Is there any company that pays insurance AND co-pay/deductibles

[4everHis]

for its' employees anymore? Or even ever? Even when we had really good insurance we were responsible for co-pays/deductibles. I'm on the board of a very small company and the the director is asking us to pay all the deductibles/co-pays for the few (less than 5) employees that use our insurance. The insurance they have is some of the best still available and, of course, cost much more than it did a few years ago. I didn't know of another way to poll multiple people about this.

 

Thanks in advance!

[Just Kate]

I work in the insurance industry and I haven't heard of that. Sure sounds nice though (nice for the employees, that is!).

[4everHis]

I work in the insurance industry and I haven't heard of that. Sure sounds nice though (nice for the employees, that is!).

 

I thought it sounded nice too. I think their thinking is that before they had no deductibles but with the cost of insurance and the new way it's all working, I just couldn't imagine that there were companies that covered EVERY.thing any more. I hate this for them and would love to vote to do it but financially I just don't see it.

[4everHis]

I doubt it.  My sister's husband works for a town.  They have probably the best insurance I've seen (lately), but they still have some copays.  I don't think they have deductibles though.

 

I worked for the insurance industry years ago and I did see plans like that.  GM used to have stuff like that.  I bet not anymore.

 

That's what I was thinking. 

[Um_2_4]

We have copays but no deductible and pay a % of the monthly premium and as far as I know from friends we have the best insurance of anyone I have spoken to about it. Except for someone I know on MediCal (low income free govt insurance in CA), they have no copays and many more meds are covered (even OTC if the dr writes a script, like Benadryl or Tylenol).

[marbel]

We have had both copay plans and deductible plans.  Never had anything where our premiums paid it all.

 

We have a high-deductible plan now.  I am not sure, but I think I prefer the deductible plan because it's easier to see when we will reach out out-of-pocket maximum.  Whenever we've had a copay plan it seemed so many things didn't apply to the oop max.  I'd think we should have reached it and they'd say "oh no, this and this and this didn't count toward it."   

 

ETA: After reading Sparkly's post above... I agree with that.  People don't value that which is perceived to be free.   But with the copay plans we've had, we had no idea how much things cost.   I do like seeing how much things cost.  With our current plan, I get an explanation of benefits with the cost and the negotiated rate discount.  I have been shocked at the cost of lab work recently.  I've never been inclined toward "do this test 'cause insurance will pay for it" but with some plans there is no way to know how expensive some tests and procedures really are so it's really easy to just go in to the doc rather than wait a little bit. 

[4everHis]

I'll have to check again. . . I know at one point they didn't pay any of the premium and may have to do that now. I understand their pain, we have zero insurance. . . I get it!

[TrixieB]

I remember in 1990 or 1991 someone telling me that there was a subset of Boeing employees that had zero out-of-pocket medical costs with their insurance plan.  Supposedly the employer paid the premiums too.  I was rather envious because I had a $10 copay at the time, plus whatever my monthly premium was - $40?

 

Ah, the good ol' days...

 

 

[Spryte]

Is this what you mean?

 

DH's company pays all families' insurance.  So if an employee has no kids or is married with 3 kids - company pays for the insurance.  (I don't know how they'd react to a very large family, we've never been down that road in this company.)  This year, they switched to a plan with an HSA and a higher deductible, so what they did was what the insurance agent called, "Make it whole."  The company paid the high deductible in advance, by depositing the amount in the HSA account.  Once the deductible is reached, there are no co-pays.  So essentially, yes, they paid all the co-pays.  

 

ETA: DH and I are well aware that this is not the norm here, and we're grateful!  He works for a European based company, who views health care for its employees as essential, and is determined to provide it.  They have been horrified at the sharp increases in health care the last few years though, so every year we worry that their take on this may change.  

[Tap]

No it is not common anymore. What we do see is employer funded HRA or HSA.

 

 

Your board could consider doing an HRA/HSA fund that is funded by the company.  I would look for one with a roll over option. The company puts a set amount per year into each employees fund to use as they want. It can be used to cover deductibles/copays or things like eyeglasses, a few OTC items or other medical supplies.  

