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Would speak with your company's HR group to nail down what the premiums actually are, and whether you have another option (e.g., HMO) that is available to you. Normally employees see what premiums they'll pay before they sign up for a given plan.
I plan on it, and yeah there are other options but I’ve always had ppo’s. Yes they’re expensive but at 2K a month! I never would have thought. Now I have to look at their high deductible combined with hsa. This is just a nightmare!
Do they pay for any of it? My employer pays 3/4 of my family plan but I’m still at like $300 a paycheck. So the normal cost would be like $2,400 a month if I had to pay the whole thing. If they don’t subsidize your insurance in any way, find out if maybe you can waive it and pick up some cheaper insurance on the healthcare marketplace thing
I BELIEVE but I could be wrong, if your employer OFFERS health insurance it makes you ineligible for the marketplace. At least that is what my employer told me
Well of course they would say that lol as far as I know you can but you won’t get any discounts or anything. For OP, it might benefit them to look into it for cheaper options anyway.
This is the case and anyone can prove it by going to the [https://www.healthcare.gov/get-coverage/](https://www.healthcare.gov/get-coverage/)
answer the questions and you can go from there. It might be helpful if your employer doesn't offer a plan you like or isn't paying much into that plan. I do this every year for shits and giggles. Health Insurance is just costly in the USA unfortunately.
It depends on if what they offer is considered affordable or not. If it costs more than 9.61% of your household income you are allowed to shop the marketplace. Additionally, this is a huge pain for your employer; it's supposed to incentivize offing affordable work insurance.
Note, this is for the marketplace subsidies. There's never anything stopping you from buying private insurance yourself except the price.
I’m not sure if it varies by state, but at least where I am, it makes you ineligible for *subsidies* but not marketplace plans in general. I’m not sure about family rates, but the marketplace plan Im eyeing for when I turn 26 with BCBS has pretty good coverage and is cheaper than OPs individual rate
It depends how much you make and how much the offered plan costs. If it is over like 9 point something % of your income you are still eligible for subsidies if you turn it down.
Yeah, it has to be considered affordable and meet some other minimum requirements. The problem for OP is that its the cheapest priced individual plan that has to fall under the 9.61% threshold. I did actually just do the math out (I hadn't before) and using the $192/biweekly number OP gave for an individual plan, if they're making less than about $52k/year its not affordable which is definitely possible
A family of 4 with both adults making 13/hour will put gross income above 60K. I read some comments saying there are ways to calculate higher income people to bring gross income down greatly. I’m afraid I’m not that savvy.
If the health insurance offered is less than a percentage of your salary that s true but I've absolutely been on the ACA before with an employer who offered a plan but contributed nothing making the monthly premium unfeasible. I had to prove it in writing to the ACA people but I was approved to use the ACA with subsidies.
Mines $15 per hour. Which equates to 2400 per month pretty much. But it's a good plan where I don't pay any copays or deductibles, ppo and does everything (dental, eye, mental, etc). If you have a high deductible included with that amount, you're really paying too much.
A while back my wife was offered a job through a past coworker who had moved on to a new company and they were desperately hiring. The family plan insurance for us would have been close to that amount - BCBS also. The catch was that it was a small employer so there was no helping it. They were offering a substantial raise in pay versus her current job at the time, but when you considered this insurance - it was barely any more than what she was already making. So she turned down the job solely because of the insurance plan.
I'm not saying quit this job, but just be on the lookout in the future to get a count of all benefits before taking a position. Your employment offer is a package deal.
There's an affordability calculator that you can use to see if you can opt out of employer coverage and use marketplace coverage instead.
Last time I looked for California, your premium had to be over 8% of your income, but it was a little complicated so I might be wrong about the assessment.
affordability test for employer-sponsored coverage applies only to the amount you’d have to pay to insure just yourself under your employer’s plan. If that amount is less than 9.61% of your 2022 household income, you’re not eligible for a premium subsidy in the exchange, and neither are your family members if they’re allowed to enroll in your employer’s plan, regardless of how much it would cost to actually enroll them in your employer’s plan. This is known as the ACA’s “family glitch,”
My husband has insurance paid for 100% by his employer and my son and I can be added to his policy, but they do not cover any of that cost. It would have been about $1200 a month to add my son and I to his policy. We were able to sign up for plans through MNSure - Minnesota created their own website for ACA plans. And I found a great plan and the cost is $580 a month for both of us. And we do not qualify for any type of subsidy like you said. It is still absolutely worth looking at healthcare.gov or your state’s website for ACA plans. Even without the subsidy it will save you money.
Hi, fellow Minnesotan. I'm in the same situation, which is called the "family glitch" of the ACA. It was unintended, but it hurts nevertheless. Al Franken was working on it before he resigned from the Senate. Rep. Angie Craig is trying to get a bill together to address this, but I'm not optimistic.
Fair. I guess it's hard to know intent.
But most of these hundred- or thousand-page bills (ACA was more than 900) are not nearly as vetted as they should. My understanding is that this was a legit oops that negatively affected about 1 million families, a small number in the grand scheme, but a huge impact on those families.
What state are you in? What is your family size? You may qualify for Medicaid or at least your dependents may qualify. You qualify based on your adjusted gross income, which means you can deduct the 23k annual premium from your income for eligibility. Medicaid may reimburse you for your premium costs or part of it if they deem your plan cost effective.
