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It’s very hard to do the math here. It’s largely invisible to me how much my employer is paying in health insurance premiums and it’s unknown that they will ad

It’s very hard to do the math here. It’s largely invisible to me how much my employer is paying in health insurance premiums and it’s unknown that they will add that sum to my salary.

jjoonathan 5y ago
Which is why it's important to structure the "tax" to land in exactly the same place that health care costs land.
- lukemercado 5y ago
  Yes, at first that is SUPER important, but wouldn't you ultimately want to fully decouple it from employers and just go to income taxes per individual for it? The distinction is subtle, but in my mind having it structured as an individual paid income tax would yield better results for edge cases and not incentivize bad corporate behavior like running 1099 contractors instead of FTEs.
coderintherye 5y ago
It's not invisible at all, what your employer pays for your health insurance is clearly stated on your W-2 in Box 12 unless you work for an exempt company. https://www.irs.gov/affordable-care-act/form-w-2-reporting-of-employer-sponsored-health-coverage https://www.irs.gov/affordable-care-act/form-w-2-reporting-o...
thrwn_frthr_awy 5y ago
I'm not sure either, but during my time at Apple (one the richest and most advanced companies in the world) an additional $5-$6k was taken out of my paycheck if I wanted health care for me and my family. It's not like health care is automatically free for the working population.
thatfrenchguy 5y ago
Your employer is required to tell you the value of the benefit, you can notably find it in the imputed income sheet for unmarried folks.
onphonenow 5y ago
I've got access to employer numbers. Grandfathered plans are an absolutely screaming deal. You can do an HSA plan with a $2000 deductible and low OOP max, fully fund the HSA ($7,200) and come out way ahead at modest cost. This let's you do things like vision / dental / chiro / accu / whatever day to day stuff on the HSA, then keep costs controlled (after 2K) for a major issue. If you don't end up using the HSA you can basically use it in retirement. The obamacare bronze HSA plans (which actually cost a bit more) have a $4,800 ind deductible and something like a $13K (!!) out of pocket max and something like a $9K+ family deductible limit. And they cost more. This is totally unworkable absent the subsidies. I like obamacare, but something happened as part of obamacare that has CLEARLY driven up costs. Is it the lack of limits (ie, $10M in coverage during last weeks of life?) Is it some sort of other mandate? One area where govt care is better priced is for the elderly. The grandfathered / free market type plans get expensive at 60 years +. The obamacare plans are more of deal here (relatively). At the 20 year old range obamacare is horrible for the coverage if you actually have to pay for them.
- oxymoran 5y ago
  It’s the preexisting injury part that jacked up the prices. They aren’t allowed to deny enrollment or charge significantly higher premiums if some was has cancer or something. And that totally makes sense morally, but that causes the risk burden to be offset on the aggregate of the subscribers resulting in higher premiums for everyone. It would be kind of similar to forcing auto insurance carriers to afford coverage to cars they didn’t previously insure after they had already been in an accident.
  - onphonenow 5y ago
    I've NEVER seen an employee denied (or asked) about their medical conditions ever. The enrollment paperwork to the carrier is like basic address / name / effective date for coverage. That is it.
    - PopAlongKid 5y ago
      And before ACA, the prospective employee would normally have to show evidence of continuous creditable coverage before being added to the new employer group plan. This is how pre-existing conditions were handled - if you had always had coverage, OK, but if you went uninsured for a while and then tried to re-join a group, tough luck.
deleted 5y ago
[deleted]
commandlinefan 5y ago
> it’s unknown that they will add that sum to my salary I'm pretty sure I do know the answer to that question...
sam0x17 5y ago
At most startups it's about $1.3k for self + one.
professoretc 5y ago
> it’s unknown that they will add that sum to my salary. Well, if they didn't, you could just change jobs. The old benefit of working for an employer that paid all of your premium would be gone, so that wouldn't be a reason to stick with them.

It’s very hard to do the math here. It’s largely invisible to me how much my employer is paying in health insurance premiums and it’s unknown that they will add that sum to my salary.

jjoonathan 5y ago

Which is why it's important to structure the "tax" to land in exactly the same place that health care costs land.

lukemercado 5y ago
Yes, at first that is SUPER important, but wouldn't you ultimately want to fully decouple it from employers and just go to income taxes per individual for it? The distinction is subtle, but in my mind having it structured as an individual paid income tax would yield better results for edge cases and not incentivize bad corporate behavior like running 1099 contractors instead of FTEs.

coderintherye 5y ago

It's not invisible at all, what your employer pays for your health insurance is clearly stated on your W-2 in Box 12 unless you work for an exempt company. https://www.irs.gov/affordable-care-act/form-w-2-reporting-of-employer-sponsored-health-coverage https://www.irs.gov/affordable-care-act/form-w-2-reporting-o...

thrwn_frthr_awy 5y ago

I'm not sure either, but during my time at Apple (one the richest and most advanced companies in the world) an additional $5-$6k was taken out of my paycheck if I wanted health care for me and my family. It's not like health care is automatically free for the working population.

thatfrenchguy 5y ago

Your employer is required to tell you the value of the benefit, you can notably find it in the imputed income sheet for unmarried folks.

onphonenow 5y ago

I've got access to employer numbers. Grandfathered plans are an absolutely screaming deal. You can do an HSA plan with a $2000 deductible and low OOP max, fully fund the HSA ($7,200) and come out way ahead at modest cost. This let's you do things like vision / dental / chiro / accu / whatever day to day stuff on the HSA, then keep costs controlled (after 2K) for a major issue. If you don't end up using the HSA you can basically use it in retirement. The obamacare bronze HSA plans (which actually cost a bit more) have a $4,800 ind deductible and something like a $13K (!!) out of pocket max and something like a $9K+ family deductible limit. And they cost more. This is totally unworkable absent the subsidies. I like obamacare, but something happened as part of obamacare that has CLEARLY driven up costs. Is it the lack of limits (ie, $10M in coverage during last weeks of life?) Is it some sort of other mandate? One area where govt care is better priced is for the elderly. The grandfathered / free market type plans get expensive at 60 years +. The obamacare plans are more of deal here (relatively). At the 20 year old range obamacare is horrible for the coverage if you actually have to pay for them.

oxymoran 5y ago
It’s the preexisting injury part that jacked up the prices. They aren’t allowed to deny enrollment or charge significantly higher premiums if some was has cancer or something. And that totally makes sense morally, but that causes the risk burden to be offset on the aggregate of the subscribers resulting in higher premiums for everyone. It would be kind of similar to forcing auto insurance carriers to afford coverage to cars they didn’t previously insure after they had already been in an accident.
- onphonenow 5y ago
  I've NEVER seen an employee denied (or asked) about their medical conditions ever. The enrollment paperwork to the carrier is like basic address / name / effective date for coverage. That is it.
  - PopAlongKid 5y ago
    And before ACA, the prospective employee would normally have to show evidence of continuous creditable coverage before being added to the new employer group plan. This is how pre-existing conditions were handled - if you had always had coverage, OK, but if you went uninsured for a while and then tried to re-join a group, tough luck.

deleted 5y ago

[deleted]

commandlinefan 5y ago

> it’s unknown that they will add that sum to my salary I'm pretty sure I do know the answer to that question...

sam0x17 5y ago

At most startups it's about $1.3k for self + one.

professoretc 5y ago

> it’s unknown that they will add that sum to my salary. Well, if they didn't, you could just change jobs. The old benefit of working for an employer that paid all of your premium would be gone, so that wouldn't be a reason to stick with them.