Questions about HRAs

[AikenRooster2112]

A) If the employer is paying part of of the bill for instances that occur AFTER the deductible is met, how is he saving money over a traditional insurance plan?
B)Doesn't this allow th employer to "spy' on your health care situation and give him cause to fire you or lay you off IF you or tour spouse and/or family members have to many instances where the employer is billed?
C)Is it just better to take the HSA and make sure none of this occurs, even if this means more of the bill will be paid by the employee?

Ugh, I need to get a job with a traditional insurance plan. High Deductible plans suck. It's going to be $99, per week, for me and my wife, plus $7000 deductible, with no co pays and no drug card. The HRA is even more, but the HR lady said it might be better if my wife goes to the doctor a lot. Gees, that's $12000, per year!

No political comments, please, so this can stay in his water cooler.

[Captain9Dragons]

sounds pretty standard these days

i pay $100/week for family, $6000 deductible

[The Yancey]

I pay for all of my plan's cost: $475/month and a $2k deductible. That is for me only. Everything will change in '14 though. All plans will have to provide basic coverages.

[The Yancey]

As it so happens my list of charges from my first day at mayo came today. This consisted only of a 45 minute visit with my doctor, a few X-Rays, and some blood and urine tests. It amounted to $4757.00. Since that time I have had an abdominal ultrasound, and EKG, and a stress Doppler study. Can't wait to get those charges. Tomorrow I have a cranial MRI and a urological consult. They look at big head and little head on the same day. Lucky me!

This is why you need insurance. Your PPO will have negotiated those rates waaay down. Maybe to 1/4 to 1/3 of that amount. I've already met my deductible and since Mayo is in my network they will pay 80% of that amount. My maximum out of pocket cost per year is $4K so I can't get too screwed.

[FloydTheBarber]

Originally Posted by AikenRooster2112

A) If the employer is paying part of of the bill for instances that occur AFTER the deductible is met, how is he saving money over a traditional insurance plan?
B)Doesn't this allow th employer to "spy' on your health care situation and give him cause to fire you or lay you off IF you or tour spouse and/or family members have to many instances where the employer is billed?
C)Is it just better to take the HSA and make sure none of this occurs, even if this means more of the bill will be paid by the employee?

Ugh, I need to get a job with a traditional insurance plan. High Deductible plans suck. It's going to be $99, per week, for me and my wife, plus $7000 deductible, with no co pays and no drug card. The HRA is even more, but the HR lady said it might be better if my wife goes to the doctor a lot. Gees, that's $12000, per year!

No political comments, please, so this can stay in his water cooler.

I'm not sure how you would even think B to be the case.

[AikenRooster2112]

Originally Posted by FloydTheBarber

I'm not sure how you would even think B to be the case.

It's a question. In an HRA, the employer is providing the funds, right? If you meet your deductible, even if extremely high, and you incur major costs, the employer's funds would quickly be drained, right? Wouldn't they have an incentive, then, to find some reason to terminate you???

[FloydTheBarber]

Originally Posted by AikenRooster2112

It's a question. In an HRA, the employer is providing the funds, right? If you meet your deductible, even if extremely high, and you incur major costs, the employer's funds would quickly be drained, right? Wouldn't they have an incentive, then, to find some reason to terminate you???

I have an HRA and believe once your deductible is met, then its the insurance company that is paying the 80% or however much you're not responsible for.

But even if it were the employer paying, I'm pretty sure it would be illegal for them to terminate you based on insurance claims

[AikenRooster2112]

Originally Posted by FloydTheBarber

I have an HRA and believe once your deductible is met, then its the insurance company that is paying the 80% or however much you're not responsible for.

But even if it were the employer paying, I'm pretty sure it would be illegal for them to terminate you based on insurance claims

I don't mean to sound like a douchebag, or insult your integrity, or be a smartass, but in the industry that I am in (trucking), the law is skirted all the time (hence the major uptick in enforcement in the last 5-6 years). I call it "the real world."

But, I think I am misunderstanding it, so I am back to researching it on the internet. I have to have something, even if it is high deductible.

[usc_yogi]

Y'all are making me very grateful for my State BC/BS health plan. It is one of the few benefits of being in the public sector.