It’s important to note that the affordability test for employer-sponsored coverage applies only to the amount you’d have to pay to insure just yourself under your employer’s plan. If that amount is less than 9.61% of your 2022 household income, you’re not eligible for a premium subsidy in the exchange, and neither are your family members if they’re allowed to enroll in your employer’s plan, regardless of how much it would cost to actually enroll them in your employer’s plan. This is known as the ACA’s “family glitch,” and although some lawmakers — and countless consumer advocates — have proposed fixes, it’s still an issue for several million Americans.
I'm not talking about marketplace coverage, but Medicaid.
For instance, in Minnesota, dependents under age 18 qualify if the households adjusted gross income is under $85k for a family of five. Minnesota will then reimburse the policy holder the total premium amount for those dependents. So an employee paying 2k monthly might only have to pay $800 per month after reimbursement.
Remember, adjusted gross income can be reduced by health care premiums, 401k / IRA contributions, student loan interest and other things. So someone making 110k could in theory reduce their AGI below 85k to have their dependents on medicaid and reduce total monthly cost for the health care plan.
They won't qualify for tax credits since they could be on the employer plan. And straight up getting a plan will be just as expensive.
I pay $480 twice per month for myself and my spouse. 😕 It would have been $68 twice a month for just me.
It depends on your location and coverage pick. I’m in a HCOL city and picked a bronze plan to cover my four member family. It’s about $1150 per month without subsidy. It’s expensive but still less than $2k…
Right. That's applicable to OP's employee-enrollee premium alone. It doesn't matter how much more would be deducted from the employee's pockets of money to enroll non-employees in an employer-dependent health coverage scheme.
Mine is very similar - I go with the High Deductible, load up the HSA, and hope I don't need it any time soon. HSA's carry over and can be put into investment funds to (hopefully) cover future premiums or nursing homes.
It stinks, but of the bad options available, it was the best for my family.
It depends substantially on age. I deal with insurance for my employer. We use a high-end BCBS PPO. For example, these are our total premium costs in the Chicago metro region:
Child: $340/mo
25 year old: $450/mo
30 year old: $500/mo
40 year old: $600/mo
50 year old: $750/mo
60 year old: $1,200/mo
We pay 100% of the employee's cost, but we don't subsidize the family costs. So, I am on my employer's plan, but my wife and daughter use my wife's employer's plan because it subsidizes more of the child costs.
It certainly can be true. Health insurance in US is crazy expensive (especially if it is good insurance). Sounds like your employer doesn't contribute as much towards the premium as others do. Did you not ask for details on health insurance and other benefits before you accepted offer? You have to know these things ahead of time so you can factor into your compensation negotiations.
My current employer subsidizes the entirety of the premiums as a benefit. I want to go explore my options at other employers since my employer underpays but then they spend $20k+ on my family plan so maybe it's worth staying unless I can get a substantial raise.
Is asking about benefits as simple as just saying, "what are your benefits and premiums?" during an interview?
Basically yes it is that simple. Whenever the topic of pay comes up is the appropriate time to ask about benefits and employee cost. If they give you an actual offer I recommend asking for their latest open enrollment/benefits booklet/paperwork to review. Understanding the full compensation package including benefits (premiums, deductibles, etc) will allow you to make a better decision or counter offer. I would never accept an offer without knowing this info first.
Exactly, run fast and never look back. If they are willing to make you an offer but not willing to share their benefits information, they are not being transparent about what they are actually offering you.
Oftentimes, depending on who you are interviewing with and the size of the company, asking for this info will catch the HR rep or manager off guard because so few people actually ask for it. As such, they may have to reach out to someone internally to get the info for you. So if they don’t have it for you right away but they are willing to get it for you, that is fine. But if they flat out refuse to provide it, that would be a hard pass for me.
Whenever I get an offer I always ask to see their health plans. Do you have a spouse and kids? If so 944 for the PPO doesn’t surprise me based on the individual cost, your company probably does not subsidize that much. That’s the kicker about family plans for kids, it’s the same whether you have one kid or six, so you subsidize the cost of families with a lot of kids
It's not uncommon for employers to subsidize nearly all of the individual plan, but to have employees pay 100% of the cost to add any dependents. There are likely better deals to be had for your spouse through their own job, and for your kids via marketplace.
I'm surprised this isn't higher up. I'm job searching and the first two questions are:
1) What is the pay
2) What are all the benefits (in detail)
I pay \~$14,000/year for family coverage. A new position I'm looking at is only \~$8,000/year! that is a raise in an of itself!
I've seen this trend too, it seems like every year or two the premiums shift to make HDHP look more attractive.
One place I worked was transparent about these costs. They showed the employee + family top tier PPO rate was $2k/month cost, but employee portion was only $300/month.
5 years later family rate for PPO is now $700, while HDHP is $400.
Sometimes the employer might generally offer HMO at a good price and then PPO as the premium but way more expensive option. What else does the company offer. Are you getting good salary? 401k package? Jusy Because the cost of PPO is high doesn’t mean the company is shit. It is one of many potential factors.
Based on your update that most of this cost ($700 of it) is for your family I would look at the cost of insuring your family on the ACA marketplace, and yourself on the employer’s plan.
This sounds completely "normal" for a low deductible PPO family plan if the company pays zero percent.
At my small company once the healthcare marketplace came online we stopped offering health plans altogether so our people could go to the marketplace. We just gave everyone a big raise across the board equivalent to the average we were paying per month in health insurance premiums. Everyone was very happy with this arrangement.
I haven't had a PPO in years. The premiums are usually more than the out of pocket max of the hdhp option.
