My health insurance renewal

Jewelry Discussion
1

Health Insurance

Just wanted to share my experience this week with MY renewal of our
health insurance policy and three things I learned from it.

For about the past 10 years Renie and I have been insured with Blue
Cross/Blue Shield and have been pretty happy with the coverage and
very happy with the service. They’ve covered huge amounts of pay outs
as 4 years ago I had tonsil cancer and this year Renie went through
breast cancer (we’re both fine now).

Each year our premiums keep going up and it has nothing to do with
our health; costs are spread out amongst the masses. But a 15-24%
increase is typical each year. Our renewal comes this October.

Our daughter is 28 and works and lives on her own, we only cover
ourselves. This year we have been paying $1784 a month with a $3000
deductable for each one of us. After the deductable is met there is a
70/30 split between us and the insurance company until we have spent
another $2000 out of pocket. Then they pay everything.

Because of our cancers we both get doctor visits 3-5 times a year
each along with CT scans. So we have both exceeded and paid out our
deductable as well. Add up the insurance premiums along with paying
out the deductibles this year we will have spent easily $27,408.00,
if not more.

Our renewal letter came yesterday, going up to $2099 a month. A 15%
increase.

A few years ago our policy was going to increase to almost $2400 a
month so I called and asked “What can we do to lower our increase?”

I’m glad I asked because you’ll be amazed at what you’ll find.

There are many plans to choose from and the rep on the phone told me
this:

“You’re on a very old plan and there are less people staying on that
plan. Because there are fewer people on the plan each member pays a
higher percentage of everyone’s costs. You should switch.”

We had to accept a slightly higher deducible and switching lowered
our monthly premium rather than increasing it.

REVELATION #1

Lesson learned, when you get your renewal letter call and ask that
question.

That was maybe 4-5 years ago. So I called again yesterday for my new
increase letter-going to $2099 per month for 2 people. I asked the
same question and again got a great answer.

“What can I do to lower my increase?”

The rep at Blue Cross told me

“You have a family plan. It covers you and your wife and also if you
had a bunch of kids at home and their costs. We now offer a
husband/wife plan that will save you money.”

That made a lot of sense. The old plan could pay for 10 people and
the new one will only pay for 2. Years ago we got the family plan
because our daughter was in school and when I asked to drop our
daughter how much would it save they said nothing. We also looked
into a company plan (JewelerProfit is a C Corporation) and that was
even more money than a family plan!

So now with the husband/wife plan we will have to accept a $500
higher deductable each ($3500) and it will only pay for generic drug
prescriptions. Without giving you detail by detail it has some better
coverage’s in some areas and will costs us more some doctor
visits-after the first 3, our old plan paid for 6.

Cost of health insurance next year for us?

Instead of $2099 a month it will be $1428 a month. A saving of $671
a month.

There was a paper included in with the increase plan describing
“grand fathering”. I asked the rep at Blue Cross about grand
fathering and this is what she told me:

"The new health care law starts in 2014. If you do not change your
plan now and stick with it then when the new health care law comes
into effect in 2014 you can choose to keep some aspect of your plan
if you like it better than what the new health care law offers.

But if you change your plan as you are considering then grand
fathering isn’t guaranteed for you. This means that when the health
care law take effect you will have to accept policy changes as
mandated by the new law."

So I asked her this question:

“OK, can you tell me what parts will be better and which will be
worse for me if I stay or change my policy?”

REVELATION #2

The front line people don’t know yet. I’m sure the underwriting
staff knows but remember when the law was passed the House Speaker
said “you’ll have to read it to find out what’s in it.”

The end result is we’ll be changing our policy to save almost $700 a
month.

REVELATION #3

You should ask the question about what else your insurance company
offers each year.

I do recommend Blue Cross/Blue Shield. Many jewelers on Polygon.net
keep asking if there is an association you can join to help all of us
save money on health insurance. I haven’t seen that there is one. Its
not the same as “15 minutes will save you 15% or more”.

