NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

  1. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     




     

    [/QUOTE]

    That's essentially New York's policy, and the reason premiums are more than $1000/month.  If you can't deny pre-existing conditions, I'll just wait until I get a 'condition' before I get insurance.  Hence the mandate.

     
  2. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to slomag's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

     

    [QUOTE]

     

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     

     




     

     

     

    [/QUOTE]

    That's essentially New York's policy, and the reason premiums are more than $1000/month.  If you can't deny pre-existing conditions, I'll just wait until I get a 'condition' before I get insurance.  Hence the mandate.

     

    [/QUOTE]

    I know why the mandate was put in place. Which is why I've never been against the mandate. It's needed if we all want to keep our insurance premiums from heavily spiking each year.

     

     
  3. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to slomag's comment:

    [QUOTE]

     

    In response to FortySixAndTwo's comment:

     

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    In response to slomag's comment:

     

     

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    In response to FortySixAndTwo's comment:

     

     

     

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    In response to slomag's comment:
    [QUOTE

     

     

    Prior to Obamacare, if you're a 25-year-old with an "I only have to pay $12K if I get hit by a bus plan" you pay for everything out of pocket.  

    After Obamacare, you're probably not paying anything because you're on your parents' insurance.  

     

    Right....but the parents are paying for it. Maybe you'd be ok with being a 25 year old adult sponging off your parents. To each his own I guess.

     

     

     

     

     

     

     




     

     

     

     

     

     

     

    [/QUOTE]

    Puh-lease.  I say it's 50/50 you're typing this from your mother's basement.

     

     

     

     

     

     

    [/QUOTE]

    Great comeback. So are you saying the parents wouldn't be paying more for having their 25 year old childadult on the plan? 

     

     

     

     

    [/QUOTE]

     

    More than the $92 / month median plan?  No, I think that's unlikely for most families.  The child counts toward the house-hold calculations, so if the family is susidized, it could actually cost more when he/she leaves the plan.  

    California has a cost calculator - plug in the numbers.  A family of four with a house-hold income of 70K pays the same as a family of three with a house-hold income of 70K.  At 90K, the family of four pays less than the family of three.

    http://www.coveredca.com/calculating_the_cost.html

    [/QUOTE]

    Psst...not everyone will be on subsidized exchange plan. So a husband and wife who could have gone to maybe two individual plans, at their respective companies, instead of a family plan now need to stay on the more expensive family plan because Beavis isn't able to be an adult at the age of 25.

    [/QUOTE]

    It doesn't work that way - the exchange isn't a public option.  It's only available to those who cannot get insurance through their employers.  And the employers cannot provide an 'individual plan' that provides coverage inferior to the 'bronze level' exchange plan.  And besides all that, after 25 years, no parent is counting the days until he/she can drop his/her kids' health coverage.  It's a ridiculous notion, and argument.

     
  4. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to slomag's comment:

    [QUOTE]

     

    In response to FortySixAndTwo's comment:

     

    [QUOTE]

     

     

    In response to skeeter20's comment:

     

     

    [QUOTE]

     

     

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     

     

     




     

     

     

     

     

    [/QUOTE]

    That's essentially New York's policy, and the reason premiums are more than $1000/month.  If you can't deny pre-existing conditions, I'll just wait until I get a 'condition' before I get insurance.  Hence the mandate.

     

     

     

    [/QUOTE]

    I know why the mandate was put in place. Which is why I've never been against the mandate. It's needed if we all want to keep our insurance premiums from heavily spiking each year.

     

     

    [/QUOTE]

    Sorry - sometimes it's hard to see who wrote what in these forums.

     
  5. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to slomag's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to slomag's comment:

     

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    In response to FortySixAndTwo's comment:

     

     

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    In response to slomag's comment:

     

     

     

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    In response to FortySixAndTwo's comment:

     

     

     

     

    [QUOTE]

     

     

     

     

     

    In response to slomag's comment:
    [QUOTE

     

     

    Prior to Obamacare, if you're a 25-year-old with an "I only have to pay $12K if I get hit by a bus plan" you pay for everything out of pocket.  