OP, you're probably locked into this until open enrollment though.
>the family ppo rate at $944
>The ppo plan for only me is $192/biweekly
It really sounds like this employer doesn't want to be in the health insurance buying/re-selling business for non-employees.
I agree. I just retired from a small company of about 15 employees. My employer was able to get group rates through a health care consulting company. The plan was pretty good with a $1,500 deductible. After retiring (not age 65 yet), the best I could do on the Govt Marketplace for about the same premium amount was a $6,000 deductible plan. Employers have leverage in the market, even a small employer. One nice thing was getting the ACA subsidy to cover about half of my premium.
Yeah the company has links to affordable care act .gov so I think this has been an issue before. This is only my first day working on enrollment so I will definitely spend a lot more time and research.
Go with the high deductible plan. The HSA follows you when you leave and has yearly tax advantages. High deductible plans usually cover things like yearly physicals in full, you just have to call the doctor's office and schedule an "annual well visit" specifically so the office doesn't screw you over.
Those premiums sound right for an employee plus family PPO. If you want to pay $20 per visit you gotta pony up for the premiums.
Is your company fairly large? I’ve noticed many large globals are going to self insured where companies use an insurance company like bcbs to administer the plan but all costs are actually paid by the employer. I don’t know if there’s any way to know as an employee, I just know because I work with our finance group and both my abs my wife’s employers offer pretty much the exact same 4 plans, same cost and coverage but different insurance providers so I assume her company is also now self insured. In the past, both these employers offered low cost PPO plans but that ended almost a decade ago.
There is another reason to quit this employer. This employer is terrible at managing money. They are making the employees pay for health insurance with after tax dollars whereas they could have paid it with pre tax dollars (as a business expense) and just lowered the salary proportionately. Run away from this dumb asses.
This happened to my husband in 2020. He’d been at the same company for 17 years with excellent benefits and didn’t really know what bad benefits are, so when he asked a new job about benefits and was told “they are really good” he believed him. When we saw the benefits he should have known right then that his boss was a massive asshole lol.
Anyways he just started at a new job with nearly 90% more pay AND they have a no cost medical option for family.
If I was you, I’d start applying elsewhere immediately. He waited it out a year to see if it would get better, but it didn’t. They didn’t care about their employees at all.
I had this happen when I worked at a small startup. They covered me almost 100%, but my family was quoted at $2300/month!
I ended up getting my wife and son healthcare through the marketplace (healthcare.gov), even at full price (no subsidies) it was $650 vs. $2300. I used my work's insurance for just me. The only downside was that my family OOP was higher.
PPO plans can be very expensive and many employers don’t provide any meaningful subsidy to family coverage (the provider has nothing to do with it). Mine is around $24K/year between my contributions and what my employer pays so that tracks with your number.
It doesn’t help with your issue, but as a lesson for all, if you need anything other than coverage for yourself, always get details on the benefits before accepting a job. You can’t negotiate the rates, but an increase in base pay, a healthcare stipend, etc. might be on the table.
My company(CO based) the family PPO plan is almost 3k a month out of pocket....But the individual one on the same plan is 220 per month out of pocket. My employer doesn't pay anything towards dependents.
Family plans are expensive and it’s awful.
You can sign up for GoodRX gold and GoodRX care for Pennies on the dollar for regular doctor check-ups and visits. blood work, and medications. But it won’t protect your needs for surgeries or accidents at the hospital.
You can also ask your employer to cover more, they may be willing to do so. Not to ask for a raise in pay, but for them to help you pay for medical insurance (or more of it)
Why didn't you ask about benefits before accepting the job? It's part of your total compensation. Meaning you evaluate 401k match, benefit costs, fringe stuff like discounts, PTO, etc in addition to the pay rate.
I thought everyone did this....
This is a lesson I learned hard about 10 years ago. I quit a job for a 15K pay raise at another company but didn't take into account that the insurance went from $70 a week to $1400 a month. So now if I'm talking with a company about joining their team the first thing I ask for are hard numbers for their benefits.
Yep. It sucks. I have turned down a job before because of the medical costs similar to what you are paying. They wouldn't raise the salary to make up for it.
Current job I negotiated a bump in salary to make up for an increase in medical costs from my previous employer.
It can make a HUGE difference in your overall compensation. Always get the rates with the offer.
Can you take the insurance and move family to another plan?
We pay $25k a year for health insurance for 7 of us. The funny part is that that is insurance for an employee of a hospital. Our deductible is $4750. Then they cover 80% until we hit $12500 and they cover everything.
It sounds like there is a spousal surcharge on your insurance which is driving up cost. It's why I didn't add my wife to my insurance (and then she forgot to sign up for her employer sponsored insurance so that's another issue).
My insurance is $180/pay period for the kids and I and I'm using the high deductible plan (buttcheeks are clenched since I have two kids under 5) and the HSA. If I had added my wife, I would've been charged $430 per pay period due to the spousal surcharge.
Insurance is crazy expensive. Our office pays full premium for our employees as a perk with a $1k annual deductible through BCBS. However, we don't pay for family members' premiums.
Nope, seems quite typical, welcome to medical insurance in the USA.
Typically companies only cover your single insurance, and even then not always 100%. The single rate is likely far lower than half the family rate, I'd guess around $200-300 per paycheck. Most employers won't cover any of the portion to upgrade to a family plan, hence why they are more expensive. They are hiring you, not your family.
