Archbishop Chaput: shutting down charitable services is 'very much a possibility' [CWN]

[JimR-OCDS]

The issue is about the self-insured not having the funds to self-insure after the law goes into effect. As I understand it, even without a contraception mandate, institutions which self-insure will probably not be able to provide the level of health care coverage for their employees that the health-care law will mandate. The result will be that either they’ll have to provide health insurance from licensed health insurance companies, or go out of business.

I worked for a large corporation that at one time self-insured. Quite frankly, the coverage stunk. My son was born prematurely, while I was working for them, and the out of pocket expenses I had to pay for was staggering.

Jim

 

[Corki]

The issue is about the self-insured not having the funds to self-insure after the law goes into effect. As I understand it, even without a contraception mandate, institutions which self-insure will probably not be able to provide the level of health care coverage for their employees that the health-care law will mandate. The result will be that either they’ll have to provide health insurance from licensed health insurance companies, or go out of business.

I worked for a large corporation that at one time self-insured. Quite frankly, the coverage stunk. My son was born prematurely, while I was working for them, and the out of pocket expenses I had to pay for was staggering.

Jim

Most companies that self-insure still offer the coverage through a licenced health insurance company. For example, one of my prior employers self-insured but all of our health care expenses went through Aetna. I had both of my children on that plan and each cost me $80 out of pocket - $75.00 for the first prenatal doctor’s visit and $5.00 for the hospital stay since I wanted a phone in my room. There are companies that do it totally in-house but the more usual is for the company to assume the financial risk but the insurance company to do the adminstration.

 

[JimR-OCDS]

Most companies that self-insure still offer the coverage through a licenced health insurance company. For example, one of my prior employers self-insured but all of our health care expenses went through Aetna. I had both of my children on that plan and each cost me $80 out of pocket - $75.00 for the first prenatal doctor’s visit and $5.00 for the hospital stay since I wanted a phone in my room. There are companies that do it totally in-house but the more usual is for the company to assume the financial risk but the insurance company to do the adminstration.

The company I worked for also had a private insurance company handle the administration. However, the company chose what they would pay for and it was lousy.

My son was born premature at the time, and spent six weeks in a neonatal ER. It was expensive and the company only covered 80%. The cost was $75,000 and this was back in 1981, when my wages were low. It was great when they finally purchased insurance from an outside company. It ended up being cheaper and they covered more.

Jim

 

[Corki]

The company I worked for also had a private insurance company handle the administration. However, the company chose what they would pay for and it was lousy.

Sorry to hear about your son. The point is that it’s not **because **your company was self-insured that the coverage was lousy. A company that chooses to fully insure (through an agency) could just as easily have lower coverage levels. Some insurance plans don’t cover maternity at all or well child visits or non-emergency surgery or cover dependents. Lots of plans, by the way have 80/20 splits for coverage but most have a stop loss (the maximum the patient has to pay themselves) that is lower than $75,000. And this is true for self-insured AND fully insured plans.

 

[JimR-OCDS]

Sorry to hear about your son. The point is that it’s not **because **your company was self-insured that the coverage was lousy. A company that chooses to fully insure (through an agency) could just as easily have lower coverage levels. Some insurance plans don’t cover maternity at all or well child visits or non-emergency surgery or cover dependents. Lots of plans, by the way have 80/20 splits for coverage but most have a stop loss (the maximum the patient has to pay themselves) that is lower than $75,000. And this is true for self-insured AND fully insured plans.

Well, arguing the point before the SCOTUS makes it’s decision is probably moot.

Happy Easter
Jim