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> I now pay $120 for me and my wife for a plan that is better than the $1000 plan through the ACA in Oregon because I'm no longer self employed. Look at box 12
by lotsofpulp 2y ago
> I now pay $120 for me and my wife for a plan that is better than the $1000 plan through the ACA in Oregon because I'm no longer self employed.
Look at box 12 code DD on your W-2. That is the total amount you are paying for your health insurance (it’s just that your employer is paying it directly). It’s still counted in the cost of employing you though, obviously.
Assuming you have a silver or gold level plan, total cost to insure you and your wife is the same on healthcare.gov or if your employer buys it.
The only broad savings are if your employer is self insuring and their risk pool (employees and their families) are disproportionately low risk (young and single).
- demondemidi 2y agoIt is much lower than what I would pay on ACA.
- lotsofpulp 2y agoI wonder if your employer sponsored plan is not ACA compliant. Health insurance has a 2% profit margin, and premiums are tightly regulated by state insurance commissioners. So a wildly different premium indicates a change in coverage, or a change in the underlying risk pool. For an annual out of pocket maximum of $10k to $18k and age rating factors capping age 64 premiums to 3x age 21, the minimum bronze/silver monthly premium should be somewhere in the ~$400 to $1,200 depending on age. For example, see NJ’s premiums here: https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates2024.pdf https://www.nj.gov/dobi/division_insurance/ihcseh/ihcrates20...
- demondemidi 2y agoThis is very informative. I am investigating. Thank you!
- demondemidi 2y agoYou're probably not reading this, but I didn't include what I pay out of pocket to 12d DD ... turns out it is MORE than than the most expensive ACA plan, but I have way more coverage at my job. E.g., I can go out of network, where the ACA plans do not allow that; and the deductibles are less than 1/3 of the lowest deductibles on the ACA. Thanks for that nudge. Where did you get that 2% profit thing? I've been googling for that too and insurance profits and all I can find is that ACA only allows 20% admin costs. Non ACA plans indicate that their profit is ~15-20% of their revenue.
- lotsofpulp 2y agoSearch UNH/Elevance/CVS/Cigna/Humama/Molina/Centene profit margins on macrotrends. These are all publicly listed health insurers, so all their financials are public. It is not a very profitable business, as pretty much all insurance business.
- deleted 2y ago[deleted]