But I will tell you the only time I saved on health insurance was
when I had my store with 16 employees.

We changed from having our own payroll done in house and went with
an outside payroll service. In fact it was much different than a
payroll service.

We went with Employee Leasing.

With Employee Leasing you actually give all of the employees away
and the leasing company takes them from you (stop getting excited!).
Then similar to a temporary staffing service you lease them back. So
if an employee’s gross pay is $500 a week the leasing service charges
you:

. $500 for the employee

. Plus the matching taxes

. Plus any benefits you give them (matching retirement, etc)

. Plus the health insurance they provide for your company and each
employee

. Plus they pay all of your taxes for you and take out of your
checking account one fell swoop all costs for payroll as described
above.

. Plus they file all forms.

. Plus a small monthly fee for their service.

That’s a lot of headache removed from your shoulders. Why did I do
it? Because all of the employees including myself no longer worked
for Jewelry Artisans but rather for this huge company with “25,000
employees” and our health insurance premiums dropped dramatically.

I’m not up on the latest on employee leasing but you could check
that out.

REVELATION #4

Check out employee leasing options or even just see if a large
payroll company like ADP or Paychex can make your life easier for
payroll and save you money on health insurance.

So start now and be proactive.

Sincerely
David Geller
www.JewelerProfit.com

2

Another good option for people who are living in the US, self
employed, not in a group and have pre-existing health conditions
that make health insurance very expensive or impossible to get is to
check to see if your state has chosen to offer HIRSP (Health
Insurance Risk Sharing Plan). It’s a high risk coverage pool. In my
state (Wisconsin), it’s been in place for 30 years. I’m not sure of
your age David, but I think it may be much cheaper than the plan
you’re in. It’s something to be aware of anyway. Mark

3

And people say I’m gambling by not having any health insurance!
Last year I needed EMT’s and spent $2400. I take a certain
medication that costs me $35 per quarter. I never go to the doctor
unless I can’t fix what’s wrong myself.

Oh and I always remember that damned near everyone dies before they
reach 100.

4 
Another good option for people who are living in the US, self
employed, not in a group

There may be group coverage available from other sources, as well.
Many professional organizations have plans. Also, check out the local
Chamber of Commerce - when I was in Rochester, NY, they had a group
insurance plan for members.

Al Balmer
Pine City, NY

5

David, thanks for sharing all of this detailed Really
helpful.

I have been self insured for a long time, too and it is exorbitant!
Several years ago I switched to a health savings account plan with
BCBS which also has a very high deductible. Not sure if you have
that, too. The advantage to a HSA is that I pay my deductible out of
PRE-tax dollars. I also can use PRE-tax dollars for dental, vision,
acupuncture, etc. I can put up t 4000 dollars (think that is correct
amount) into this account per year and can add the money as I need
it throughout the year. It is a medical savings account basically. I
have a debit/credit card that I use from that account to pay for any
medical related expenses. I can also decide to put in the maximum
amount each year and then keep accruing the money. My understanding
is that once I am eligible for Medicare, then I can use any money in
this HSA towards medical expenses that Medicare doesn’t cover but
can not keep contributing to the HSA after 65.

Some companies offer HSA plans to their employees, too.

When renewal time occurs for BCBS in our area, there is a chart that
I can look at to see the various options and then try to figure out
what plan makes the most sense.

Hope this is helpful to some folks. It is such a maize to figure it
all out and outrageous that one should have to pay so much for
health care!!! I hope that the health care plan is maintained and
that it gives us more affordable options.

6 
And people say *I'm* gambling by not having *any* health
insurance!

It is quite a gamble to be without health insurance. I wish you
continued good health.

I took that gamble for a few years, and was very lucky that I got
smart before the odds went against me.

7

If I had gambled, Holly Cow!

I KNOW my insurance company paid over $150,000 for my tonsil
treatment.

My wife’s breast cancer cost them $15,000 to $25,000 SO FAR. Every
CT scan costs $1850, I know because until I reached my $3000
deducible I had to pay the whole thing.

David Geller