I've seen family plans go for over $1100-1300 in NYC, while a singles plan from the same company is like $300-400.
It's typically cheaper from my experience if you and your spouse each have a separate insurance plan from your own employer, than have a family plan under just 1 person. Obviously this depends on the company as rates and coverage varies. I'm going off my typical experience working many various white-collar jobs in NYC.
I changed jobs recently and also suffered sticker shock at health insurance rates. The pay is high enough to make up for it but still hurts.
Many family plans will cost around 20k/year in just premiums (which is absolutely fucking outrageous) so it’s just a matter of how the employer splits the cost with you.
But yeah, go with the cheapest plan, try to put some money away in a HSA if available, and hope you don’t get sick or injured.
Holy crap?! What state are you in and how big/small is your company?!
I have BCBS and it's a quarter of that for the PPO plan and I am \~$125/pp (biweekly) for myself+family. **I'd look for a new job.**
$950/paycheck is $24,700/yr - I hope they pay you \~$30k more than the market average...
Holy crap indeed! I’m not disclosing as much info as possible. If you made 48K a year which is over $21/hour you would spend half your income on insurance.
You are aware that you don't have to take the employer healthcare plan, right? You can go out and buy it on your own. I'd suggest you contact a local insurance person and see what other plans you can get, because that sounds way too high.
Same at my husbands' job, he pays $35 a week for insurance but to add me and the kids it's an additional $20,000 per year. I can't get any subsidies on the marketplace because I am offered insurance through his job. Needless to say, we haven't had insurance in 5 years.
I always ask to see what the insurance plan is before accepting any job. Sometimes they are so bad that even though they are offering 10k more I would have less take home.
Medical insurance premiums are pre-tax
Out of pocket healthcare costs are post-tax until you reach 7.5% of annual income, then they become deductible, but only if you itemize.
The trick is to get an HDHP + HSA, contribute to the HSA pre-tax, then use the HSA to pay out of pocket costs.
How often do you get paid, how much is your gross pay, and how many people are covered and what ages? If the employee paid premium for just your coverage is greater than 8.5% of your household income, you qualify for ACA subsidies for a non-employer sponsored plan. Even without subsides, you might be better off buying your own plan.
This doesn't make any sense.
I used to work for a small company (fewer than 50 people). My wife and I had a BCBS Platinum PPO. $0 deductible, $3,000 OOPM, 0% coinsurance, only copays (maxed out at $100 for an ER visit or outpatient surgery).
My wife and I paid $500/month, and my employer paid about $750/month. That's $1,250/month total for arguably 100% coverage for everything. If you are going to pay $2,000/month, that's gotta be the best coverage in the country in a VHCOL area like SF or NYC.
I’m saying if it’s a family of 2, your insurance costs are insane. If it’s a family of 4, they are probably average and your company isn’t subsidizing your family’s coverage at all.
Regardless, you’ll need to find a way to make the PPO work, the HDHP work, or find a new job. It Fucking sucks, but there aren’t many options
I noticed this in like 2007? 2008? I was working at Best Buy and my premiums went from \~450 a month for a family of 5 to 700 a paycheck. It was insane. I was told this was because maternity/prenatal care was now a requirement on all insurance plans so they were all expensive. My current company I negotiated they pay all benefits for my family. On my w2 this year it states they paid 28400 in employee benefits on my behalf.. THAT IS INSANE. Also, I should just go to the doctor more. We literally have done nothing with that benefit this year. no sick kids, no injuries. Insurance is a horrible mess in the US.
I have a family member whose health insurance was almost that for himself and his 3 kids. He got laid off and the COBRA version was almost $1800 a month because the employer no longer contributes. He wound up signing up for an HMO plan through Blue Cross and the affordable care act for only a few hundred a month. $900 for a family through an employer sadly doesn't seem out of whack. It should though.
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Would speak with your company's HR group to nail down what the premiums actually are, and whether you have another option (e.g., HMO) that is available to you. Normally employees see what premiums they'll pay before they sign up for a given plan.
I plan on it, and yeah there are other options but I’ve always had ppo’s. Yes they’re expensive but at 2K a month! I never would have thought. Now I have to look at their high deductible combined with hsa. This is just a nightmare!
2k is what I had to do on cobra, so sounds like they not subsidized from your company at all
The PPO option for my company is 650/month for just the employee. I pay 90 of the premiums for them.
Do they pay for any of it? My employer pays 3/4 of my family plan but I’m still at like $300 a paycheck. So the normal cost would be like $2,400 a month if I had to pay the whole thing. If they don’t subsidize your insurance in any way, find out if maybe you can waive it and pick up some cheaper insurance on the healthcare marketplace thing
I BELIEVE but I could be wrong, if your employer OFFERS health insurance it makes you ineligible for the marketplace. At least that is what my employer told me
Well of course they would say that lol as far as I know you can but you won’t get any discounts or anything. For OP, it might benefit them to look into it for cheaper options anyway.
This is the case and anyone can prove it by going to the [https://www.healthcare.gov/get-coverage/](https://www.healthcare.gov/get-coverage/) answer the questions and you can go from there. It might be helpful if your employer doesn't offer a plan you like or isn't paying much into that plan. I do this every year for shits and giggles. Health Insurance is just costly in the USA unfortunately.
It depends on if what they offer is considered affordable or not. If it costs more than 9.61% of your household income you are allowed to shop the marketplace. Additionally, this is a huge pain for your employer; it's supposed to incentivize offing affordable work insurance. Note, this is for the marketplace subsidies. There's never anything stopping you from buying private insurance yourself except the price.
