7 ms·

You can’t change insurers without changing jobs. The “private market” doesn’t exist because there’s no way to access the premium your employer pays for you to t

You can’t change insurers without changing jobs. The “private market” doesn’t exist because there’s no way to access the premium your employer pays for you to take it somewhere else, and even if you could you have to wait for open enrollment. No such window exists for cost increases in health plans.

lotsofpulp 1y ago
You can go to healthcare.gov and pick the same plans, many millions of people do it and price shop every year. You can tell your employer you don’t want to pay for the employer subsidized plan, but then you lose access to the employer subsidy and ability to pay premiums with pre tax income.
- throwaway173738 1y ago
  My employer subsidizes my plan to the tune of 2/3 of the list price. Are you seriously suggesting I should pay 3x as much so I can shop around? This is by law too that they have to offer insurance.
- supertrope 1y ago
  Paying 25K a year in health insurance premiums instead of 2.5K is not a realistic choice for most people. That employer subsidy is a massive difference.
- dml2135 1y ago
  They are not the same plans. Most employer plans are not available to the individual market. The marketplace plans often have vastly reduced networks, higher premiums, higher deductibles, etc.
  - lotsofpulp 1y ago
    Most are, as ACA compliant plans have metal levels that are based on the expected annual costs that the plan covers. A silver plan an employer subsidizes is similar to a silver plan from healthcare.gov (expect plan to pay 70% and insured to pay 30%). https://www.healthcare.gov/choose-a-plan/plans-categories/ https://www.healthcare.gov/choose-a-plan/plans-categories/
    - dml2135 1y ago
      But that means nothing if you can't find a doctor -- these plans have paltry networks. They are better than nothing if you qualify for a subsidy, but if you don't and you live in a HCOL area (which the subsidies are not adjusted for) you are pretty much screwed.
      - lotsofpulp 1y ago
        They sell the same networks in my experience (west and northeast coast). The MCOs are not carving out different networks for specific employers. You buy a bronze PPO from United Health directly, or your employer does, it’s going to be all the same providers. If you get gold, then the deductibles/copay will be less. The networks used to be different when HMOs were in vogue, but if your employer is only giving you an HMO option, you need to find a different employer. PPOs are the only sensible option (except maybe Kaiser on the west coast, but even they sell PPOs, just costs more to see a non Kaiser provider).
        dml2135 1y ago
        This was not my experience on the NY exchange but that was several years ago at this point. So I guess it's possible that things improved.

lotsofpulp 1y ago

You can go to healthcare.gov and pick the same plans, many millions of people do it and price shop every year. You can tell your employer you don’t want to pay for the employer subsidized plan, but then you lose access to the employer subsidy and ability to pay premiums with pre tax income.

throwaway173738 1y ago
My employer subsidizes my plan to the tune of 2/3 of the list price. Are you seriously suggesting I should pay 3x as much so I can shop around? This is by law too that they have to offer insurance.
supertrope 1y ago
Paying 25K a year in health insurance premiums instead of 2.5K is not a realistic choice for most people. That employer subsidy is a massive difference.
dml2135 1y ago
They are not the same plans. Most employer plans are not available to the individual market. The marketplace plans often have vastly reduced networks, higher premiums, higher deductibles, etc.
- lotsofpulp 1y ago
  Most are, as ACA compliant plans have metal levels that are based on the expected annual costs that the plan covers. A silver plan an employer subsidizes is similar to a silver plan from healthcare.gov (expect plan to pay 70% and insured to pay 30%). https://www.healthcare.gov/choose-a-plan/plans-categories/ https://www.healthcare.gov/choose-a-plan/plans-categories/
  - dml2135 1y ago
    But that means nothing if you can't find a doctor -- these plans have paltry networks. They are better than nothing if you qualify for a subsidy, but if you don't and you live in a HCOL area (which the subsidies are not adjusted for) you are pretty much screwed.
    - lotsofpulp 1y ago
      They sell the same networks in my experience (west and northeast coast). The MCOs are not carving out different networks for specific employers. You buy a bronze PPO from United Health directly, or your employer does, it’s going to be all the same providers. If you get gold, then the deductibles/copay will be less. The networks used to be different when HMOs were in vogue, but if your employer is only giving you an HMO option, you need to find a different employer. PPOs are the only sensible option (except maybe Kaiser on the west coast, but even they sell PPOs, just costs more to see a non Kaiser provider).
      - dml2135 1y ago
        This was not my experience on the NY exchange but that was several years ago at this point. So I guess it's possible that things improved.