 

The advantage it that it puts a limit on how much the company is willing to contribute (in case of a person who wants to go weekly) but also allows some rollover in case the patient doesn't go to the doctor for the  year or so. 

[BlsdMama]

John Deere is amazing insurance.  But, trust me, that's going to change.  No company can afford to do it anymore.

[Plateau Mama]

I remember in 1990 or 1991 someone telling me that there was a subset of Boeing employees that had zero out-of-pocket medical costs with their insurance plan.  Supposedly the employer paid the premiums too.  I was rather envious because I had a $10 copay at the time, plus whatever my monthly premium was - $40?

 

Ah, the good ol' days...

We had Boeing insurance in the 80's & 90's and everything, and I mean everything was covered 100%. My dad left there in 95/96.

 

Up until 2 years ago Microsoft was the same way. Now we pay 100% of the first $3700 and 10% up to $20,000. That doesn't include whatever our share of our premiums are. I have no idea what that is anymore.

[Annie G]

No, it's not common now. But back in the 90's we had Kaiser and we paid nothing. No deductible, no co-pays, nothing for prescriptions. I was able to have fertility treatments at no cost to me.  We saw people going to the doctor for every little thing.  (I mean the people dh worked with. The company generously gave them time off for doc appointments and his staff seemed to always be at the doctor for something) Today his company still lets people take time for doc appointments but he has no problem with staffing issues.   Since we now have high premiums, a large deductible and also pay the 20% the insurance doesn't cover, people are more choosy about seeing a doctor. Some of that is good, some is not. I would hate for someone to not see a doc because of the cost. 

 

 

[4everHis]

No it is not common anymore. What we do see is employer funded HRA or HSA.

 

 

Your board could consider doing an HRA/HSA fund that is funded by the company.  I would look for one with a roll over option. The company puts a set amount per year into each employees fund to use as they want. It can be used to cover deductibles/copays or things like eyeglasses, a few OTC items or other medical supplies.  

 

The advantage it that it puts a limit on how much the company is willing to contribute (in case of a person who wants to go weekly) but also allows some rollover in case the patient doesn't go to the doctor for the  year or so. 

 

A couple of us have just talked about HRA/HSA. I was also wondering about some kind of health incentive. One smokes but is the only one not seriously overweight. The smoker was also diagnosed with cancer. Their insurance will obviously cost the company more.  Can we encourage healthier choices in exchange for monetary help?

[4everHis]

have to run out for a bit but appreciate the feedback. 

[vonfirmath]

I remember in 1990 or 1991 someone telling me that there was a subset of Boeing employees that had zero out-of-pocket medical costs with their insurance plan.  Supposedly the employer paid the premiums too.  I was rather envious because I had a $10 copay at the time, plus whatever my monthly premium was - $40?

 

Ah, the good ol' days...

 

I worked for Boeing in 2001. By then we had some co-pays and such. Maybe even some cost for the health insurance. Not outrageous for sure. It was still pretty generous though. No co-insurance that I can recall.

[stripe]

People don't value that which is perceived to be free. 

Eh, I know what you mean, but I also don't think people should be scrimping on medical care, which most people don't do for kicks. You know? I just don't see medical care as that sort of a thing.

 

And if it is, it's the only darn thing you buy without knowing what it's going to cost you. I just took a family member for a procedure....even though I was able to get a ball park figure from my insurance of what that procedure costs at various places, I still didn't know quite what it would cost at the hospital we went to! Given that the costs before the deductible will be all mine to pay, it was and is a bit unnerving. The other really weird thing about insurance is the negotiated prices! I just got a prescription filled that costs $45 if paid in cash. My insurance has a $20 copay for generics, so I thought it would cost me $20. Nope. It cost me $15 and the insurance didn't actually pay any of it, but it did reduce the price. The same with blood labs -- the lab charged $47 for one thing, the insurance paid $0, but my charge is less than $4. Another one, the fee was $19, the insurance paid $0, and I was charged $2.95. So even when your insurance doesn't actually pay, their negotiated prices are seriously advantageous.

 

I think it's nice that now people can get an annual check up for free. I think that can help find problems when they're in the beginning stages and help connect people to a doctor that then they feel comfortable going to when sick or worried.