[thekob]

Originally Posted by AikenRooster2112

I don't mean to sound like a douchebag, or insult your integrity, or be a smartass, but in the industry that I am in (trucking), the law is skirted all the time (hence the major uptick in enforcement in the last 5-6 years). I call it "the real world."

But, I think I am misunderstanding it, so I am back to researching it on the internet. I have to have something, even if it is high deductible.

Mission failed.

ususally high deductible plans come with a large flexible spending allowance. In the trucking industry however the benefits definitely aren't the best, especially with all the cuts in recent years.

Also, my wife works for the state (LLR) and her insurance is crappy...so crappy in fact that we're both on my insurance.

[FloydTheBarber]

Originally Posted by AikenRooster2112

I don't mean to sound like a douchebag, or insult your integrity, or be a smartass, but in the industry that I am in (trucking), the law is skirted all the time (hence the major uptick in enforcement in the last 5-6 years). I call it "the real world."

But, I think I am misunderstanding it, so I am back to researching it on the internet. I have to have something, even if it is high deductible.

Like I said- the HRA should be payig the amount the employee is not responsible for. That is what you an your employer pay premiums for. Premiums are not the same as costs of services. I have my HRA through UnitedHealth. I suggest you do what I did...call the insurance compan directly and ask them these questions about who is paying what (employer vs insurance company)

[FloydTheBarber]

Originally Posted by usc_yogi

Y'all are making me very grateful for my State BC/BS health plan. It is one of the few benefits of being in the public sector.

You're welcome for your subsidized insurance plan.

[gamecockphan]

Originally Posted by AikenRooster2112

A
Ugh, I need to get a job with a traditional insurance plan. High Deductible plans suck. It's going to be $99, per week, for me and my wife, plus $7000 deductible, with no co pays and no drug card. The HRA is even more, but the HR lady said it might be better if my wife goes to the doctor a lot. Gees, that's $12000, per year!

No political comments, please, so this can stay in his water cooler.

$400/month for employee spouse is very high for an HDHP. Ideally you would be paying significantly less for the HDHP, keep a few thousand more in your paycheck and squirrel some of the $ into the HAS which can be used as an investment tool as well.

Most folk (90% or so) never even hit a 3K deductable so and HDHP is very attractive if you do not have many medical expenses. Also - while copays are not part of an HDHP, on average people only see their PCP once a year, they see a specialists 1.5 times per year. So while you do not have a copay, you are not paying the rate a Dr would charge to someone with no insurance – you are paying the contracted rate with the carrier which is 120ish for a PCP visit.

Sounds like your boss is screwing his employees on how much he is contributing. Also – the HDHP that you are currently covered under would likely not pass the test of the ACA. I’ve heard that the deductable for HDHPs will have to be not larger than 5K, possibly 3K for an individual.

Thing are only going to get worse for small to medium size businesses with 2014. Expect renewal increases of at least 25% on the open market. Also the ACA is doing away with the Risk Adjustment Factor (RAF) so even high performing groups will not be getting a break on their premiums.

Calling the ACA “healthcare reform” is not true. It is not reforming the system it is just providing benefits to everyone now. Cost is never addressed in the 2000+ pages of the law. Costs will only continue to rise while consumers pay more to subsidize those who previously did not have health care.

[AikenRooster2112]

Originally Posted by gamecockphan

$400/month for employee spouse is very high for an HDHP. Ideally you would be paying significantly less for the HDHP, keep a few thousand more in your paycheck and squirrel some of the $ into the HAS which can be used as an investment tool as well.

Most folk (90% or so) never even hit a 3K deductable so and HDHP is very attractive if you do not have many medical expenses. Also - while copays are not part of an HDHP, on average people only see their PCP once a year, they see a specialists 1.5 times per year. So while you do not have a copay, you are not paying the rate a Dr would charge to someone with no insurance – you are paying the contracted rate with the carrier which is 120ish for a PCP visit.

Sounds like your boss is screwing his employees on how much he is contributing. Also – the HDHP that you are currently covered under would likely not pass the test of the ACA. I’ve heard that the deductable for HDHPs will have to be not larger than 5K, possibly 3K for an individual.

Thing are only going to get worse for small to medium size businesses with 2014. Expect renewal increases of at least 25% on the open market. Also the ACA is doing away with the Risk Adjustment Factor (RAF) so even high performing groups will not be getting a break on their premiums.

