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


4everHis
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I envy those of you who have employer-provided insurance.  

We pay nearly $700 each month for BC/BS and have a $10K deductible.  

And you only have 2 kids. We have 5 and hence, no insurance. We couldn't afford the $700 much less what I know would be more for 3 more kids.. . .

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Are you saying your employer provides some part of your insurance and you are STILL kicking in $700? If so, OH MY!!!!!

 

Employer pays at least as much as we do. Every year they send out the details about how much they pay on our behalf- for health insurance, disability, etc.

 

And we got the news yesterday that premiums next year are going up based on how much you make. So they're going to be paying a smaller percentage of our insurance because dh earns over  a certain amount. So we're paying 12% more and the guys who work for him will pay 5% more.   Oh, and they're taking out dental and eye insurance and selling them separately so we'll be paying 12% more for a lot less coverage.     Crazy, huh?

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The insurance I have through work is fully funded (i.e.. I don't have to pay a percentage of the premium) and there is not a co-pay for in-network services.  There is a $100/individual and $250/family deductible for in network services.  The only pitfall is that out of network services are really essentially not covered.  Hence having the family covered on both my insurance and DH's insurance.  

 

DH's insurance is a pretty standard commercial plan.  There are co-pays and we have a individual/family deductible and a max OOP clause.  The plan has a reasonable network and also reimburses reasonably for out of network even if one goes out of network purely by choice (i.e. we use a pediatrician who doesn't accept any commercial insurance for our kids).  The one really good feature is that they don't subcontract out their prescription coverage and no prior authorization is needed for prescriptions as long as they are written by a MD/DO.  Our prescription co-pay is non-tiered as well. Of course, to an extent you pay for what you get and some of this is what DH negotiated for when he set up the insurance in the first place.  

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OP, you need a professional to answer your questions. I am an employee benefits attorney, and most of what has been stated on here is wrong (not people's experiences--everyone's opinions on whether this is legal or how you can charge extra for tobacco use or other health conditions). Do you have a benefits consultant or broker who can help? These are complicated issues, and a professional can help you sort them out.

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OP, you need a professional to answer your questions. I am an employee benefits attorney, and most of what has been stated on here is wrong (not people's experiences--everyone's opinions on whether this is legal or how you can charge extra for tobacco use or other health conditions). Do you have a benefits consultant or broker who can help? These are complicated issues, and a professional can help you sort them out.

Thank you. We had just come to that conclusion as a board too. That this is not a matter of what we'd like to do for our people but that we need to consult with someone about what we are ABLE legally to do or not do. 

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