I’m not sure if it varies by state, but at least where I am, it makes you ineligible for *subsidies* but not marketplace plans in general. I’m not sure about family rates, but the marketplace plan Im eyeing for when I turn 26 with BCBS has pretty good coverage and is cheaper than OPs individual rate
It depends how much you make and how much the offered plan costs. If it is over like 9 point something % of your income you are still eligible for subsidies if you turn it down.
Yeah, it has to be considered affordable and meet some other minimum requirements. The problem for OP is that its the cheapest priced individual plan that has to fall under the 9.61% threshold. I did actually just do the math out (I hadn't before) and using the $192/biweekly number OP gave for an individual plan, if they're making less than about $52k/year its not affordable which is definitely possible
A family of 4 with both adults making 13/hour will put gross income above 60K. I read some comments saying there are ways to calculate higher income people to bring gross income down greatly. I’m afraid I’m not that savvy.
If the health insurance offered is less than a percentage of your salary that s true but I've absolutely been on the ACA before with an employer who offered a plan but contributed nothing making the monthly premium unfeasible. I had to prove it in writing to the ACA people but I was approved to use the ACA with subsidies.
My deductible is 7k and has no coverage at all for anything, not PCP even until you hit it. I paid 150 to get a check up :(
Mines $15 per hour. Which equates to 2400 per month pretty much. But it's a good plan where I don't pay any copays or deductibles, ppo and does everything (dental, eye, mental, etc). If you have a high deductible included with that amount, you're really paying too much.
A while back my wife was offered a job through a past coworker who had moved on to a new company and they were desperately hiring. The family plan insurance for us would have been close to that amount - BCBS also. The catch was that it was a small employer so there was no helping it. They were offering a substantial raise in pay versus her current job at the time, but when you considered this insurance - it was barely any more than what she was already making. So she turned down the job solely because of the insurance plan. I'm not saying quit this job, but just be on the lookout in the future to get a count of all benefits before taking a position. Your employment offer is a package deal.
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There's an affordability calculator that you can use to see if you can opt out of employer coverage and use marketplace coverage instead. Last time I looked for California, your premium had to be over 8% of your income, but it was a little complicated so I might be wrong about the assessment.
affordability test for employer-sponsored coverage applies only to the amount you’d have to pay to insure just yourself under your employer’s plan. If that amount is less than 9.61% of your 2022 household income, you’re not eligible for a premium subsidy in the exchange, and neither are your family members if they’re allowed to enroll in your employer’s plan, regardless of how much it would cost to actually enroll them in your employer’s plan. This is known as the ACA’s “family glitch,”
My husband has insurance paid for 100% by his employer and my son and I can be added to his policy, but they do not cover any of that cost. It would have been about $1200 a month to add my son and I to his policy. We were able to sign up for plans through MNSure - Minnesota created their own website for ACA plans. And I found a great plan and the cost is $580 a month for both of us. And we do not qualify for any type of subsidy like you said. It is still absolutely worth looking at healthcare.gov or your state’s website for ACA plans. Even without the subsidy it will save you money.
Hi, fellow Minnesotan. I'm in the same situation, which is called the "family glitch" of the ACA. It was unintended, but it hurts nevertheless. Al Franken was working on it before he resigned from the Senate. Rep. Angie Craig is trying to get a bill together to address this, but I'm not optimistic.
> It was unintended I'm not so sure about that. Without it, the total cost for subsidies would be considerably higher.
Fair. I guess it's hard to know intent. But most of these hundred- or thousand-page bills (ACA was more than 900) are not nearly as vetted as they should. My understanding is that this was a legit oops that negatively affected about 1 million families, a small number in the grand scheme, but a huge impact on those families.
What state are you in? What is your family size? You may qualify for Medicaid or at least your dependents may qualify. You qualify based on your adjusted gross income, which means you can deduct the 23k annual premium from your income for eligibility. Medicaid may reimburse you for your premium costs or part of it if they deem your plan cost effective.
Hey you might be right about my dependents may still qualify
It’s important to note that the affordability test for employer-sponsored coverage applies only to the amount you’d have to pay to insure just yourself under your employer’s plan. If that amount is less than 9.61% of your 2022 household income, you’re not eligible for a premium subsidy in the exchange, and neither are your family members if they’re allowed to enroll in your employer’s plan, regardless of how much it would cost to actually enroll them in your employer’s plan. This is known as the ACA’s “family glitch,” and although some lawmakers — and countless consumer advocates — have proposed fixes, it’s still an issue for several million Americans.
I'm not talking about marketplace coverage, but Medicaid. For instance, in Minnesota, dependents under age 18 qualify if the households adjusted gross income is under $85k for a family of five. Minnesota will then reimburse the policy holder the total premium amount for those dependents. So an employee paying 2k monthly might only have to pay $800 per month after reimbursement. Remember, adjusted gross income can be reduced by health care premiums, 401k / IRA contributions, student loan interest and other things. So someone making 110k could in theory reduce their AGI below 85k to have their dependents on medicaid and reduce total monthly cost for the health care plan.
Enroll in the insurance just for you and get a quote for insurance for your wife and kids off the exchange? Really the only option I can see.
They won't qualify for tax credits since they could be on the employer plan. And straight up getting a plan will be just as expensive. I pay $480 twice per month for myself and my spouse. 😕 It would have been $68 twice a month for just me.
