Is anyone considering non-employer health insurance for 2014?

[maryofdoom]

Hi friends,

I am sorry if this has been discussed before - but is anyone here considering buying health insurance on an exchange for 2014, instead of getting it through your employer?

I ask for the following reason: I'm about to switch jobs. At the moment, the husband and I get health insurance through my OldEmployer, which is a university with good benefits (but not much else to recommend it, as there is a long, non-bikeable commute, as well as jerk co-workers). Regardless, health insurance for both of us right now is $200/month for an HMO plan that covers a lot of what we need.

Husband works for a SmallEmployer and the health insurance costs for both of us on his plan are fairly large, probably about $300/month for the both of us.

My NewEmployer is also a small company, with correspondingly large monthly health insurance costs. Plus, I can't get both of us on their plan until I've worked there for three months. Their premiums run between $350 and $400 per month for an employee and spouse.

We are two reasonably healthy, non-smoking adults. The largest health issues we've had are a bone spur in my toe last year (removed through surgery) and a vasectomy for him...although he is going to need a new rotator cuff at some point.

We live in southwestern Pennsylvania.

I'm not interested in debating the relative merits of the health insurance mandates - I want to know what you think is best in my situation. Should we continue with employer-sponsored health insurance, either on his plan or my new plan (once it's available), or is it worthwhile to look into purchasing insurance on the exchanges?

Any insight that anyone has would be most welcome.

[CB]

It was my understanding that if you had employer coverage available you weren't eligible for ACA subsidies.

Anyway, you can estimate your premiums by using the Kaiser Family Foundation premium/subsidy calculator here to get an idea about what you'd be looking at cost-wise.

[maryofdoom]

It was my understanding that if you had employer coverage available you weren't eligible for ACA subsidies.

Anyway, you can estimate your premiums by using the Kaiser Family Foundation premium/subsidy calculator here to get an idea about what you'd be looking at cost-wise.

Hmm...maybe this isn't an option for me, then. Thanks for your help!

[ichangedmyname]

I did look around since my insurance will go up next year to about $230/month for me and my husband. But most I saw on the exchange was $300-$400 or maybe I was doing it wrong?

[msilenus]

Health insurance is a really weird market.  I wouldn't be surprised if some people with terrible employer-subsidized group policies would be better off paying full price on the exchange.  The perfect storm would be something like this:
 * Employer offers only plans with high benefits levels.
 * Employer requires the employee to pay for much of the plan.
 * Employee's family is healthy and uses almost no medical services.
 * Employee is in a high tax bracket.
 * Employee is in a state with a high income tax, and which mirrors federal tax-deductibility of HSA contributions.
 * Employee is in an area with low-cost plans available on the exchange.

If you're healthy enough, an HSA-eligible HDHP purchased on the exchange can act like a kind of backdoor exchange subsidy by sheltering up to $6550/yr in income.  It's not hard to imagine that being worth $200/mo in the right state and to the right family.  If your employer requires you to pay a lot, and if you're in one of those areas that's offering some of the cheaper plans, it could make a lot of sense to forego employer coverage.

[msilenus]

Looks like there's a bronze plan in Washington county Pennsylvania for $278/mo.  Dental would be another $28/mo.  I think those numbers qualify as relatively low-cost relative to some others I've seen.  That's about break even with maryofdoom's employer-based options.

So if maryofdoom can park their entire typical health care budget for things that they can't defer into 2015 into X * $6550, where X is their marginal Federal tax rate, then they can come out ahead by taking an exchange-based plan.

I'm starting to wonder if we might see an adverse-selection death spiral in the group market place over the next five year or so.  That would be ironic!

[rubybeth]

I went with a plan from my state (Minnesota) exchange while DH is sticking with his employer's coverage. My employer plan went up in cost, and the state exchange had a much, MUCH cheaper plan, with a lower deductible. It's literally going to save me thousands in 2014, since my employer gives us flexible benefit dollars and I'm going to be saving most of mine into my HSA and my 457b account. I feel like I've gotten a huge raise, even though my actual pay has been frozen for the foreseeable future. I don't qualify for any subsidies since we make too much money (I have no complaints about this). It's worth it to run a search of plan options on your state exchange or on http://www.ehealthinsurance.com just to make sure you're getting the best deal.

[nawhite]

It was my understanding that if you had employer coverage available you weren't eligible for ACA subsidies.

I believe this is correct, but that doesn't mean you can't pay full price for it (thats what we will be doing)

For DW and I, we decided to split our insurance and went from both of us on a private plan to me on my employer plan and her on an ACA plan. My work started offering a HDCP with HSA for $150 less per month than my previous private plan was costing. My wife on the other hand is really well served by a Gold plan because of some strict prescription needs so we upped her coverage on the ACA market (increase was less than $50/month for her)

As 2 young people without kids, the private market was an awesome deal for us before ACA (way better than the previous employer options). Now with ACA and the new plan from my work, its a wash for us to go both private or both with my employer so we split who we went with.

[rubybeth]

It was my understanding that if you had employer coverage available you weren't eligible for ACA subsidies.

I believe this is correct, but that doesn't mean you can't pay full price for it (thats what we will be doing)

Yes, this is correct. If you qualify for employer health insurance, then you likely won't qualify for subsidies UNLESS you employer's coverage costs more than a certain percentage of your income. But still, the exchange may save you money without a subsidy, as in my case...

Employer coverage options:

$485/mo for $1,500 deductible
$385/mo for $3,000 deductible

State exchange option I selected:

$153/mo for $2,750 deductible