    After Obamacare, you're probably not paying anything because you're on your parents' insurance.  

     

    Right....but the parents are paying for it. Maybe you'd be ok with being a 25 year old adult sponging off your parents. To each his own I guess.

     

     

     

     

     

     

     

     




     

     

     

     

     

     

     

     

     

    [/QUOTE]

    Puh-lease.  I say it's 50/50 you're typing this from your mother's basement.

     

     

     

     

     

     

     

     

    [/QUOTE]

    Great comeback. So are you saying the parents wouldn't be paying more for having their 25 year old childadult on the plan? 

     

     

     

     

     

     

    [/QUOTE]

     

     

    More than the $92 / month median plan?  No, I think that's unlikely for most families.  The child counts toward the house-hold calculations, so if the family is susidized, it could actually cost more when he/she leaves the plan.  

    California has a cost calculator - plug in the numbers.  A family of four with a house-hold income of 70K pays the same as a family of three with a house-hold income of 70K.  At 90K, the family of four pays less than the family of three.

    http://www.coveredca.com/calculating_the_cost.html

     

    [/QUOTE]

    Psst...not everyone will be on subsidized exchange plan. So a husband and wife who could have gone to maybe two individual plans, at their respective companies, instead of a family plan now need to stay on the more expensive family plan because Beavis isn't able to be an adult at the age of 25.

     

    [/QUOTE]

    It doesn't work that way - the exchange isn't a public option.  

    Which is why I didn't say it was.

    It's only available to those who cannot get insurance through their employers.  And the employers cannot provide an 'individual plan' that provides coverage inferior to the 'bronze level' exchange plan.  

    I was talking about employer group insurance...which majority of people are on. 

     

    And besides all that, after 25 years, no parent is counting the days until he/she can drop his/her kids' health coverage.  It's a ridiculous notion, and argument.

    You're kidding right? You don't think most parents want their kids to fly on their own? 

     

    [/QUOTE]


     
  6. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     




     

    [/QUOTE]

    My point was that we don't needthe ACA to resolve your issues.  Not takinga swing at them, or you, just indicating that the ACA is over kill for theses issues, and probably for most of the other issues being mentioned as reason for why we need the ACA.

    In fact, that there are so many issues  that are sopposedly being resolved, AND costs are going down, should trigger anyone's BS meter.

     
  7. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to slomag's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to slomag's comment:

     

    [QUOTE]

     

     

    In response to FortySixAndTwo's comment:

     

     

    [QUOTE]

     

     

     

    In response to skeeter20's comment:

     

     

     

    [QUOTE]

     

     

     

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     

     

     

     




     

     

     

     

     

     

     

    [/QUOTE]

    That's essentially New York's policy, and the reason premiums are more than $1000/month.  If you can't deny pre-existing conditions, I'll just wait until I get a 'condition' before I get insurance.  Hence the mandate.

     

     

     

     

     

    [/QUOTE]

    I know why the mandate was put in place. Which is why I've never been against the mandate. It's needed if we all want to keep our insurance premiums from heavily spiking each year.

     

     

     

     

    [/QUOTE]

    Sorry - sometimes it's hard to see who wrote what in these forums.

     

    [/QUOTE]

    I'm a former health insurance underwriter so I know the significance of having everyone covered in order to make getting rid of pre-x work. 

     
  8. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to WhatDoYouWantNow's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

    The aspect of health insurance being compensation has largely been eliminated by the ACA.

    What's so hard for you to understand?

     



    What's hard for me to understand? The bolded.

     

     

    Because it isn't true at the moment.

    [/QUOTE]

    Right.  Because it is being delayed, the employee provision.  sigh.  

