HSA and their attachment to high deductible plans

6,074 Views | 50 Replies | Last: 11 mo ago by bigjag19
YouBet
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62strat said:

TXTransplant said:

P.H. Dexippus said:

My wife has her and the kids on a Cadillac HDHP through her job. The cost of going from "employee + kids" to "family" is around $300/mo. My company subsidy 100% covers my HDHP premium on our company plan.

Despite this most of our single employees of all ages avoid the HDHP (and HSA).


My company really does not want to insure spouses who have access to their own insurance. Our plans have a surcharge if you add a spouse who can get their own insurance through their employer. It's a pretty significant extra fee.

The fee is waived if your spouse doesn't work or doesn't have access to health coverage.
how would they check something like this?

This seems borderline illegal, or breaking some sort of privacy laws.


I assume it's legal but I noticed during my annual enrollment that this was a question now being asked.
htxag09
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It's really expensive for companies to insure people and more so their families. I don't see an issue with it, my current employer, nor my wife's employer, do it. But a previous employer has. If I'm remembering correctly it's just something you sign, not like they're doing background checks on your family.

And, if we're being honest, the alternative would be to just raise premiums (so the company subsidizes less of the premiums) for all family plans. So I think this kind of set up is a pretty good compromise.
62strat
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my company pays my premium if I'm on it solo, but adding spouse or family is all of a sudden $500+ a pay period.

And we're paid weekly!

So I don't think they are covering much of it if anything.
My wife and kids on her employers plan which is like $600/mo, and has an HSA, which they contribute $100/mo.
BenTheGoodAg
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Holy smokes! For a HDHP? That seems like a terrible rate. $26k a year.

Our HDHP premiums are about $23 a week for a family.
Bert315
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I'm on a low deductible plan. My employer has not made the HDHP worth it yet. The OOP max on the low deductible plan is lower by $3k, the HDHP is only $50 less PPP, and the company does not add anything to the HSA. For a young family with 3 kids, we hit our $700 family deductible quickly and then a 10% coins. HDHP is $4500 deductible so big gap and not worth it. Would love the HSA but I've run the numbers the last 2 years on our medical expenses and the HDHP would have costed quite a bit more. Now if my company started to give an extra $1500 or so towards the HSA I might jump in.
cjo03
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62strat said:

TXTransplant said:

P.H. Dexippus said:

My wife has her and the kids on a Cadillac HDHP through her job. The cost of going from "employee + kids" to "family" is around $300/mo. My company subsidy 100% covers my HDHP premium on our company plan.

Despite this most of our single employees of all ages avoid the HDHP (and HSA).


My company really does not want to insure spouses who have access to their own insurance. Our plans have a surcharge if you add a spouse who can get their own insurance through their employer. It's a pretty significant extra fee.

The fee is waived if your spouse doesn't work or doesn't have access to health coverage.
how would they check something like this?

This seems borderline illegal, or breaking some sort of privacy laws.

dependent eligibility audits are legal - similar to an employer requesting a birth certificate or marriage license to add a new dependent, employers can also request info on spousal surcharge provisions.
TXTransplant
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It's not illegal. I know there is a form/paperwork involved, but I do not know how they verify (I don't have a spouse). I suspect if you lie and they find out, you can be terminated for fraud.

My company is self-insured, so every $ spent is a $ removed from our profits. Why should we absorb the costs of someone who has access to coverage through their own employer?

As others have mentioned, it's more expensive to insure adults than kids (and it's reflected in our premiums).

My HDHP used to be free. Now I think I pay $50-$60 a month for myself and my son.

This is for a plan with a $3200 deductible; the max OOP is $9k. Very minimal coverage for prescription drugs, and you pay OOP for everything except one annual preventative visit (at discounted in-network provider and service rates). Company puts $1000 in the HSA for those with dependents.

The next plan up has a lower dedictible/OOP max, but by the time you pay the premiums, the expenses are the same for most scenarios.

I basically look at it as self-insuring for the first $8k. If we don't spend that much in a year, I get the benefit of investing it in my HSA.
EliteZags
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side question: assuming company pays full premiums for all employees+family coverage,
would an employee that's single (vs one that inures family of 4) directly cost the company less in benefits to the extent that it could be potentially be considered as a factor in salary increase negotiations?
htxag09
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EliteZags said:

side question: assuming company pays full premiums for all employees+family coverage,
would an employee that's single (vs one that inures family of 4) directly cost the company less in benefits to the extent that it could be potentially be considered as a factor in salary increase negotiations?

Would it cost the company less? Yes.

Would it be a negotiation point? Probably depends on the company. I would think not as likely at large corporations as you're talking about two different budgets. Also, what happens if you get married and have kids? Do they lower your salary?
62strat
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EliteZags said:

side question: assuming company pays full premiums for all employees+family coverage,
would an employee that's single (vs one that inures family of 4) directly cost the company less in benefits to the extent that it could be potentially be considered as a factor in salary increase negotiations?
related, when I was hired I was offered a salary and if I didn't join their plan I was paid more.
That's what I did.

Years later I joined their plan, no decrease in salary. (Salary had gone up quite a bit by then anyway)
ABATTBQ11
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The high deductible plan is essentially how insurance is supposed to work. It is catastrophic risk transference as opposed to maintenance, which is what health insurance has become. If nothing is really covered until and unless you hit the deductible, you're not insuring for all the random doctor visits and things you have throughout the year, and if you're not insuring for them, the insurer isn't trying to recoup the costs through premiums. So with the catastrophic HDHP, you keep your money instead of paying an insurer for a lot of lesser care you probably won't end up needing.
CapCity12thMan
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I pay $74.61/month for a $2500 Ind. deductible, $5k max OOP, which after reading all the above I guess I'm in pretty good shape? I go to a doc maybe 1-2x per year. Last year I went to a dermatologist and an orthopedist for a broken finger but thats it.
Drawkcab
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BenTheGoodAg said:

Holy smokes! For a HDHP? That seems like a terrible rate. $26k a year.

Our HDHP premiums are about $23 a week for a family.


I'm in the same boat. Our HDHP is about $550/month. Not as high as strats but still damn high. I know it's typically much less, if not the cheapest plan available, at most employers.
BenTheGoodAg
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Just shows how saavy you need to be when considering a comp package. Between the three of us, $26k vs $6.6k vs $1.2k, which could make up for a lot of base salary. Granted, that's a deducted cost, but still.
SnowboardAg
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Not sure why we couldn't have an HSA option for home and auto insurance. Same concept to save and use for retirement of house and auto insurance. With a cap on risk of say 30-50k, and roof replacements
bigjag19
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Family deduct 4K. OOP max 7500.

Company puts 1k in.

Monthly difference plus what I would put into an FSA is greater than max HSA, which is basically the OOP max.

Under the old low deductible I was always out of pocket come October as fsa was wiped. Now I'm never out of pocket with no difference to my take home and usually rolling money.

I hit the OOP max in 23 in February. Had 2 surgeries and 60 rounds of PT after that and didn't pay a dime beyond normal pay check contribution and ended year with 1500 still in HSA. Dental costs are separate and easily paid with HSA. No brainer.
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