Monday, September 6, 2010

COBRA Coverage

This will not be discussing new healthcare rules. Rather this will be discussing current rules and corporation's math skills.
At my previous employer, I paid for 50% of my health insurance on a biweekly basis for a high deductible plan. Under COBRA rules, I am able to keep my coverage if I pay 102% of the costs. It is 102% so that administrative costs can be covered.
Let's go over the math. $13.85 for medical and $4.23 for dental every two weeks for a year equals $470.08 or $39.17 per month. Now if I have to pay 102% that would be $79.91 per month. Correct?
I get the bill for the coverage. I call up, they can't go over the math, but they can assure me it is correct. The bill is for one month is $355.53. Now this would be at 100% of cost $348.56 per month or to convert that back to a biweekly pay period it would be $160.87. This would mean I had only been paying slightly over 11% of the costs. Believe me I can't find the documentation to cite, but this is not the figure we were given. We were told 50%, but even this isn't 25% or 33%.
To make this more affordable, the government is subsidizing the cost. I know this is quite controversial between the Republicans/Democrates/Tea Partiers. While not taking a side completely, I do know that I'm fortunate that at the moment I can qualify and that not everyone could afford the full cost. After the government credit, I owe $124.44.
For the sake of argument, if that was my full premium than previously I was paying 32.11% of my premium. Still less of a percentage than I was told.
Bottom line: Rather than debating if the government should be handing out money. I think it would be much simpler if the government required the corporation/insurance company to send an explanation of benefits or costs. Here is how much you paid, see employee handbook this was x percentile. Here is the full cost per year. Here is the administrative cost we are allowed to add. This is how much you owe per month. I believe someone is switching something and I can't get a good read on where it's occuring, but the numbers aren't working as you read above. If the cost is the true cost, maybe it would encourage people to realize how much they are spending because I'm pretty sure hypochondria is driving up some of the cost. Pet Peeve: we were told at one point each man, woman, and child had on average 14 distinct perscriptions each year. As this is more than one per month, and I averaged one every three years, I can't help but wonder how often this was truly needed.
I'll step off of the soapbox now.

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