 

I would think a flex spending type account would be helpful for employees and might address some of these issues, including not having the cash on hand to pay for issues when they come up.

[Carrie12345]

 

 

DH's company pays all families' insurance.  So if an employee has no kids or is married with 3 kids - company pays for the insurance.  (I don't know how they'd react to a very large family, we've never been down that road in this company.)

 

It might not be a big deal, depending on the insurance company.

We pay for our own, with all 5 kids as members, but our premium is only applied to my spouse, me, and the eldest 3 kids. The last two have $0 next to their names on our policy.

[Spryte]

It might not be a big deal, depending on the insurance company.

We pay for our own, with all 5 kids as members, but our premium is only applied to my spouse, me, and the eldest 3 kids. The last two have $0 next to their names on our policy.

 

That's good to know.  DH manages the US division, thus the insurance, too.  He's wondered what would happen if a person with a large family applied for a job (he's hiring right now, so this has come up).  For now, they do pay for each child, but most of the families have 3 kids, and he can see the rates go up based on each child.  I'll let him know to ask the ins broker about more kids, so he knows how it will work if a candidate for the current job has more kids (unlikely, since the current opening is for entry level, but you never know!).  Thanks.  :)

[Annie G]

A couple of us have just talked about HRA/HSA. I was also wondering about some kind of health incentive. One smokes but is the only one not seriously overweight. The smoker was also diagnosed with cancer. Their insurance will obviously cost the company more.  Can we encourage healthier choices in exchange for monetary help?

 

 

Our health insurance info for next year was released today.  We have to do a health screening that covers blood pressure, cholesterol, weight, and some kind of test to detect nicotine.   If you do not do the screening there will be a $500 surcharge for the heath insurance- one for the employee and one for the spouse. If you smoke, there is a $500 surcharge. If you do not lower your blood pressure, cholesterol, or BMI by a certain percentage, there is a $1000 surcharge. 

 

For folks who do the screening, they deposit money into your HSA so you can spend it as needed on health care. However, dh makes enough that he doesn't get the HSA money. The new premiums were also revealed today and they are going up based on what your annual salary is- so dh is going to pay more than the guys who work with him. While many think that is fair, I do not.  It essentially means he's not getting as large a benefit package as someone who makes less than he does. 

 

While I'm in favor of healthier choices reducing my premium I'm not sure they can survive under that model unless they charge more for people with cancer or something. And that is not something I would support. 

[marbel]

Eh, I know what you mean, but I also don't think people should be scrimping on medical care, which most people don't do for kicks. You know? I just don't see medical care as that sort of a thing.

 

Oh yes.  After I left the house for most of the day, I thought "hmm... I should have also said..."    I have known, and known of, people who run to the doc for everything because it's "free."  I have no idea how pervasive that is, though.   

 

It is eye-opening to see the costs.  When I was on a co-pay plan, I had no idea how much things cost.  On the deductible plan, I get an explanation of benefits that shows the cost before and after the negotiated rate.  And you are right, you only get that after it's billed.  It's difficult for a lot of people.

[G5052]

I've never heard of a company that pays insurance and co-pays/deductibles!

 

Our insurance costs are low, and so are our co-pays/deductibles.  And it still breaks us at times.  Unless there's a surprise down the road, this month will be four doctor visits, two hospital procedures, and wisdom teeth.  I can't wait to see the bills  :crying: .

 

One of DH's relatives is job-hunting primarily because of health insurance issues.  He works for a small company and the monthly costs, deductibles, and co-pays are very high to the point that they're barely making it.

[Word Nerd]

My first real job was for a small company that paid 100% of employees' health premiums as well as a free membership to the health club across the parking lot. The plan had a relatively low deductible, then paid 100% for in-network providers. One of the reasons they could do this is that not smoking was a condition of employment.

[LostSurprise]

Until 2000 dh worked at the American arm of Panasonic. Everything was covered. 

 

When we moved to this job we asked how the insurance was. They told us 'good, some of the best around.' We laughed. 

 

 

I don't remember people running to the doctor for every little thing. I don't even remember it being easy. Often the more unusual stuff (like having a neonatal specialist stop by after a birth because you're 4 weeks early) got kicked back and you had to have it appealed, but eventually it was all paid. 