    But, it is law, it will at somepoint be enforced, and it wil lat that point cease the exist as compensation.

    But, don't let the fact that even Obama is walking away from it keep you arguing for it.

     
  9. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to slomag's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

     

    [QUOTE]

     

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     

     




     

     

     

    [/QUOTE]

    That's essentially New York's policy, and the reason premiums are more than $1000/month.  If you can't deny pre-existing conditions, I'll just wait until I get a 'condition' before I get insurance.  Hence the mandate.

     

    [/QUOTE]

    So, you argree that adding pre-exisitng conditions drives the price of insurance through the roof, right?

    So, how does Obamacare change that?

     
  10. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to slomag's comment:

    [QUOTE]

     

    In response to FortySixAndTwo's comment:

     

    [QUOTE]

     

     

    In response to slomag's comment:

     

     

    [QUOTE]

     

     

     

    In response to FortySixAndTwo's comment:

     

     

     

    [QUOTE]

     

     

     

     

    In response to skeeter20's comment:

     

     

     

     

    [QUOTE]

     

     

     

     

     

    So, let the market handle them.  It is not like it hasn't in the past.  I've dealt with pre-existing conditions (chronic and serious), and have not had trouble geting health insurance.  Obamacare does absolutely nothing for me in this regard.

    The market wasn't handling them. Your pre-x condition obviously wasn't that serious since you were able to get coverage without issue. Or you got your insurance through an employer in which case pre-x wasn't an issue.

    Or, conversely, pass a one line bill, not a 2,700 page behemoth with 13 new taxes, a few hundred thousand new government employees, a two trillion dollar price tag, and a confiscation of our rights to cotrol our own health care, to solve a simple problem, if it is really a problem.

     

    Here's my proposed bill.

     

    No one shall be denied health insurance by reason of a pre-existing medical condition, or be subject to a lifetime cap on expenses.

     

    See?  Easy.  Didn't take 2,700 pages, destroying our economy, and removing our freedoms.

     

    And if I was arguing we needed 2,700 pages you'd have a great point. But I wasn't. So you don't. 

     

     

     

     

     




     

     

     

     

     

     

     

     

     

    [/QUOTE]

    That's essentially New York's policy, and the reason premiums are more than $1000/month.  If you can't deny pre-existing conditions, I'll just wait until I get a 'condition' before I get insurance.  Hence the mandate.

     

     

     

     

     

     

     

    [/QUOTE]

    I know why the mandate was put in place. Which is why I've never been against the mandate. It's needed if we all want to keep our insurance premiums from heavily spiking each year.

     

     

     

     

     

     

    [/QUOTE]

    Sorry - sometimes it's hard to see who wrote what in these forums.

     

     

     

    [/QUOTE]

    I'm a former health insurance underwriter so I know the significance of having everyone covered in order to make getting rid of pre-x work. 

     

    [/QUOTE]

    Do underwriters set rates? Or do they simply qualify people for plans and rates set by business?

     
  11. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

     




    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

    [/QUOTE]


     
  12. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to WhatDoYouWantNow's comment:

    In response to skeeter20's comment:

    [QUOTE]
    So, let the market handle them.  It is not like it hasn't in the past.

     

     



    Groan. No, that's entirely the point: THe market wasn't handling them.

     

    Pre-X, no insurance and/or no employer will hire you. Lifetime max: hit the limit and kiss your backside goodbye.

    You know what a pure unregulated free market insurance scheme would look like?

     

     


    No pre-X, small lifetime maxes, no requirement for anything even like an internal appeal of denial of claim, and plans that cover less and less.

    "Regulation" - without pointing to a specific one - ensures that certain things must be covered, and limits the ways in which your golden gods can shaft the customer.

     

     

     

    Pure free market capitlism has never - repeat never - existed. At the point closest to pure free market systems, both employee and customer are shafted the most.

    At the other end of the spetrum - communism - everything breaks down and all you've got is a totalitarian regime governing the ruins of an economy.