It depends on your location and coverage pick. I’m in a HCOL city and picked a bronze plan to cover my four member family. It’s about $1150 per month without subsidy. It’s expensive but still less than $2k…
Much appreciated!
Right. That's applicable to OP's employee-enrollee premium alone. It doesn't matter how much more would be deducted from the employee's pockets of money to enroll non-employees in an employer-dependent health coverage scheme.
I hate the fact that it's solely due to an IRS rule.
*That's* ... what you hate most about this scheme? Idk what else to say.
Sounds like you're have an expensive plan and your employer doesn't subsidize any of it.
Doesn’t look like it. I tried searching regular cost of bcbs ppo but I need to fill out a bunch of info so, to be continued…
Mine is very similar - I go with the High Deductible, load up the HSA, and hope I don't need it any time soon. HSA's carry over and can be put into investment funds to (hopefully) cover future premiums or nursing homes. It stinks, but of the bad options available, it was the best for my family.
It depends substantially on age. I deal with insurance for my employer. We use a high-end BCBS PPO. For example, these are our total premium costs in the Chicago metro region: Child: $340/mo 25 year old: $450/mo 30 year old: $500/mo 40 year old: $600/mo 50 year old: $750/mo 60 year old: $1,200/mo We pay 100% of the employee's cost, but we don't subsidize the family costs. So, I am on my employer's plan, but my wife and daughter use my wife's employer's plan because it subsidizes more of the child costs.
How much is your paycheck? You're paying 23k/year for health insurance?
For a family thats far from the worst I've heard of. It sounds like they opted for the highest plan available.
I don’t make enough to get that insurance and will probably settle with their hsa but I need to research more.
I'm in IL and have a BCBS Blue Choice Preferred PPO and yep...I pay about $2,000 a month in premiums for my family.
It certainly can be true. Health insurance in US is crazy expensive (especially if it is good insurance). Sounds like your employer doesn't contribute as much towards the premium as others do. Did you not ask for details on health insurance and other benefits before you accepted offer? You have to know these things ahead of time so you can factor into your compensation negotiations.
This, always ask to see benefits before accepting a job with a new company
Great advice.
Super important but salt in the wound for op now. I had to turn down a good job because of insurance. Was a pay cut after the fact.
My current employer subsidizes the entirety of the premiums as a benefit. I want to go explore my options at other employers since my employer underpays but then they spend $20k+ on my family plan so maybe it's worth staying unless I can get a substantial raise. Is asking about benefits as simple as just saying, "what are your benefits and premiums?" during an interview?
Basically yes it is that simple. Whenever the topic of pay comes up is the appropriate time to ask about benefits and employee cost. If they give you an actual offer I recommend asking for their latest open enrollment/benefits booklet/paperwork to review. Understanding the full compensation package including benefits (premiums, deductibles, etc) will allow you to make a better decision or counter offer. I would never accept an offer without knowing this info first.
Awesome, thanks! And I suppose the obvious answer is if a company says you have to accept first, run away! Lol
Exactly, run fast and never look back. If they are willing to make you an offer but not willing to share their benefits information, they are not being transparent about what they are actually offering you. Oftentimes, depending on who you are interviewing with and the size of the company, asking for this info will catch the HR rep or manager off guard because so few people actually ask for it. As such, they may have to reach out to someone internally to get the info for you. So if they don’t have it for you right away but they are willing to get it for you, that is fine. But if they flat out refuse to provide it, that would be a hard pass for me.
Lesson learned
Whenever I get an offer I always ask to see their health plans. Do you have a spouse and kids? If so 944 for the PPO doesn’t surprise me based on the individual cost, your company probably does not subsidize that much. That’s the kicker about family plans for kids, it’s the same whether you have one kid or six, so you subsidize the cost of families with a lot of kids
It's not uncommon for employers to subsidize nearly all of the individual plan, but to have employees pay 100% of the cost to add any dependents. There are likely better deals to be had for your spouse through their own job, and for your kids via marketplace.
I'm surprised this isn't higher up. I'm job searching and the first two questions are: 1) What is the pay 2) What are all the benefits (in detail) I pay \~$14,000/year for family coverage. A new position I'm looking at is only \~$8,000/year! that is a raise in an of itself!
Good deal!
$2000/month family coverage for a PPO is not unusual particularly if the company is looking to steer employees to the HDHP.
I've seen this trend too, it seems like every year or two the premiums shift to make HDHP look more attractive. One place I worked was transparent about these costs. They showed the employee + family top tier PPO rate was $2k/month cost, but employee portion was only $300/month. 5 years later family rate for PPO is now $700, while HDHP is $400.
This is very sad that it’s probably the case. For my second day at this employer, this paints a very bad picture in my opinion.
Sometimes the employer might generally offer HMO at a good price and then PPO as the premium but way more expensive option. What else does the company offer. Are you getting good salary? 401k package? Jusy Because the cost of PPO is high doesn’t mean the company is shit. It is one of many potential factors.
And just remember, it was like this before, the employer just hid the full extent of the price from you
Seems these days every plan is a high deductible plan.
Are you looking at the total rate or your portion of the premium?
It is the employees contribution semimonthly
Oof. Any chance you get insurance through your wife’s work? Or go for a lower plan, like an HMO?
Wife’s no… but I’m not giving up yet and I will update.
Based on your update that most of this cost ($700 of it) is for your family I would look at the cost of insuring your family on the ACA marketplace, and yourself on the employer’s plan.
