My wandering thoughts on requirements for healthcare insurance premiums

[melmichigan]

My BMI is to high according to my DH's company's healthcare insurance criteria since I have shrunk an inch somewhere since the last time they measured my height. :glare: My blood sugar, cholesterol, blood pressure, everything but my BMI, are great and certainly fall into their guidelines. So the company paying for our healthcare has a solution for this year and is requiring that those of us who fall outside of the developed criteria document activity.

 

After wearing a fitbit since the beginning of the month to avoid paying more for my healthcare insurance I have mixed feelings. Not fulfilling the criteria means an increase in my coinsurance so that in itself is certainly motivation enough to put the thing on every morning. But as I sit here pondering the significance of the "first step badge" I earned yesterday, and my lack of steps today I wonder how many people put the thing on their child, or even their dog and send them off? Is this really the long term solution?

 

For this year the requirement is the equivalent of what I already walk in a given day running up and down the stairs doing laundry or walking up and down the hallway half a dozen times looking for children, so it's no hardship and takes nothing more than putting the device on my bra each morning. It in and of itself will not make a difference in my weight, that is in my hands alone. I wonder how that will change for next year, or the year after? Once this door is cracked open how far will it swing?

 

I will be curious to see as the year goes on how subconsciously, or even consciously this little thing will impact my everyday activity. I wonder if I will be drawn in to the gaming competitiveness of who has more badges, or who has more steps for the day? It reminds me of the time back in high school when everyone was aiming for the next patch or medal on their high school jacket. I hated high school.

 

ETA: It is the company that requires it depending on what insurance you have.

[melissad2]

Ummmm...I wouldn't go for that AT ALL.

[tearose]

It seems like it's really opening a Pandora's box for the insurance company--like you say, what will they track in future years?

[TranquilMind]

My BMI is to high according to my DH's company's healthcare insurance criteria since I have shrunk an inch somewhere since the last time they measured my height. :glare: My blood sugar, cholesterol, blood pressure, everything but my BMI, are great and certainly fall into their guidelines. So the company paying for our healthcare has a solution for this year and is requiring that those of us who fall outside of the developed criteria document activity.

 

After wearing a fitbit since the beginning of the month to avoid paying more for my healthcare insurance I have mixed feelings. Not fulfilling the criteria means a 15% increase in my coinsurance so that in itself is certainly motivation enough to put the thing on every morning. But as I sit here pondering the significance of the "first step badge" I earned yesterday, and my lack of steps today I wonder how many people put the thing on their child, or even their dog and send them off? Is this really the long term solution?

 

For this year the requirement is the equivalent of what I already walk in a given day running up and down the stairs doing laundry or walking up and down the hallway half a dozen times looking for children, so it's no hardship and takes nothing more than putting the device on my bra each morning. It in and of itself will not make a difference in my weight, that is in my hands alone. I wonder how that will change for next year, or the year after? Once this door is cracked open how far will it swing?

 

I will be curious to see as the year goes on how subconsciously, or even consciously this little thing will impact by everyday activity. I wonder if I will be drawn in to the gaming competitiveness of who has more badges, or who has more steps for the day? It reminds me of the time back in high school when everyone was aiming for the next patch or medal on their high school jacket. I hated high school.

 

 

Wow. I knew it was going to get bad. That much was obvious. But...wow. You are being monitored.

 

Yikes. How far will it swing, indeed. Next thing you know, insurance companies will want to monitor your bedroom to be sure you are getting adequate sleep or something, all for your benefit, of course.

[Annie G]

I would totally HATE if my insurance company wanted to monitor my activity like yours is doing. I've been wearing a fitbit for a year and convinced dh to wear one too. For me, it's not about the badges or competition- it's that when I have a really lazy day I am reminded of it. It kind of keeps me from fooling myself that I'm active. So for over a year it's worked to motivate me to keep my step count up or log my bike riding. But if my insurance company required me to wear it, I'd probably start hating the device.

[JumpyTheFrog]

So the company paying for our healthcare has a solution for this year and is requiring that those of us who fall outside of the developed criteria document activity.