Calling the ACA “healthcare reform” is not true. It is not reforming the system it is just providing benefits to everyone now. Cost is never addressed in the 2000+ pages of the law. Costs will only continue to rise while consumers pay more to subsidize those who previously did not have health care.

Yes, I know. That is why I am going to go with the HSA. Screw it. I have to have something, even if it is crap, because, when you're married, you have to have insurance because of your wife. So, it's $99, per week, just for the medical, and I am going to have them withhold another $100 for the HSA. I mean, if the deductible is $7000, might as well. There are no copays with this and there is no drug card until the deductible is met. We'll make it. At least we don't have kids and the land and trailer are paid for and the car is almost paid for. We'll cut off the DirecTV and cell phones if we have to.

[AikenRooster2112]

Originally Posted by thekob

Mission failed.

ususally high deductible plans come with a large flexible spending allowance. In the trucking industry however the benefits definitely aren't the best, especially with all the cuts in recent years.

Also, my wife works for the state (LLR) and her insurance is crappy...so crappy in fact that we're both on my insurance.

Sorry, didn't mean to be rude. Thanks for all of y'alls input, seriously. I am going with the HSA, because I have failed my wife by not having insurance the last few years and not getting a better job. It's a shame that $50,000 per year is not considered a good enough job anymore. I really don't know how people with kids and house payment make it. God bless.

[LegalCock]

Aiken, I'm not expert in this particular subject but I've done a teeny bit of employee benefits work and my understanding is that an HRA serves the same function as an HSA, but it really only for people who can't qualify for an HSA due to being covered by other insurance or having a taxable income exceeding the limit or the like. Most HDHP plans put some money into the HSA for you out of your premiums. What I've seen is half of the annual deductible. You may also contribute pre-tax funds to the HSA up to the annual limit which is $6,250 for a family plan if you're under 50 (add another grand if you're over 50). If your employer won't take them out on the front end for you then you can deduct them from your return (the withholding is better because these funds are exempt from employment taxes aas well as income tax).

The $7000 deductible would be very high, but I suppose could be offered as a legally permissible, albeit crappy, choice although make sure you (our your HR lady) are not confusing the maximum annual out of pocket with the deductible. That figure sounds more like it would be a maximum before the catastrophic insurance kicks in. The HSA is preferable to the HRA for most because if you fund it and don't spend it the money is in basically an IRA that you can use tax free for future medical expenses or for whatever you want once you reach retirement age (it would be subject to ordinary income tax like an IRA but no penalties). So basically you and/or your employer fund this account and you pay the first (usually) $3000 (whatever your deductible is) out of that account but it is alot better than no insurance because it is pre-tax money you are paying with and you're getting the rate negotiated by your insurance company for services. Your plan may also cover preventative stuff like physicals 100% on the first dollar, lots do and I think all will have to once the ACA ("Obamacare") goes into effect. Also you may be one of the people who will benefit from having access to the healthcare exchange so you can get some decent coverage, if your deductible is actually that high.

also, one more thing, if you had large medical expenses this year make sure to look into deducting those on your tax return with your return preparer. They have to be pretty large though before you get to deduct them which is another reason why using the HSA will be better for you.

[LegalCock]

Originally Posted by FloydTheBarber

You're welcome for your subsidized insurance plan.

You're welcome for his subsidized rate of labor.

[LeeSC]

Aiken,

Don't worry about the "getting fired for spending to much". Many traditional plans are either partially or completely self funded. This means that an employer will contract a company to administer their program and the employer will pay out the costs. Some are self funded to a certain level (say $100K) where the contracted company picks up after that.

Self funded programs are profitable to companies because they are not subject to State Insurance regulations.

[gamecockphan]

Originally Posted by AikenRooster2112

Yes, I know. That is why I am going to go with the HSA. Screw it. I have to have something, even if it is crap, because, when you're married, you have to have insurance because of your wife. So, it's $99, per week, just for the medical, and I am going to have them withhold another $100 for the HSA. I mean, if the deductible is $7000, might as well. There are no copays with this and there is no drug card until the deductible is met. We'll make it. At least we don't have kids and the land and trailer are paid for and the car is almost paid for. We'll cut off the DirecTV and cell phones if we have to.

Next year you will likely have the option of entering the federal exchange if you so choose.

[FloydTheBarber]

Originally Posted by LegalCock

You're welcome for his subsidized rate of labor.

Fail