    The best solution is somewhere inbetween, and where depends on the industry in question.

     

     

    You're a nutter, in short.

    [/QUOTE]

    Said the loon.

    did I say pure free market capitalism? 

    Why do you persist in these wild exaggerations? Do you think it makes you look wicked smaht?

    The health care market has been closer to the free market in comparison.  I suggest we roll some of this regulation back until prices go down. Let's try that before we crater the entire economy in order to cover pre-existing illnesses without exception or review.

     
  13. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

     

     



     


    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

    [/QUOTE]


    [/QUOTE]

    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     
  14. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to WhatDoYouWantNow's comment:

    In response to skeeter20's comment:

    [QUOTE]So, how does Obamacare change that?



    Even a "dope fiend" has better memory.

     

     

    The mandate. Duh.

    [/QUOTE]

    I'm going to start to call you the snippet king.

    to answer the question, as it relates to New York, Obamacare does not change cost parameters significantly for  preexisting conditions as it was already covered in NY.

     
  15. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

    In response to WhatDoYouWantNow's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

     

    [QUOTE]
    So, let the market handle them.  It is not like it hasn't in the past.

     

     

     

     



    Groan. No, that's entirely the point: THe market wasn't handling them.

     

     

    Pre-X, no insurance and/or no employer will hire you. Lifetime max: hit the limit and kiss your backside goodbye.

    You know what a pure unregulated free market insurance scheme would look like?

     

     


    No pre-X, small lifetime maxes, no requirement for anything even like an internal appeal of denial of claim, and plans that cover less and less.

    "Regulation" - without pointing to a specific one - ensures that certain things must be covered, and limits the ways in which your golden gods can shaft the customer.

     

     

     

    Pure free market capitlism has never - repeat never - existed. At the point closest to pure free market systems, both employee and customer are shafted the most.

    At the other end of the spetrum - communism - everything breaks down and all you've got is a totalitarian regime governing the ruins of an economy.

    The best solution is somewhere inbetween, and where depends on the industry in question.

     

     

    You're a nutter, in short.

     

    [/QUOTE]

    Said the loon.

     

    did I say pure free market capitalism? 

    Why do you persist in these wild exaggerations? Do you think it makes you look wicked smaht?

    The health care market has been closer to the free market in comparison.  I suggest we roll some of this regulation back until prices go down. Let's try that before we crater the entire economy in order to cover pre-existing illnesses without exception or review.

    [/QUOTE]

    Because health care costs were going down prior to Obamacare?

     
  16. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

    In response to WhatDoYouWantNow's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

     

    [QUOTE]So, how does Obamacare change that?



    Even a "dope fiend" has better memory.

     

     

     

    The mandate. Duh.

     

    [/QUOTE]

    I'm going to start to call you the snippet king.

     

    to answer the question, as it relates to New York, Obamacare does not change cost parameters significantly for  preexisting conditions as it was already covered in NY.

    [/QUOTE]

    What do you mean?  The mandate is bringing costs way down in NY - that's the point of the OP.

     

     
  17. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

     

    [QUOTE]

     

     

     

     

     



     

     


    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

    [/QUOTE]


     

    [/QUOTE]

    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

    [/QUOTE]

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

     
  18. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to slomag's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

    In response to WhatDoYouWantNow's comment:

     

    [QUOTE]

     

     

    In response to skeeter20's comment:

     

     

    [QUOTE]
    So, let the market handle them.  It is not like it hasn't in the past.

     

     

     

     

     

     



    Groan. No, that's entirely the point: THe market wasn't handling them.

     

     

     

    Pre-X, no insurance and/or no employer will hire you. Lifetime max: hit the limit and kiss your backside goodbye.

    You know what a pure unregulated free market insurance scheme would look like?

     

     


    No pre-X, small lifetime maxes, no requirement for anything even like an internal appeal of denial of claim, and plans that cover less and less.