 

 

So it is your DH's employer and not the insurance company requiring the documentation?

[magnificent_baby]

I agree with the others. I have never heard of such thing. I'd be shopping for a new insurance company if possible. DH works for a small business and we have a huge deductible, but I would never consent to that.

 

I could (maybe) understand a life insurance policy to require that if you were wanting to get your premiums down, but that is bordering invasion of privacy for health insurance.

[melmichigan]

So it is your DH's employer and not the insurance company requiring the documentation?

 

The company is requiring the documentation, which varies based on which insurance company you choose. Primarily those of us who still have PPO insurance are targeted. Those who have HMO will pay $5 more for a prescription and an office visit if they don't comply, they don't pay coinsurance. Those of us who have PPO will have to pay more coinsurance as well as more for prescription and an office visit if the employee and spouse don't complete healthy living requirements- physicals, blood work, health screening, and intervention if we fall outside the set criteria.

[elegantlion]

Don't comply sounds too much like the Borg for me.

[Annie G]

Last year our insurance offered $250 added to our HSA cards if we completed a free health screening. (Is it an HSA card? It's the one that can roll over year to year) Anyway, it was painless but it showed I am bordering on a cholesterol issue and have slightly elevated blood pressure. No big deal- completing the assessment was all that was required and we collected out money.

This year, to get the same money, I had to actually visit a doctor about these issues, follow his recommendations, AND have a few phone counseling sessions about how to eat healthy and exercise. a HUGE waste of time, but still easy.

 

The kicker is that dh has 8 stents in his heart and still needs to lose weight. He had to do nothing to get the money because he's visited a doctor in the past year for a check up...his cardiologist, which he sees yearly.

 

Yeah, all in an attempt to lower costs. But we did it because it was $250 for each of us- and cost us nothing out of pocket. But it really, really bugged me- the doc was more interested in talking about the Packers than he was about my health, and the phone counseling was a joke.

[Joker]

Ours hasn't become that extreme but we do get money put on our HSA cards if we do certain things. The one big thing that bothers me is that dh is tall and skinny, and has perfect cholesterol, bp, bmi, etc. The way it's worded is that you get money if you make improvements, but he honestly has nothing to improve so I wonder if we will get that part of the money or not. It seriously reads as if they expected no one to not need to improve in those areas. I can improve so we should get extra money for that, but it will be interesting to see if we get money for dh staying constant.

[Annie G]

Ours hasn't become that extreme but we do get money put on our HSA cards if we do certain things. The one big thing that bothers me is that dh is tall and skinny, and has perfect cholesterol, bp, bmi, etc. The way it's worded is that you get money if you make improvements, but he honestly has nothing to improve so I wonder if we will get that part of the money or not. It seriously reads as if they expected no one to not need to improve in those areas. I can improve so we should get extra money for that, but it will be interesting to see if we get money for dh staying constant.

 

 

I know- staying healthy isn't good enough anymore. I cost my insurance company NOTHING for the past two years- only went to the doc once and paid out of pocket since I hadn't met the deductible. Now they add ever increasing hoops to jump through every year. A guy who works for dh enrolls in a stop smoking program every year in order to get his HSA money. He doesn't finish it OR stop smoking...but he gets the money because he's 'making improvements'.

 

Can't imagine what your dh would need to improve!

[Joker]

 

 

I know- staying healthy isn't good enough anymore. I cost my insurance company NOTHING for the past two years- only went to the doc once and paid out of pocket since I hadn't met the deductible. Now they add ever increasing hoops to jump through every year. A guy who works for dh enrolls in a stop smoking program every year in order to get his HSA money. He doesn't finish it OR stop smoking...but he gets the money because he's 'making improvements'.

 

Can't imagine what your dh would need to improve!

 

He's crunched some numbers and is going to run a few races, including a half marathon to make up the money. I told him to watch out because he does what he does to maintain his weight (meaning it's hard to keep weight on). If he starts running even more, we may lose money because his bmi will drop too low. It feels like you can't really win.

