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## mlctvt (Apr 24, 2014)

I work for a small Connecticut company with 27 employees. We offer health insurance for our employees and pay 80% of the cost, the employee pays the rest. We currently have Blue Cross Blue Shield coverage with a substantial deductible. My company pays over $1500 per month for coverage for my wife and I. Family policies are $1800+/month. 



 When the states online exchange went active I looked at what was offered. Surprising that I could buy a much better policy with lower copays and lower deductibles from the same Blue Cross Blue Shield on the exchange for less than $1000, it was actually $520 per month cheaper! We are locked into our current contract until the end of the year and we'll be watching what the rates do.  If the costs don't equalize next year we may be dropping insurance for employees and let them buy less expensive insurance on the exchange. Possibly give them a stipend towards buying their own. 


The current structure sucks. It seems small companies are subsidizing others? Either that or the rates for the ACA were artificially or intentionally set too low the first year?


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## hammer (Apr 24, 2014)

mlctvt said:


> I work for a small Connecticut company with 27 employees. We offer health insurance for our employees and pay 80% of the cost, the employee pays the rest. We currently have Blue Cross Blue Shield coverage with a substantial deductible. My company pays over $1500 per month for coverage for my wife and I. Family policies are $1800+/month.
> 
> 
> 
> ...


Could be that your company has a significant claim history...do you have a number of older workers or workers who are getting more medical care?

The rates set up on the exchanges are likely based on a complete mix of insured where with an employer the mix is smaller and known based on past history.  Just a guess...I'm not in the field but I did have a decent breakfast this morning.

That is a pretty high rate, think the total premiums for family coverage where I work is around $1100/month (of which I'm also fortunate enough to pay just 20% of).


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## Geoff (Apr 24, 2014)

hammer said:


> Could be that your company has a significant claim history...do you have a number of older workers or workers who are getting more medical care?



This is the whole problem with corporate group health plans.   If you work for a company with mostly older workers mixed with childbearing-age women, the premiums are nuts.   My company outsources the HR function so I work for a co-employer based in Florida.  My W-2, ADP payroll stuff, and all my benefits come from the co-employer.   We happen to be with a co-employer group that is mostly young male high tech workers.   My gold-plated Aetna PPO plan with $500 deductible, small co-pays, and 100% coverage for anything after that is about $7,000 as long as I stay in-network.   If I worked for a small company with a bunch of old geezers, it could easily be twice that.   In addition, my employer pays 88% of the premium so my pre-tax contribution is just about invisible in my paycheck.

Personally, I think the biggest problem with Obamacare is that they didn't rescind the "Emergency Rooms have to accept uninsured people" law.   Hospitals are still choking on people who don't pay their bills.   If you're gaming the system or you're an illegal, it shouldn't be everybody else's problem when you get injured or sick.
If you're looking at changing jobs, the questions about how health insurance works are now critical because it's all over the map.


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## Not Sure (Apr 24, 2014)

Warp Daddy said:


> OK heres my take :
> 
> Seems the only ones reaping the benefits so far are the INSURANCE industry . Our hospital albeit one of only 17 % in this state that is profitable with a margin of approx 1.5  will be taking a very deep and substantial HIT on the bottom line over the next decade as as result of Healthcare reform ( reform is CODE language for cuts ) .
> 
> ...



ACA limits the amount Ins co's can make , 80% must be spent on healthcare 20% on overhead ect.
My Wife works in the feild...Hospitals have seen a major drop off in elective surgerys , speculation is due to raising deductables.
There are contiuing layoffs, One of my wifes coworkers just got laid off , They have 3 kids, her husband is laid off and recently diagnosed with Cancer and going through Chemo....How ironic ,
ACA has nothing to do with healthcare and everything do do with Politics, It was designed to fail from the start, O wants single payer and said so before the first election.


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## Geoff (Apr 25, 2014)

I think that the correct solution wold have been to scale back Medicaid to be about 80% as good as good private health insurance instead of 95% as good as private health insurance, let anyone who is denied coverage by private insurance pay a means-tested Medicaid monthly premium, and allow private health insurance to continue being "insurance" based on risk instead of "benefits administration".   In addition, I'd get rid of the requirement that emergency rooms and hospitals that take Federal money (Medicare, Medicaid, etc) can't turn away the uninsured.   If you're an illegal, you pay cash or you go home.   If you game the system and opt out of buying health insurance, nobody should be obligated to treat you.


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## Glenn (Apr 25, 2014)

On employer sponsored plans, between 1% and 5% of your employee population will drive you overall claim experience. If you have a small population, there isn't a lot of room to make up for a few large claims. In larger populations, you usually(but not always) have enough lives to help spread out the expenses.


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## deadheadskier (Apr 25, 2014)

Geoff said:


> In addition, I'd get rid of the requirement that emergency rooms and hospitals that take Federal money (Medicare, Medicaid, etc) can't turn away the uninsured.   If you're an illegal, you pay cash or you go home.   If you game the system and opt out of buying health insurance, nobody should be obligated to treat you.



Never happen and really couldn't.  If you spent some time working in the ER you'd understand its not always easy to differentiate between the payers and non-payers.  And treatment for trauma can begin way before figuring any of that stuff out.


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## Puck it (Apr 25, 2014)

Total US population 320M
Total Uninsured 39M
Total goal for Obamacare sign up intentionally 17M
Total of actually signed up (new goal 6M) 7M


20000 page law for 2.5% of the population and that is on the high side since we don't know of the 7M had insurance and lost it and also who has actually paid.


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## mlctvt (Apr 25, 2014)

hammer said:


> Could be that your company has a significant claim history...do you have a number of older workers or workers who are getting more medical care?
> .




This is probably the reason Our average worker is 50 years old. Also we've had 4 people on our plan with cancer All 4 are women with breast cancer. Also several older men with heart problems. 

Everyone forgets about the 20+ years where we had a young workforce and few claims were made. As a small company we've always paid more.


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## hammer (May 16, 2014)

And the hits keep coming...

http://bigstory.ap.org/article/cost-control-plan-health-care-could-cost-you


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## Puck it (May 16, 2014)

We just hit our $2500 deductible!  The plan now kicks in.


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