[Caroline]

We have co-pays but no deductibles. We pay under $1000/year in premiums. Co-pays are $10 for sick doctor visit, $50 for ER. We have never paid any more to an ER than that $50.

 

Less than 5 years ago, it was all covered by the company. That was great.

[maize]

I've never heard of the company paying copays or deductibles.

[Ellie]

We were members of Kaiser for 30 years in California, and although we had to pay a small co-pay, there were no deductables or anything. That may have changed in the last 10 years, and I also think that there might have been different levels of HMO membership. At any rate, we didn't pay anything except a small co-pay, and a small amount for drugs, at the three different companies Mr. Ellie worked for when we were there. We SO miss Kaiser!!

[QueenCat]

Dh's company loads the HSA with an amount to cover the deductible. It's cheaper for them to purchase a policy with a high deductible and then pay it for the employee than to purchase a policy with no deductible.

[freesia]

My dh's employer pays our deductible and co-insurance. They only have 2 employees.

[marbel]

I don't take those prices they list as real.  I just can't.  LOL  I mean I once got a bill that claimed the lab fee for a pap smear cost $200 (the insurance rate was $12).  $200?  On what planet?  Even the doctor didn't charge me that for the entire physical exam.  It's just stupid how that all works.

 

I suspect one of the reasons they do it is because they have all sorts of contracts with insurance companies.  If they have a percentage discount it makes sense to charge a lot of money (or claim to) so you get the biggest percentage you can get. 

 

Yeah, I should have said the billed amount.  I have no idea what actual costs for procedures are, and I am not sure anyone really does anymore.

 

I had to have some labs run for some typical female symptoms that an OTC remedy didn't relieve. On our old co-pay plan, I would have paid $30 and that was it.  On the deductible plan, I see by the explanation of benefits that the lab charged our insurance company $1200. After the adjustments for the negotiated rates for all the steps involved (it took 7 day with someone looking at it every day), my part of the bill was $900 because we haven't met our deductible yet.    Of course I don't know if hospitals, doctors, and labs bill different insurance companies different amounts - I know they may have different negotiated rates.  I also don't know if they would bill someone without insurance differently.  Some people say they bill at a lower rate because they don't have to deal with the insurers.   But yeah, who knows!

 

Back to people taking advantage of low/no co-pays.  I don't disagree with you who say it's probably not common, because I just don't know.  I was thinking about it more while I was out though and I guess my thinking that way comes from a couple of people I know who do, and from comments from two doctors.  One is an acquaintance who has said she is continually disgusted with people who go in asking for all sorts of tests because they don't have to pay anything for them.  Another was a doctor my son saw a few times about ADD.  A different doctor wanted to do an ADD test and the other doctor said he thought that type of test was worthless.  But  he said "if you want to do it, and your insurance will pay for it, go ahead."  I told him I wasn't really into getting every test possible just 'cause insurance would pay and he looked at me kinda funny and said "most people will take every test they can if it's covered."  So, fwiw, that's where I get that perspective.

 

It's so complicated. 

 

And yes the $900 is a burden, but our premiums are low and the deductible seems reasonable.  I can pay it all at once or pay it off monthly without interest, and it will all go toward the deductible.  So overall the cost is not too bad.   But I understand I am fortunate to be able to pay it; for some people it would be impossible, I know.   My main point was that it is interesting to be able to see it, 'cause for all I knew those labs could have been billed out at $50 or $5000 or anywhere in between.  . 

 

 

 

[marbel]

Duplicate post - my first, I think!

[Cera]

I've never heard of copayments and deductibles being paid by the company.

[bzymom]

Once upon a time, we had a separate plan provided for executives by the company which paid any copays, deductibles, etc.

 

*Sigh* 

 

Now insurance, copays, etc., are the biggest expense we have.

[4everHis]

Can the 'healthy choices' incentive be put out there by the actual company or must it be through the insurance company?

[Lanny]

I read an article, 1 or 2 days ago, that stated that large companies are looking very closely at their "Cadillac" health plans. The tax on those under the ObamaCare regulations has been delayed until 2018, and those companies are not going to pay that tax. So, the deductibles, co pays, etc., will be rising in the future.