[Laurie4b]

Scary.

[mommaduck]

Some of us actually NEED the extra weight to be healthy or we have extra weight because we have gotten healthier. Sorry, but the BMI is a bunch of carp!

[melmichigan]

Last year our insurance offered $250 added to our HSA cards if we completed a free health screening.

 

The kicker is that dh has 8 stents in his heart and still needs to lose weight. He had to do nothing to get the money because he's visited a doctor in the past year for a check up...his cardiologist, which he sees yearly.

 

 

My DH doesn't have to do anything more than the physical and bloodwork because he's already on blood pressure and cholesterol lowering drugs. We were joking about that part.

 

 

[Miss Peregrine]

I have never heard of such a thing and I am appalled!

[kewb]

The monitoring is seriously creepy and a huge invasion of privacy.

[melmichigan]

The monitoring is seriously creepy and a huge invasion of privacy.

 

 

Ah, but they get around the invasion of privacy by having another company compile the information and just let them know if we comply or not. So if you picked Medical Weight Loss, or Jenny Craig, they would only know that you did or did not comply with your weight loss plan. I'd much rather they monitor my steps than my actual weight and attendance at meetings.

[Murphy101]

I have two friends who have it worse. They were both required to join weight watchers or have their premiums and copays upped by over $80 a paycheck. They have to log in daily to the company health website and document their WW activity to avoid the penalties. The company health plan is paying for the first 6 months of WW, but if they don't lose weight, they have to pay for it after that.

 

If that's the only way you can get health insurance, then it's not an option to not do it. It's not like either the jobs pay particularly well either.

 

I think it's just all kinds of wrong.

[TranquilMind]

I know- staying healthy isn't good enough anymore. I cost my insurance company NOTHING for the past two years- only went to the doc once and paid out of pocket since I hadn't met the deductible. Now they add ever increasing hoops to jump through every year. A guy who works for dh enrolls in a stop smoking program every year in order to get his HSA money. He doesn't finish it OR stop smoking...but he gets the money because he's 'making improvements'.

 

Can't imagine what your dh would need to improve!

 

 

I cost my company nothing but the rare office visit for illness for 25 years, nor has my husband. I did have one burst appendix hospitalization, and that's it for the entirety of our marriage. I paid my own midwife myself - no insurance. NOTHING.

 

Yet our premiums still skyrocketed.

[TranquilMind]

I have two friends who have it worse. They were both required to join weight watchers or have their premiums and copays upped by over $80 a paycheck. They have to log in daily to the company health website and document their WW activity to avoid the penalties. The company health plan is paying for the first 6 months of WW, but if they don't lose weight, they have to pay for it after that.

 

If that's the only way you can get health insurance, then it's not an option to not do it. It's not like either the jobs pay particularly well either.

 

I think it's just all kinds of wrong.

 

 

I'm pretty sure that penalties are illegal, but no one has challenged it yet, because they don't want to lose a job. The EEOC has suggested that it is impermissible to impose penalties, but permissible to impose rewards. They can call it whatever they want, but we all know what they are doing - they are penalizing employees financially.

[Murphy101]

 

 

I'm pretty sure that penalties are illegal, but no one has challenged it yet, because they don't want to lose a job. The EEOC has suggested that it is impermissible to impose penalties, but permissible to impose rewards. They can call it whatever they want, but we all know what they are doing - they are penalizing employees financially.

 

 

Right. It's not a penalty because whT they are saying is they will give an $80 discount/reward or whatever is the legal loophole. But that's total BS bc they didn't raise everyone's rates, just those who don't comply. That's a penalty in any language except legalese. :/

[melmichigan]

 

 

I'm pretty sure that penalties are illegal, but no one has challenged it yet, because they don't want to lose a job. The EEOC has suggested that it is impermissible to impose penalties, but permissible to impose rewards. They can call it whatever they want, but we all know what they are doing - they are penalizing employees financially.

