Has anyone successfully navigated ObamaCare?

[Kathy813]

Nancy, there is a link in my post that takes you to the website with that information. I don't remember the exact amount but I know difficult child's out of pocket was a lot lower than $6300.

Just so others can compare . . . my difficult child is 28 and makes approximately $22,000 a year which is 191% above the poverty level. She got a subsidy of $109 a month which brought her premium down to $81.00 for the silver plan which pays approximately 70% of her medical expenses compared to the bronze level plan that covers 60%. She also is a smoker.

~Kathy

 

[Nancy]

Sig one of the ideas my husband is toying with also is to drop their coverage and give them a raise to cover their cost in the marketplace. His business is also in the 20-50 range and yes the rates are awful. If he drops coverage they will be eligible for the marketplace.

 

[Nancy]

Kathy you have great plans there, or I should say difficult child does where she lives. The best my difficult child can do is $66.27 with a $2,000 deductible but out of pocket is $4500.

 

[DammitJanet]

MWM, for the Medicaid for Pregnant women they will only count both incomes if they are married. House is not an issue. Her income would almost make me certain that she is eligible. She would be here. And like I said, the baby is automatically given medicaid until age 1 if they are born to a mother on medicaid.

 

[BusynMember]

Thanks, Janet. Which is a reason not to get married (sigh).

 

[DDD]

No...I don't know anything about the Presidents plan. I do, however, know that I paid almost a grand a month to keep myself covered until I turned 65. From everything I have read the "new" plan is an improvement over dealing with the private insurance industry. I sincerely hope that the Country benefits and that difficult child's benefit even more. DDD

 

[Nancy]

Wow DDD I thought we were the only ones who were paying over a thousand a month. Was that for just you or you and your husband?

 

[LittleDudesMom]

*As a very small business, our insurance expense is intense. For bonehead, his wife, the two kids and myself we pay almost 3K a month! It was 2400 a month this year and our renewal this month was 2800! Rather than do the small business insurance, we were able to get coverage for me and the kids on one plan and bonehead and his wife on another plan for under 800 a month (through the same insurance company)!! 61K a year versus 17K -- the new insurance is definitely a bonus for us. None of our other employees either qualified or wanted the insurance as the few full timers we had were on their spouse's plans.

Sharon

 

[Nancy]

That's great Sharon. At one time just several years ago we were paying $3000 a month for four of us and it's now $1350 for two of us. But under the plan we can get it for $950 a month for the two of us with a smaller deductible and max out of pocket. I haven't signed up for it yet as we are waiting to see if husband can get his employees covered and if he does he will have to be under their plan but the SHOP side is having problems so I willprobably have to sign us both up and drop him later if necessary. I'm also surprised to hear your employees are covered under their spouse's plans because I've been hearing about all these companies that are dropping spouse coverage.

 

[witzend]

Janet, I don't have Part B, I only have Part A. I'm a spouse on husband's plan, and since he is working as a contractor they're not putting any money into it. But we make too much money for any discounts from anything.

I also pay $0 for generic rx's, which my doctor never writes, $20 for certain rx's which I'm not on, $40 for others I'm not on, $120 for some I'm on but can't afford so I go with a "comparable generic", and $580 for some that I just can't take anymore.

husband's actual workplace offered him a position that would include benefits at about $490 a month but they wanted him to take a 25% pay cut. That was last year. He said "no thanks". He reminded them a month or so ago that he'd like to be a permanent employee under the right conditions, and they said "great"! and we heard nothing more. His temp agency told him his contract is being renewed and he should ask for a raise, which if it is 5% the supervisor can approve without moving it up the chain. Oh - and he should have asked for one last year, too, but the agency forgot to tell him about it.

 

[witzend]

I won't feel successful until I actually I get that bill reflecting the tax credit and all the ducks are in a row

Will you be happy with it if you get what you are expecting?

 

[witzend]

Sig one of the ideas my husband is toying with also is to drop their coverage and give them a raise to cover their cost in the marketplace. His business is also in the 20-50 range and yes the rates are awful. If he drops coverage they will be eligible for the marketplace.

I think I would jump at that opportunity either as a small business employer or as an employee.


Summary of ObamaCare and Small Business
A quick summary of what ObamaCare means for small businesses:

ObamaCare creates the Small Business Health Options Program or SHOP, a part of each States Health Insurance Marketplace, where small businesses with under 50 full-time equivalent employees can shop for group health plans starting October 1st, 2013. In 2016 those with 100 full-timers or less can use the SHOP.

Taxes and tax credits are based off of the number of full-time equivalent employees (FTE) and their average annual wages, not solely on the number of full-time employees.

Small businesses with fewer than 25 full-time equivalent employees with average annual wages below $50,000 can get tax credits (as adjusted for inflation beginning in 2014) to help pay for employee premiums.

Small businesses with more than 50 full-time equivalent employees with average annual wages above $250,000 must provide health coverage to full time employees come 2015. This is sometimes called "the employer mandate".

Businesses making over $250,000 in profit must pay a .9% increase on the current Medicare part A tax. The tax is split (.45% each) between the employer and employees making over $200,000 individual ($250,000 family).

All businesses with over 50 full-time equivalent employees have to let their employees know about their State's Health Insurance Marketplace / exchange. What Do I Need to Tell My Employees about ObamaCare? "


http://obamacarefacts.com/obamacare-smallbusiness.php

 

[Signorina]

Our problem is that we employee 23 or so part time workers and "x amount" of part time workers will equal the equivalent of 1 full time worker. So, our 23 part timers will easily turn into 8 full timers if not 13 full timers...

We are still trying to figure that out. Since we don't renew until 2/1 it's on our agent's back burner. For the purpose of the health care tax credit - we have 32 equivalent full time workers. I swear between the benefits administration, keeping the software/hardware up to date, PCI and the OSHA regulations, and tax forms/mandated notification, we spend way too much time & resources on managing this stuff instead of managing and growing our primary business aka generating OFFSETTING REVENUE. Half the time I feel like we are working for our Point of Sale software instead of our software working for us... it's making me crazy lately.

Nancy, in IL an aggregate owner (defined by the IRS, generally more than a 5% owner or a first degree relative of a 5% owner) is not treated as an employee for the purpose of benefits. So in our business, we can decline the health insurance for instance because technically we are an employer and not an employee. Works the same for our 401K matches - we do not match our own contributions.

 

[ctmom05]

yes

 

[witzend]

yes

That's the most important part!

 

[Nancy]

That is very interesting Sig. My husband's business is a law firm and he is a partner so I'm not sure it works the same way but I will pass on the info to him. If he can opt out as a partner then we will just enroll under the marketplace as a couple. We are not eligible for subsidies or tax breaks but the rates are much better than we are paying.