 

I suspect that High Deductibles are going to either keep a lot of people from going for medical treatment in the future or cause them to declare bankruptcy. Hoping that I am wrong about that...

[FaithManor]

Dh works for GM. Our individual deductible is 2500/family max 5500. They put 2500 each year into our HSA to help with that and if the employee gets a physical that year and listens to a health lecture or something like that ( I need to ask dh exactly what it is) he gets another 1500. So this year they put 4000.00 total in the HSA.

 

It's the absolute best we've ever had in his entire career. Our premium contributions are very reasonable.

[4everHis]

Dh works for GM. Our individual deductible is 2500/family max 5500. They put 2500 each year into our HSA to help with that and if the employee gets a physical that year and listens to a health lecture or something like that ( I need to ask dh exactly what it is) he gets another 1500. So this year they put 4000.00 total in the HSA.

 

It's the absolute best we've ever had in his entire career. Our premium contributions are very reasonable.

 

But you DO contribute some to the premiums?  I'm just trying to be reasonable when we bring some of this before the board. I have a hard time believing that many small companies (or townships for that matter) are able to totally cover the insurance costs of employees anymore. 

[Cammie]

I find the constant statement that "companies can't afford to do that anymore" to be very interesting.  From all I have been reading companies (in particular the larger ones) are doing fairly well.  HUGE bonuses to the guys at the top, stock prices rebounding, corporate taxes at an all time low.  So I find it interesting that people seem willing to believe more that "companies can't afford it" than "employees deserve this as part of their compensation."  I have a feeling this may be particular to the American context. 

[Spryte]

I find the constant statement that "companies can't afford to do that anymore" to be very interesting.  From all I have been reading companies (in particular the larger ones) are doing fairly well.  HUGE bonuses to the guys at the top, stock prices rebounding, corporate taxes at an all time low.  So I find it interesting that people seem willing to believe more that "companies can't afford it" than "employees deserve this as part of their compensation."  I have a feeling this may be particular to the American context. 

 

I agree with you here.  

[Arcadia]

Yeah, I should have said the billed amount. I have no idea what actual costs for procedures are, and I am not sure anyone really does anymore.

When my mother was here, she pays cash for all her medical expense since she is a foreigner. It is cheaper.

When I ask my neighborhood dentist how much I have to pay without insurance, it was a low price that was much lower than the billed amount from our in-network dentist.

I have asked at many convenient to me doctors and dentists how much it would cost without insurance. They give discount for walk in customers without insurance who just pay a lump sum.

[FaithManor]

But you DO contribute some to the premiums? I'm just trying to be reasonable when we bring some of this before the board. I have a hard time believing that many small companies (or townships for that matter) are able to totally cover the insurance costs of employees anymore.

Yes, I would say about 3600 of the 13,600 premium but I haven't looked at a pay stub in a long time so this is just an estimate.

[4everHis]

I find the constant statement that "companies can't afford to do that anymore" to be very interesting.  From all I have been reading companies (in particular the larger ones) are doing fairly well.  HUGE bonuses to the guys at the top, stock prices rebounding, corporate taxes at an all time low.  So I find it interesting that people seem willing to believe more that "companies can't afford it" than "employees deserve this as part of their compensation."  I have a feeling this may be particular to the American context. 

 

I agree with you but in this case we are talking a very small business, less than 5 employees that get insurance. I probably should have stipulated that in the original post.

[StephanieZ]

That is insane.

 

How would you even keep track of that? And how would it be reported to the IRS? I'm 99% sure it'd be taxable wages, and tracking and reporting would be an utter nightmare.

 

Either buy your staff a more expensive insurance policy that has lower copays/deductibles, or not, but no way, no how, do you pay copays or deductibles.

 

Or give them all raises and call it a day. 

 

Or just say no. 

 

If you did want to do something like that, I think there may be HSA type accounts that have some ability to do that . . . but that is for very high deductible insurance products. 

 

Personally, I'd look at getting a new director, because that is such a bizarre and unrealistic request, I wouldn't want someone in charge of my business who was that out of touch with reality.