This sounds completely "normal" for a low deductible PPO family plan if the company pays zero percent. At my small company once the healthcare marketplace came online we stopped offering health plans altogether so our people could go to the marketplace. We just gave everyone a big raise across the board equivalent to the average we were paying per month in health insurance premiums. Everyone was very happy with this arrangement.
I haven't had a PPO in years. The premiums are usually more than the out of pocket max of the hdhp option. OP, you're probably locked into this until open enrollment though.
As a new EE I still have 30 days as of start date so 28days now
>the family ppo rate at $944 >The ppo plan for only me is $192/biweekly It really sounds like this employer doesn't want to be in the health insurance buying/re-selling business for non-employees.
I agree. I just retired from a small company of about 15 employees. My employer was able to get group rates through a health care consulting company. The plan was pretty good with a $1,500 deductible. After retiring (not age 65 yet), the best I could do on the Govt Marketplace for about the same premium amount was a $6,000 deductible plan. Employers have leverage in the market, even a small employer. One nice thing was getting the ACA subsidy to cover about half of my premium.
Go to healthcare.gov. Fill in the blanks. See if you can get it cheaper. Then say I have other insurance. Unless it's mandatory.
Yeah the company has links to affordable care act .gov so I think this has been an issue before. This is only my first day working on enrollment so I will definitely spend a lot more time and research.
Go with the high deductible plan. The HSA follows you when you leave and has yearly tax advantages. High deductible plans usually cover things like yearly physicals in full, you just have to call the doctor's office and schedule an "annual well visit" specifically so the office doesn't screw you over.
Those premiums sound right for an employee plus family PPO. If you want to pay $20 per visit you gotta pony up for the premiums. Is your company fairly large? I’ve noticed many large globals are going to self insured where companies use an insurance company like bcbs to administer the plan but all costs are actually paid by the employer. I don’t know if there’s any way to know as an employee, I just know because I work with our finance group and both my abs my wife’s employers offer pretty much the exact same 4 plans, same cost and coverage but different insurance providers so I assume her company is also now self insured. In the past, both these employers offered low cost PPO plans but that ended almost a decade ago.
Many companies don’t want to subsidize family members. Thus it’s a lot more expensive to add them.
There is another reason to quit this employer. This employer is terrible at managing money. They are making the employees pay for health insurance with after tax dollars whereas they could have paid it with pre tax dollars (as a business expense) and just lowered the salary proportionately. Run away from this dumb asses.
This happened to my husband in 2020. He’d been at the same company for 17 years with excellent benefits and didn’t really know what bad benefits are, so when he asked a new job about benefits and was told “they are really good” he believed him. When we saw the benefits he should have known right then that his boss was a massive asshole lol. Anyways he just started at a new job with nearly 90% more pay AND they have a no cost medical option for family. If I was you, I’d start applying elsewhere immediately. He waited it out a year to see if it would get better, but it didn’t. They didn’t care about their employees at all.
I had this happen when I worked at a small startup. They covered me almost 100%, but my family was quoted at $2300/month! I ended up getting my wife and son healthcare through the marketplace (healthcare.gov), even at full price (no subsidies) it was $650 vs. $2300. I used my work's insurance for just me. The only downside was that my family OOP was higher.
Have your partner get insurance?
PPO plans can be very expensive and many employers don’t provide any meaningful subsidy to family coverage (the provider has nothing to do with it). Mine is around $24K/year between my contributions and what my employer pays so that tracks with your number. It doesn’t help with your issue, but as a lesson for all, if you need anything other than coverage for yourself, always get details on the benefits before accepting a job. You can’t negotiate the rates, but an increase in base pay, a healthcare stipend, etc. might be on the table.
My company(CO based) the family PPO plan is almost 3k a month out of pocket....But the individual one on the same plan is 220 per month out of pocket. My employer doesn't pay anything towards dependents.
Yeah this seems to be a trend
Family plans are expensive and it’s awful. You can sign up for GoodRX gold and GoodRX care for Pennies on the dollar for regular doctor check-ups and visits. blood work, and medications. But it won’t protect your needs for surgeries or accidents at the hospital. You can also ask your employer to cover more, they may be willing to do so. Not to ask for a raise in pay, but for them to help you pay for medical insurance (or more of it)
Why didn't you ask about benefits before accepting the job? It's part of your total compensation. Meaning you evaluate 401k match, benefit costs, fringe stuff like discounts, PTO, etc in addition to the pay rate. I thought everyone did this....
This may not be a bad deal. What is your deductible with this plan? Do you plan to be a heavy user of medical services this year?
That is horrendous, the group must have had poor loss experience. Compare your marketplace plan options.
This is a lesson I learned hard about 10 years ago. I quit a job for a 15K pay raise at another company but didn't take into account that the insurance went from $70 a week to $1400 a month. So now if I'm talking with a company about joining their team the first thing I ask for are hard numbers for their benefits.
Yep. It sucks. I have turned down a job before because of the medical costs similar to what you are paying. They wouldn't raise the salary to make up for it. Current job I negotiated a bump in salary to make up for an increase in medical costs from my previous employer. It can make a HUGE difference in your overall compensation. Always get the rates with the offer. Can you take the insurance and move family to another plan?
We pay $25k a year for health insurance for 7 of us. The funny part is that that is insurance for an employee of a hospital. Our deductible is $4750. Then they cover 80% until we hit $12500 and they cover everything.