 

 

Comply or pay more, and in our case with DC with health conditions an increase in coinsurance can be much, much more. Depending on the medical costs for a given year, many thousands of dollars more. They get away with it because the higher rate is now "standard" and if you comply you are eligible to keep the "enhanced" rates you started out with at the beginning of the year. Did the EEOC really think it would go another way?

[Mergath]

Wow. I knew it was going to get bad. That much was obvious. But...wow. You are being monitored.

 

 

Well honestly, if you knew this lady's company was going to start gathering health information for the HMO, you could have let her know ahead of time.

 

:rolleyes:

 

Insurance companies have been giving incentives for increasing one's health for years. It makes sense from a business standpoint, given that they pay more for poor health. That's how our lovely free market system works, you know.

[SunnyDays]

We also have the health assessment/activity logging/wellness activity "rewards" built into our health plan. I don't *terribly* mind completing the health assessment, and I can understand why you'd want to provide incentives for healthier living. But it does still feel a bit invasive, and like others, I wonder what they'll be asking for next.

[Jane in NC]

My husband's corporation has been giving "health incentives" for years. Those initial screenings that were viewed by some as a violation of privacy actually turned up some cases of high blood pressure that needed to be treated early on. Obviously the insurance company would rather pay for basic meds now than a stroke later.

 

The health incentive (cash payment) is not given to smokers. There is no way around that one.

 

I understand why people do not like big brother (corporate insurance companies in this case) monitoring them. But my sister in law the medical doctor has noted that the majority of her patients would not be in her office for treatments if they changed their lifestyle. Since corporations are subsidizing their employees health care costs, they are attempting (rightly or wrongly) to given employees the needed nudge toward that change.

 

Certainly one option is not to buy your employer's group insurance policy.

[Night Elf]

What happens if you do lose weight during the year and your BMI drops? Do they stop monitoring?

[NicksMama-Zack's Mama Too]

My husband's corporation has been giving "health incentives" for years. Those initial screenings that were viewed by some as a violation of privacy actually turned up some cases of high blood pressure that needed to be treated early on. Obviously the insurance company would rather pay for basic meds now than a stroke later.

 

The health incentive (cash payment) is not given to smokers. There is no way around that one.

 

I understand why people do not like big brother (corporate insurance companies in this case) monitoring them. But my sister in law the medical doctor has noted that the majority of her patients would not be in her office for treatments if they changed their lifestyle. Since corporations are subsidizing their employees health care costs, they are attempting (rightly or wrongly) to given employees the needed nudge toward that change.

 

Certainly one option is not to buy your employer's group insurance policy.

 

While I agree that the corporations have a right to do this, I have to wonder what our wonderful federal government will do when they are subsidizing people covered under the Affordable Care Act. What incentives and penalties they will impose. I've already seen what they've done to the school lunch programs.

[magnificent_baby]

I just wonder how they have this information.

 

Not the OP, but every single year when DH employer is shopping around for the best deal, we have to submit new forms. You give height and weight, along with your entire health history. It drives me nuts to fill out these forms every year for 7 people.

[magnificent_baby]

 

I've never been asked to fill out any forms with this information. We have had changes in plans too.

 

 

You are lucky! Every year they obtain quotes from multiple insurance companies, then choose the company that will cost his employer the least. It's a necessary part of running a small business when premiums increase every year. For the most part, our deductible and coverage remains the same, but the actual ins. company changes every year or two. It's annoying to do all that paperwork, but I try not to complain because at least we have insurance.

[Tammyla]

Oh my, I'm scared to hear what will be next.

[QueenCat]

Insurance companies have been giving incentives for increasing one's health for years. It makes sense from a business standpoint, given that they pay more for poor health. That's how our lovely free market system works, you know.

 

This is true. The company dh used to work for (left 8 years ago) would pay for your gym membership as long as you clocked in there at least 12x/month. If you hit that goal at least 10 months out of the year, you paid less the next year in your health insurance premiums.