    "Regulation" - without pointing to a specific one - ensures that certain things must be covered, and limits the ways in which your golden gods can shaft the customer.

     

     

     

    Pure free market capitlism has never - repeat never - existed. At the point closest to pure free market systems, both employee and customer are shafted the most.

    At the other end of the spetrum - communism - everything breaks down and all you've got is a totalitarian regime governing the ruins of an economy.

    The best solution is somewhere inbetween, and where depends on the industry in question.

     

     

    You're a nutter, in short.

     

     

    [/QUOTE]

    Said the loon.

     

     

    did I say pure free market capitalism? 

    Why do you persist in these wild exaggerations? Do you think it makes you look wicked smaht?

    The health care market has been closer to the free market in comparison.  I suggest we roll some of this regulation back until prices go down. Let's try that before we crater the entire economy in order to cover pre-existing illnesses without exception or review.

     

    [/QUOTE]

    Because health care costs were going down prior to Obamacare?

     

    [/QUOTE]

    Regulation was going up, that's part of it, a major part.

    The other part is that, on balance, the healthcare in this country does asounding things, new things.  that cost money.

    The last leg of cost is the preemptive nature of our health care.  Suing doctors is a sport  to some, and it drvies up costs, through litigation and CYA test requests.

    Obamacare really doesn't address any of this that I can see.  It adds more regulations, out of the gate, over 20,000 pages of new regulations.  Creating and enforcing regulation COSTS MONEY.

    It does attempt to interfere with the process of innovation, at least in part, by adding a 3.5% tax, a surtax, really, on top of medical devices, where much of the innovation is taking place.  

    And lastly, Obamacare is silent as far as I can see on the cost of malpractice and CYA testing, except the medical panels which seek to rigidy determine what tests and procedures are available for what medical issues.  I guess this is a small cost savings, which might be offset by increased medical malpractice by helath insurance not covering certain tests that a doctor orders.

    So, hopefully you see my point and agree.

     
  19. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

    In response to FortySixAndTwo's comment:

     

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    In response to skeeter20's comment:

     

     

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    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

     

    [/QUOTE]


     

     

     

    [/QUOTE]

    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     

    [/QUOTE]

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

    [/QUOTE]

    Right.  But the point is, the underwriters don't set the rates, actuarials do.  Underwriters use pricing provided to them, and apply it to the case.

     
  20. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

    In response to FortySixAndTwo's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

     

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    In response to FortySixAndTwo's comment:

     

     

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    In response to skeeter20's comment:

     

     

     

    [QUOTE]

     

     

     

     

     

     

     

     

     



     

     

     

     


    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

     

     

    [/QUOTE]


     

     

     

     

     

    [/QUOTE]

    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     

     

     

    [/QUOTE]

     

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

    [/QUOTE]

    Right.  But the point is, the underwriters don't set the rates, actuarials do.  Underwriters use pricing provided to them, and apply it to the case.

    [/QUOTE]

    Not sure how many times I can say this. Large group undrwriters set the rates NOT the actuaries. 

    For small group, technically yes, the rates are solely manual therefore based on actuary tables.

    So again, small group, actuary. Large group, underwriter.

    We good?

     
  21. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to skeeter20's comment:

    [QUOTE]

     

    In response to FortySixAndTwo's comment:

     

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    In response to skeeter20's comment:

     

     

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    In response to FortySixAndTwo's comment:

     

     

     

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    In response to skeeter20's comment:

     

     

     

     

    [QUOTE]

     

     

     

     

     

     

     

     

     

     

     



     

     

     

     

     


    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

     

     

     

    [/QUOTE]


     

     

     

     

     

     

     

    [/QUOTE]

    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     

     

     

     

     

    [/QUOTE]

     

     

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

     

    [/QUOTE]

    Right.  But the point is, the underwriters don't set the rates, actuarials do.  Underwriters use pricing provided to them, and apply it to the case.