 

 

[TrixieB]

Our health insurance info for next year was released today.  We have to do a health screening that covers blood pressure, cholesterol, weight, and some kind of test to detect nicotine.   If you do not do the screening there will be a $500 surcharge for the heath insurance- one for the employee and one for the spouse. If you smoke, there is a $500 surcharge. If you do not lower your blood pressure, cholesterol, or BMI by a certain percentage, there is a $1000 surcharge. 

 

For folks who do the screening, they deposit money into your HSA so you can spend it as needed on health care. However, dh makes enough that he doesn't get the HSA money. The new premiums were also revealed today and they are going up based on what your annual salary is- so dh is going to pay more than the guys who work with him. While many think that is fair, I do not.  It essentially means he's not getting as large a benefit package as someone who makes less than he does. 

 

While I'm in favor of healthier choices reducing my premium I'm not sure they can survive under that model unless they charge more for people with cancer or something. And that is not something I would support. 

 

Oooh, wow.  We haven't had to do the nicotine test yet... I wonder if that will be new on this year's health screening to get the $500 surcharge removed.

 

[vonfirmath]

But you DO contribute some to the premiums?  I'm just trying to be reasonable when we bring some of this before the board. I have a hard time believing that many small companies (or townships for that matter) are able to totally cover the insurance costs of employees anymore. 

 

We are in a small family own business.

We don't contribute for premiums. At all. But we do have copays and co-insurance (20% after the deductible is paid -- which is $1K I believe)

 

When DS was born, he was covered under my deductible for the first 30 days. When DD was born I was responsible for deductibles for BOTH of us plus the co-insurance on the rest.

 

$40 copays Ouch. More than two hours work, without even considering taxes.

 

 

[LucyStoner]

The whole point of a co-pay is that they are paid by the insured. A company reimbursing for copays is highly unusual. Insurance without high copays is increasingly uncommon. We have $20 copays and a very low deductible and I consider that pretty awesome. The copays used to be $15 but $20 is still totally manageable. Employee and children are without premium for the insurance, spouse costs $200ish a month. Worth it.

[vonfirmath]

I find the constant statement that "companies can't afford to do that anymore" to be very interesting.  From all I have been reading companies (in particular the larger ones) are doing fairly well.  HUGE bonuses to the guys at the top, stock prices rebounding, corporate taxes at an all time low.  So I find it interesting that people seem willing to believe more that "companies can't afford it" than "employees deserve this as part of their compensation."  I have a feeling this may be particular to the American context. 

 

I see the reports that come out every year about our health insurance and how it is costing more every year. Every year I expect stuff to change but so far it has not. But the money is decreasing (More coming out than going in) anyway. They have an annual report with premiums paid, amount paid out, etc.

 

[sbgrace]

We have a high deductible plan. My husband is a state employee, so it's a big insurance pool. I believe premiums are covered by the employer at or near 100 percent. The state also kicks in a certain amount toward your deductible. I can't remember specifics, but it's something like our deductible is 6,000, the company gives 2,500 to be used toward that deductible. Once you reach the deductible (including self pay 100% prescriptions, but they do cover preventative care), insurance pays 80 and employee pays 20. They don't cover that employee portion copay.

 

This would work really well for a family with low (under 2,500!) medical expenses. High deductible plans stink for those of us with high medical bills though.  We always surpass that deductible by mid-year. I'm incredibly thankful we're insured though.

[4everHis]

Thank you again Hive. It is very helpful to be able to ask questions of such a large and varied group. 

[Annie G]

Oooh, wow.  We haven't had to do the nicotine test yet... I wonder if that will be new on this year's health screening to get the $500 surcharge removed.

 

 

 

It's new for us this year also. Up until now they've allowed people to self report.  Which means some folks are lying.  Dh has an employee who doesn't smoke the day he goes on and enrolls. So he answers 'no' to the 'are you a smoker' question. Then he logs off, lights up, and resumes his habit.  Everyone has a problem employee...and I think he's the exception rather than the norm. Others  just pony up the extra premium. They spend a fortune on tobacco and just consider the premium part of the cost of their habit.   But I guess the company thinks there must be a lot of people who smoke but don't fess up, otherwise it wouldn't be very cost effective to do a nicotine test on everyone.