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[wercal]

164. The company share is very small

Last edited Fri Oct 11, 2013, 04:44 PM - Edit history (1)

As I explained, we have a large group and pay premiums to match last year's actual cost. The company share pays a relatively small administrative fee to the insurance company, and a relatively small fee for catastrophic insurance in the event that we as an entire group have claims higher than our premium payout.....which has never happened, and every year it doesn't happen, that catastrophic insurance fee stays flat.

If your husband's company had a hypochondriac, that just validates my point. (I'm not sure why you insinuate that I would be against covering him/her). We just have an atmosphere, as I described in the previous post, where we know that we are in a large group, and we know that our actions have direct cost consequences. I'll try to reiterate again - Blue Cross does not insure us for the first $2.2 million. We as a group of employees pool our resources, and pay our premium into a big pot of money...this money is not 'paid' to the in insurance company. It is our own pot, and it covers 100% of our expected claims. So payments to the insurance company are for two things:

1) Coverage for going beyond the $2.2 million cap. Now remember we have historically never gone beyond this cap. And really, most catastrophic medical treatments seem to top out at around $150k-$200k, so the odds of a multitude of major illnesses pushing us beyond that cap is relatively low, and the premium for that is very low.

2) Administrative fee. We are somewhere near 4% with this right now. So that's 20 bucks a month the company is paying instead of me.

All said, my $527 might be $600 if the company didn't pitch in. Now remember, I think that's high! And quite frankly, the $1,300 you describe absolutely blows my mind. Anyway, the company contribution is not at all HUGE.

As I stated before, we have a wellness program, we encourage each other to use generic drugs, frankly we dodge a bullet sometimes (one guy's wife needed a $450k liver transplant, but he had coverage from the railroad he used to work at), but most importantly...and I don't think you want to understand this completely - we self insure each other. This means that there is no overhead fee (recent news reports indicate this adds at least another 20%) or profit margin on any of the premium that comes out of my pocket. This is the power of a large group, and the power of a large group that is committed to each other, committed to not wasting each other's resources, and committed to collectively keeping our costs down. Our HR department spends months each year shopping around and negotiating our admin fee to keep it low. As I said before, part of our company culture includes a culture of fitness. This stuff takes a lot of work. But we do it.

Now, it sounds like your quest for a lower rate consisted of making a few phone calls. I'm not going to denigrate your approach...but please don't be so dismissive of what we have been able to do at my company, when the only lens you view insurance through is shopping rates. We do more than that...a lot more than that. If all we did was price traditional insurance, we would probably be paying a lot more....but there are a lot of very smart people here, and we didn't settle for 'normal'.

A quick edit - I just got an e-mail, and the company is sponsoring a flu shot clinic. They're paying the bill, and the people with the vaccine are coming to us. So easy breezy, I've got my flue shot next week. And kids under 18 can get a free one too. Its just a small example of our emphasis on preventative care.