[skimomma]

This would be a very big problem for me. I feel it is a HUGE violation of your privacy and I am as liberal-leaning as they get. I know sky-rocketing healthcare costs are creating all sorts of sticky problems for individuals and the companies that insure employees, but this is going way too far IMO. As an aside, my dh and I have life insurance that we fund ourselves. We both pay a higher premium because our BMIs are TOO LOW. I kid you not. You just cannot win. Our agent suggested eating "a whole lotta cheeseburgers" before our next renewal exam. Yeah, that is healthy.....

[Josie]

Oh. My. Goodness! That is TOTALLY insane. I have a little song that I sing when asinine, intrusive, and dehumanizing events take place in my life. I sing "Death on Two Legs" written by Mr. Freddie Mercury and recorded by Queen. I do believe Mr. Mercury was a "bit" peeved at his former manager!

[Tammyla]

Melissa...

 

I would consider wearing lifts in my socks and teasing my hair uber high for the next height check. I don't want to make light of what you are going through at all, but their methods are so draconian.

[JumpyTheFrog]

I understand why everyone feels like this is a violation of privacy. I would too, if I were in the same situation.

 

Is there a way for a company to encourage healthier habits to keep insurance rates down, without all the privacy concerns? It seems like there may be an awful lot of people out there who are likely to say they "eat just fine" even if they are obese and eat tons of fast food and junk food. Just like nearly everyone thinks they area good driver - it's those other bad drivers! - I bet most people think their diet is just fine, otherwise they would've attempted to change it already.

[JumpyTheFrog]

The only idea I can think of for businesses is to encourage a culture of exercise and healthy eating. They could get rid of vending machines with junk and processed cafeteria food. They could encourage employees to have walking meetings or otherwise exercise together. Gym memberships could be a benefit.

 

Unfortunately, I think few companies would follow through with this and many probably think they can't afford it.

[magnificent_baby]

 

This is true. The company dh used to work for (left 8 years ago) would pay for your gym membership as long as you clocked in there at least 12x/month. If you hit that goal at least 10 months out of the year, you paid less the next year in your health insurance premiums.

 

 

I wouldn't be opposed to incentives for gym membership, etc. Even the clocking in part would be okay. But tracking how many steps you take?? Perhaps it tracks where you go as well? That's going too far.

[Mergath]

While I agree that the corporations have a right to do this, I have to wonder what our wonderful federal government will do when they are subsidizing people covered under the Affordable Care Act. What incentives and penalties they will impose. I've already seen what they've done to the school lunch programs.

 

 

Probably no more than they do now through Medicare and Medicaid. People seem to forget that the government has been providing health insurance for years.

[BigMamaBird]

My Dh's employer offers a discount of $500 on health insurance if he participates in a program. It involves going to a healthy living presentation once a year and submitting proof that you attended a doctor's appointment had had certain tests like blood pressure and cholesterol level. He doesn't submit the results of the tests, just that he had them done.

 

My Dad's insurance pays for a Weight Watcher's membership for anyone over a certain BMI as long as they check in at least three times a month. It frustrates my Mom because she is below the required BMI but still wants to lose weight.

[Hikin' Mama]

This sounds stupid. And that's as deep as my foggy brain is gonna get on this Monday morning.

[Pawz4me]

Is there a way for a company to encourage healthier habits to keep insurance rates down, without all the privacy concerns? It seems like there may be an awful lot of people out there who are likely to say they "eat just fine" even if they are obese and eat tons of fast food and junk food. Just like nearly everyone thinks they area good driver - it's those other bad drivers! - I bet most people think their diet is just fine, otherwise they would've attempted to change it already.

 

My issue with things like this is that smoking and weight seem to be the only targets. I guess because they're such public "sins." And all the people who don't wear seat belts, drive too fast/recklessly/aggressively, engage in risky sexual behavior, use illegal drugs, have more than one drink a day, ride their bicycles (and motorcycles) w/o helmets or participate in numerous other behaviors that can lead to excessive health care costs aren't targeted one little bit. How is that fair?

[Jane in NC]

My issue with things like this is that smoking and weight seem to be the only targets. I guess because they're such public "sins." And all the people who don't wear seat belts, drive too fast/recklessly/aggressively, engage in risky sexual behavior, use illegal drugs, have more than one drink a day, ride their bicycles (and motorcycles) w/o helmets or participate in numerous other behaviors that can lead to excessive health care costs aren't targeted one little bit. How is that fair?