It sounds like there is a spousal surcharge on your insurance which is driving up cost. It's why I didn't add my wife to my insurance (and then she forgot to sign up for her employer sponsored insurance so that's another issue). My insurance is $180/pay period for the kids and I and I'm using the high deductible plan (buttcheeks are clenched since I have two kids under 5) and the HSA. If I had added my wife, I would've been charged $430 per pay period due to the spousal surcharge.
I love your humor but it also sad it’s true
Insurance is crazy expensive. Our office pays full premium for our employees as a perk with a $1k annual deductible through BCBS. However, we don't pay for family members' premiums.
Wow that is crazy. My cost was just over 500/mo for PPO plus vision and dental for a family of 4.
Nope, seems quite typical, welcome to medical insurance in the USA. Typically companies only cover your single insurance, and even then not always 100%. The single rate is likely far lower than half the family rate, I'd guess around $200-300 per paycheck. Most employers won't cover any of the portion to upgrade to a family plan, hence why they are more expensive. They are hiring you, not your family. I've seen family plans go for over $1100-1300 in NYC, while a singles plan from the same company is like $300-400. It's typically cheaper from my experience if you and your spouse each have a separate insurance plan from your own employer, than have a family plan under just 1 person. Obviously this depends on the company as rates and coverage varies. I'm going off my typical experience working many various white-collar jobs in NYC.
Lesson learned on my end, I was spoiled with a grandfather clause at my old job paying $690/month for a family United health ppo
I changed jobs recently and also suffered sticker shock at health insurance rates. The pay is high enough to make up for it but still hurts. Many family plans will cost around 20k/year in just premiums (which is absolutely fucking outrageous) so it’s just a matter of how the employer splits the cost with you. But yeah, go with the cheapest plan, try to put some money away in a HSA if available, and hope you don’t get sick or injured.
I was thinking ppo for self and pay out of pocket for family
Holy crap?! What state are you in and how big/small is your company?! I have BCBS and it's a quarter of that for the PPO plan and I am \~$125/pp (biweekly) for myself+family. **I'd look for a new job.** $950/paycheck is $24,700/yr - I hope they pay you \~$30k more than the market average...
Holy crap indeed! I’m not disclosing as much info as possible. If you made 48K a year which is over $21/hour you would spend half your income on insurance.
You are aware that you don't have to take the employer healthcare plan, right? You can go out and buy it on your own. I'd suggest you contact a local insurance person and see what other plans you can get, because that sounds way too high.
Yeah I know
Same at my husbands' job, he pays $35 a week for insurance but to add me and the kids it's an additional $20,000 per year. I can't get any subsidies on the marketplace because I am offered insurance through his job. Needless to say, we haven't had insurance in 5 years.
Take the plan for yourself and possibly dependents. Look at putting your spouse on a marketplace plan. Save a few hundred per month.
I always ask to see what the insurance plan is before accepting any job. Sometimes they are so bad that even though they are offering 10k more I would have less take home.
My family plan was over $400+/wk when I worked for someone else
I guess it would be OK if you were making 150K a year.
I don’t even think so because I think healthcare costs are post-taxes.
Medical insurance premiums are pre-tax Out of pocket healthcare costs are post-tax until you reach 7.5% of annual income, then they become deductible, but only if you itemize. The trick is to get an HDHP + HSA, contribute to the HSA pre-tax, then use the HSA to pay out of pocket costs.
I could have sworn it was pretax
Wait until next year when insurance doubles due to all the covid payouts from this and last year
I have Aetna and pay $8 a paycheck for a $3000 deductible. How is this possible? I don’t understand how people can get ripped off like that.
How often do you get paid, how much is your gross pay, and how many people are covered and what ages? If the employee paid premium for just your coverage is greater than 8.5% of your household income, you qualify for ACA subsidies for a non-employer sponsored plan. Even without subsides, you might be better off buying your own plan.
This doesn't make any sense. I used to work for a small company (fewer than 50 people). My wife and I had a BCBS Platinum PPO. $0 deductible, $3,000 OOPM, 0% coinsurance, only copays (maxed out at $100 for an ER visit or outpatient surgery). My wife and I paid $500/month, and my employer paid about $750/month. That's $1,250/month total for arguably 100% coverage for everything. If you are going to pay $2,000/month, that's gotta be the best coverage in the country in a VHCOL area like SF or NYC.
I don’t understand some of what you’re saying
I’m saying if it’s a family of 2, your insurance costs are insane. If it’s a family of 4, they are probably average and your company isn’t subsidizing your family’s coverage at all. Regardless, you’ll need to find a way to make the PPO work, the HDHP work, or find a new job. It Fucking sucks, but there aren’t many options
When you’re right, you’re right!
I noticed this in like 2007? 2008? I was working at Best Buy and my premiums went from \~450 a month for a family of 5 to 700 a paycheck. It was insane. I was told this was because maternity/prenatal care was now a requirement on all insurance plans so they were all expensive. My current company I negotiated they pay all benefits for my family. On my w2 this year it states they paid 28400 in employee benefits on my behalf.. THAT IS INSANE. Also, I should just go to the doctor more. We literally have done nothing with that benefit this year. no sick kids, no injuries. Insurance is a horrible mess in the US.
I have a family member whose health insurance was almost that for himself and his 3 kids. He got laid off and the COBRA version was almost $1800 a month because the employer no longer contributes. He wound up signing up for an HMO plan through Blue Cross and the affordable care act for only a few hundred a month. $900 for a family through an employer sadly doesn't seem out of whack. It should though.