     

    [/QUOTE]

    Not sure how many times I can say this. Large group undrwriters set the rates NOT the actuaries. 

    For small group, technically yes, the rates are solely manual therefore based on actuary tables.

    So again, small group, actuary. Large group, underwriter.

    We good?

    [/QUOTE]

    We might be talking past each other.


    So, you have someone with a heart condition.  You sit down and come up with a number based on what?  Filed rates, or you just pull a number out of thin air?  Charge them $10, or charge them a million, based on what?

    I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere.

     
  22. This post has been removed.

     
  23. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

     

    In response to skeeter20's comment:

     

     

     

    In response to FortySixAndTwo's comment:

     

     

     

     

     

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    In response to FortySixAndTwo's comment:

     

     

     

     

     

     

     

     

     

     

     

     

     

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    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

     

     

     

     

     

     




     

     

     

     

     

     

     

     

     

     

     

     

     



    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     

     

     

     

     

     

     

     

     

     

     



     

     

     

     

     

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

     

     

     

     



    Right.  But the point is, the underwriters don't set the rates, actuarials do.  Underwriters use pricing provided to them, and apply it to the case.

     

     

     

     

     

     

     



    Not sure how many times I can say this. Large group undrwriters set the rates NOT the actuaries. 

     

     

     

    For small group, technically yes, the rates are solely manual therefore based on actuary tables.

    So again, small group, actuary. Large group, underwriter.

    We good?

     

     

     

     

    We might be talking past each other.


    So, you have someone with a heart condition.  You sit down and come up with a number based on what?  Filed rates, or you just pull a number out of thin air?  Charge them $10, or charge them a million, based on what?

    I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere. 

    (Pricing and Rates are the same thing)

     



    Large group underwriting does not look at each individuals health situation. They look at the group as a whole. They look at the overall age/sex of the group AND the past claims experience to determine future claims cost. Large group underwriting does not charge each individual separately like in your example you gave above. They come up with a final ARM and then from there come up with the Single rate and Family rate.

     

    So for the last fcuking time. UNDERWRITERS set the rates for large employer groups. I am the one who was the underwriter....why the fcuk are you trying to tell ME who sets the fcuking rates? Do I tell you how your job works?

    Small group rates are the rates pretty much set from actuarial tables. 

     

    "I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere. "

    Pricing and Rates are the same thing

    [/QUOTE]

    I see the problem.  We are talking past each other.

    I understand that you use demographics and various rates to derive a "rate" or a premium for a person within a group.  You don't set the underlying rate.  in other words, you don't determine the cost or impact of, say, heart ailments on the rate.  you apply the rate to your demographic.

    To make the point even clearer, you don't go out and do primary research on the cost of heart ailments, derive a rate, and apply that to your demographic upon which you are setting rates.

    I understand that you look at a lot of these areas, health status rating, demographic ratings, expereince rating, and so on, to derive the perium.

    But, going all the way back to your earlier point that started all this discussion:  I don't see how your underwriting work gives you insight to the lack of coverage for pre-ex and lifetime caps.  Those sound more like underlying rate issues, not underwriting issues. 

    Maybe I am wrong.

     
  24. You have chosen to ignore posts from FortySixAndTwo. Show FortySixAndTwo's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

    In response to FortySixAndTwo's comment:

     

    In response to skeeter20's comment:

     

     

     

    In response to FortySixAndTwo's comment:

     

     

     

     

     

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    In response to FortySixAndTwo's comment:

     

     

     

     

     

     

     

     

     

    In response to skeeter20's comment:

     

     

     

     

     

     

     

     

     

     

     

    In response to FortySixAndTwo's comment:

     

     

     

     

     

     

     

     

     

     

     

     

     

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    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

     

     

     

     

     

     



     

     

     

     

     

     

     

     

     

     

     

     

     



    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     

     

     

     

     

     

     

     

     

     

     


     

     

     

     

     

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

     

     

     

     



    Right.  But the point is, the underwriters don't set the rates, actuarials do.  Underwriters use pricing provided to them, and apply it to the case.