 

 

My husband is in a business that requires a security clearance for the job. They certainly cannot monitor employees 24 hours a day, but they do look at credit scores, give drug tests and send employees who get DUIs to counseling.

 

Frankly I don't like having corporate American monitor my life. We opt in for monitoring by my husband's employer--that is part of the job. But I don't care for the data mining that companies like Facebook do--so I don't have an account.

 

A lot of people who complain about government intervention in their lives are happy to open windows to Internet companies or stores that monitor shopping habits by saving card programs. Let's face--companies are watching almost everything we do.

 

Creeps me out sometimes..

[Jane in NC]

Another thought: most people are happy to receive good driver discounts on automobile insurance. Are these health incentives comparable?

[PachiSusan]

Another thought: most people are happy to receive good driver discounts on automobile insurance. Are these health incentives comparable?

 

 

I don't think so, because SOME of these health issues may not be totally able to be controlled by the individual, but you can practice to be a better driver.

[melmichigan]

 

 

My issue with things like this is that smoking and weight seem to be the only targets. I guess because they're such public "sins." And all the people who don't wear seat belts, drive too fast/recklessly/aggressively, engage in risky sexual behavior, use illegal drugs, have more than one drink a day, ride their bicycles (and motorcycles) w/o helmets or participate in numerous other behaviors that can lead to excessive health care costs aren't targeted one little bit. How is that fair?

 

 

Those questions are on the health assessment, there just isn't any intervention. ;)

[Mergath]

 

I don't think so, because SOME of these health issues may not be totally able to be controlled by the individual, but you can practice to be a better driver.

 

 

But the things they generally give incentives for ARE things that the individual can control. If I'm obese, I can lose weight. If I'm a smoker, I can quit. If I'm sedentary, I can get a gym membership and work out. No insurance company is going to say, "We'll give you bonus money if you can stop having epilepsy," or whatever.

[PachiSusan]

 

But the things they generally give incentives for ARE things that the individual can control. If I'm obese, I can lose weight. If I'm a smoker, I can quit. If I'm sedentary, I can get a gym membership and work out. No insurance company is going to say, "We'll give you bonus money if you can stop having epilepsy," or whatever.

 

Many people, yes. However, there are many people who have genetic issues and problems that aren't choices. Example: Someone I know gained tons of weight on steroids for arthritis and because the BMI doesnt' reflect true body composition, health coverage was denied. Should this person have dealt with debilitating pain to get covered? No. Was it out of their control? Yes.

 

A family member had thyroid cancer. She gained tons of weight and nothing she can do can make it go away. She's at least 50 lbs over weight now and lives life healthier than anyone I know, but she would be one who would be hurt by this as well.

 

I'm not denying that MANY people (including myself) would take a choice and commitment to change it, but I don't think penalizing those who can't fix the problem is a great idea.

[Jane in NC]

Many people, yes. However, there are many people who have genetic issues and problems that aren't choices. Example: Someone I know gained tons of weight on steroids for arthritis and because the BMI doesnt' reflect true body composition, health coverage was denied. Should this person have dealt with debilitating pain to get covered? No. Was it out of their control? Yes.

 

A family member had thyroid cancer. She gained tons of weight and nothing she can do can make it go away. She's at least 50 lbs over weight now and lives life healthier than anyone I know, but she would be one who would be hurt by this as well.

 

I'm not denying that MANY people (including myself) would take a choice and commitment to change it, but I don't think penalizing those who can't fix the problem is a great idea.

Oh--you are talking about being denied coverage. I was talking about "health incentives", i.e. cash payouts that some corporations now give to employees. Under my husband's company plan, people who make strides toward healthier lifestyles still qualify for the health incentive. They don't expect someone to go from obese to svelte overnight.

 

There is a problem of people being denied coverage for pre-existing conditions. I hope your family member who has overcome thyroid cancer does not have to face that!