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Health Insurance Help
Hopefully you ladies will be willing to share some information about your current health insurance.
DH and I own a small business. We have Medica Choice with a $15/co-pay for visits and 80/20. When we had Mollie our out of pocket was just over $1000 so great insurance coverage.
However, we are paying a tremendous amount for this great coverage. Up to this point, DH has been very generous and has covered 100% of the employees insurance. Due to the rising costs and decrease in sales, we are struggling to maintain this benefit. We have started having conversations as to what is fair. No matter what, this will be a very difficult conversation and we hope to have a sliding scale for increasing the employee contribution over time.
Our problem is we have no idea what is average. I understand it varies greatly based on the industry and size of the company.
If you would be willing to share, we would like to know the following:
- What kind of coverage do you have?
- What % of your insurance do you pay monthy?
- Is any of your DH or dependent paid for by the company? How much?
- An appr size of your company. Less than 10, 10-25, 25-50, 50-100, over 100 employeess
Thanks for your help!
Re: Health Insurance Help
I just got an updated packet of information at work, so I have all my info readily available!
I have Health Partners through the U of M (so ... huge number of employees).
I pay $36 per pay period for coverage, just for myself, which is roughly 14% of the total cost. Andy has health insurance through his employer.
If I wanted to cover myself & Andy under my plan, I would pay $106 per pay period, which would be roughly 19% of the total cost.
If we had kids, and I wanted to cover myself, Andy, & our kids under my plan, I would pay $136 per pay period, which would be roughly 18% of the total cost.
Under my plan, I have no deductible.
My coverage is 100% after any co-pays.
I have no co-pay for hospital care, preventative care, lab work/diagnostic imaging, or outpatient surgery.
I have a $5 co-pay for walk-in clinics.
I have an $11 co-pay for urgent care, physician visits (other than preventative care), mental health visits, chemical dependency visits, physical therapy, speech therapy, occupational therapy, and home health care.
I have an $8 co-pay for prescriptions (generic drugs), and $25 for fomulatory drugs (brand name).
My out-of-pocket maximum is $2500 per year (would be $4000 for a family).
Does that answer everything?
Mr. Sammy Dog
jack | born 9.13.12 at 40w4d | 9 lbs 12 oz | 23 in
my puppy loves - chloe & jenson
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We have Health Partners. It's open access (no referrals needed for most things), they cover 100% and $20 copay.
We pay 25% of the premium, the county picks up the remainder. This is for family coverage for DH and I. The choices are either single or family, there's not a +1 or anything.
I work for a nothern suburb county so the policy is for 1000+ employees.
I also know about Andy's coverage since he recently had a broken leg and we've been through all the insurance stuff.
He pays 25% of the cost of his insurance. He has a $750 deductible, and 80% coverage after the deductible, up to the out-of-pocket max which is $3500 for an individual. 100% coverage after that. He's at a big company (thousands of employees).
Mr. Sammy Dog
- What kind of coverage do you have? Covered under DH's employer
Blue Cross PPO
$25 office copay, $50- specialty co-pay (which I can't figure out what it is), $250 inpatient hospital copay, $75 ER copay
deductibles: in network is $150 individual /$450 family, out of network is $300/$900
out of pocket max $1250/$3750 for in network, $2500/$7500 for out of network
- What % of your insurance do you pay monthy? I want to say around half or a little less but I can't remember the exact % off the top of my head.
- Is any of your DH or dependent paid for by the company? How much? DH's company pays the same amount for every family member.
- An appr size of your company. Less than 10, 10-25, 25-50, 50-100, over 100 employees. Very large - I thought DH said once that it was around 2000 employees and it's a national company.
Just a thought, and maybe this is obvious or you already do it, but most companies we've worked at offer at least 3 plans with various levels of coverage/costs so the employees can pick.
Tired after a long morning of hiking and swimming.
What kind of coverrage do you have? United Health Care 1500 High Deductible
What % of your insurance do you pay monthly? I don't know about percentage but I pay $50 a month for my coverage
For my spouse, I pay $115 a month. I know our company contributes 50% toward the premiums for spouse and dependents
Size of your company? 30 poeple
Ditto PP about the U. I work for the U of M, but I have their base (i.e. cheapest) health plan. You can view all of their information online at http://www1.umn.edu/ohr/benefits/index.html
The total rates (employer paid and employee contribution) are located at: http://www1.umn.edu/ohr/benefits/medical/rates/index.html and you can see what that all covers at:
http://www1.umn.edu/ohr/prod/groups/ohr/@pub/@ohr/documents/asset/ohr_52697.pdf.
To answer your questions quickly though, I cover both H and myself (no kids yet) on my insurance. I pay $81.60/paycheck (biweekly) of the total $543.70/paycheck. That puts me at about 15% of the costs.
We have a $11 copay on pretty much everything, except preventative care (annuals, etc.) H recently had hernia surgery, which was covered 100%. We have kind of a reverse deductible. Our benefits kick in immediately, but if we manage to hit our deductible, then we get fullll coverage (no copay? I don't know. We've never paid that much before.)
I should note, that my dental is in addition to this, but it's pretty cheap ($5/month?)
Eat.Drink.BeMarried. Blog.
my read shelf:
Thanks for the feedback everyone! We only have 7 people on our policy so my understanding is we cannot have multiple plans/options.
In my small employer (10 of us) he paid for solo coverage up to X dollars, so I know our 60 yr old employee had to pay more because she was wildly expensive.
20% is an extremely common % employees pay towards their coverage. The question for you as a biz owner is how much "risk" do your employees want vs less cash in their paycheck. You could have a pretty high deductible which makes the monthly payments a lot less.
Keep in mind if anyone is married and has other coverage possibilities, a "change of benefits" should legally let them go to their spouses plan (though you'd want to confirm that.)
Private insurance sucks. We pay over $600/month for two plans, one is a 5K deductible, the other is 6K deductible. So basically we pay $600/month for *nothing* except if we had a catastrophe, we'd only be out 11K.
If I were you I'd go to your insurance broker, run a bunch of numbers (you guys are also very vulnerable to the ages of your employees, though with the health care reform that is going to change/improve) so with some actuarial numbers you may be able to settle on two potential options and present those to your employees....... (tho that makes it seem like they have a say in the matter and your different age/lifestyle/health situations are going to make them answer for their own self-interest.)
Good luck! You may want to play with screwing them on health but adding life insurance or STD or something.