     

     

     

     

     

     

     



    Not sure how many times I can say this. Large group undrwriters set the rates NOT the actuaries. 

     

     

     

    For small group, technically yes, the rates are solely manual therefore based on actuary tables.

    So again, small group, actuary. Large group, underwriter.

    We good?

     

     

     

     

    We might be talking past each other.


    So, you have someone with a heart condition.  You sit down and come up with a number based on what?  Filed rates, or you just pull a number out of thin air?  Charge them $10, or charge them a million, based on what?

    I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere. 

    (Pricing and Rates are the same thing)

     



    Large group underwriting does not look at each individuals health situation. They look at the group as a whole. They look at the overall age/sex of the group AND the past claims experience to determine future claims cost. Large group underwriting does not charge each individual separately like in your example you gave above. They come up with a final ARM and then from there come up with the Single rate and Family rate.

     

    So for the last fcuking time. UNDERWRITERS set the rates for large employer groups. I am the one who was the underwriter....why the fcuk are you trying to tell ME who sets the fcuking rates? Do I tell you how your job works?

    Small group rates are the rates pretty much set from actuarial tables. 

     

    "I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere. "

    Pricing and Rates are the same thing



    I see the problem.  We are talking past each other.

    I understand that you use demographics and various rates to derive a "rate" or a premium for a person within a group.  You don't set the underlying rate.  in other words, you don't determine the cost or impact of, say, heart ailments on the rate.  you apply the rate to your demographic.

    To make the point even clearer, you don't go out and do primary research on the cost of heart ailments, derive a rate, and apply that to your demographic upon which you are setting rates.

    I understand that you look at a lot of these areas, health status rating, demographic ratings, expereince rating, and so on, to derive the perium.

    But, going all the way back to your earlier point that started all this discussion:  I don't see how your underwriting work gives you insight to the lack of coverage for pre-ex and lifetime caps.  Those sound more like underlying rate issues, not underwriting issues. 

    Maybe I am wrong.

    [/QUOTE]

    Pre-x and lifetime max is an underwriting issue.

    For example, the rates are derived based on X benefits. Those X benefits including lifetime max. So for X benefits the rate is $100 (Use $100 for ease)

    Now take X benefits and eliminate Lifetime max. As a result X beneifts is now a much richer plan because the limit has been lifted. So now there is potential for more claims costs. So now X benefits rate becomes $200 (or whatever, I don't know the actual mark up but it's more than $100) 

    So the underwriter need to adjust the rates for the richer benefits.

    For pre-x, plans will now be including individuals who have a known potential high claims cost. This needs to be factors into the rates in order for the rates to be high enough to cover costs.

     

     

     
  25. You have chosen to ignore posts from GregStillinMeffa. Show GregStillinMeffa's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    FForbes debunked this the next day and the Times went mum.

     

    In the vast majority of states, Obamacare has the net effect of raising premiums by a lot, which has given rise to the term “rate shock.” In California, for example, a healthy 40-year-old today can pay $94 per month in the individual market; that rises to $234 a month under Obamacare: an increase of 149 percent.

    Obamacare even drives up costs in heavily regulated states. In 1993, Washington instituted progressive reforms similar to those of New York, though Washington’s were somewhat less punitive. This led me to expect that Washington, along with New York and a handful of other states, could see individual-market rate decreases under Obamacare. Much to my surprise, it turns out that even in Washington state, Obamacare will drive premiums upward by 34 to 80 percent. The average of the five lowest premiums for a 40-year-old in Washington today is $162; Obamacare will drive that up to $243.

    ghttp://b-i.forbesimg.com/theapothecary/files/2013/07/community-rating.png

     

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