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2015/2016 ACA PPO Plans in 26 States


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This post is intended for those full timers under 65 who have to purchase their own health care insurance and may be considering a domicile change.

For an under 65 full timer who travels the country, the most "portable" health care plan is typically a PPO plan with a nationwide network. In most cases this will be a Blue Cross Blue Shield (BCBS) PPO plan.

While there promises to be many changes in the upcoming 2016/2017 ACA plans and offerings, I think states that currently have BCBS PPO plans should be a good place to start if you're looking for a domicile next year. We'll see.

In the following months I'll try to finish as many states as I can and then also post the health care plans for each county in all the states -- currently that's over 1700 counties.

2015/2016 ACA PPO Plans in 26 States

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I don't see how people can retire now if they are under 65 unless they get health insurance

from an old employer. I was looking for a health insurance plan for my better half for the next 11 months,

she will be 65 then. There is a silver plan at $645.11 per month no deductible but the cheapest drugs are $35 per month

or $85 for three months and she takes five. The hospital deductible is $500 per day. I am thinking of keeping her on COBRA

from my employer at $810 per month. I couldn't think of paying two times of either amount, $645.11 or $810, per month.

I just turned 67 on July 27 and I will be retiring on September 1st. My employer plan is about as good as you can get. Since

I am the CEO I picked our plan.

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Aetna's decision to pull from the exchange this week triggered some smaller companies to follow and is causing big problems in arizonia and some other southern states. Aetna's move is surprising as they came out in support of the ACA only three months ago (there is a lot of inside baseball speculation going on about Aetna's true motivations right now). The situation you refer to in Arizonia of course begs for legislative intervention but that is about the last thing we can expect these days. I suspect we will see more fall out in the next few months. This is a big hit for the ACA. The policy experts have a list of fixes for the ACA but none of them can get passed as things currently stand.

 

Three things for the under 65 crowd to remember: (1) the ACA exchange is not one big market but 50 small ones and some states have thriving exchange markets; (2) as fulltimers we have health insurance disadvantages but also the advantage of having much more fleixiblity to change domicile to a state with a healthier ACA market and (3) having places without options in Arizonia really reinforces the need for a public option to fill the gap and depending on election results could benefit under 65 fulltimers.

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. The situation you refer to in Arizonia of course begs for legislative intervention but that is about the last thing we can expect these days.

What do you have in mind? Would you pass a law requiring companies to continue to write health insurance?

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I really have not thought it all through Kirk and I know there are several articles out on this issue but I have not read them yet.

 

What I kinda had in mind when I made that comment was those residents without any option on the exchange should not then be penalized with the tax surcharge for having health insurancewhich is non-ACA compliant. Maybe a provision like that already exists in the Act but certainly people should not be fined for not performing an obligation which is impossible to perform.

 

I know you were making your comment about requiring insurance companies to participate in the exchange tongue in cheek but I do think some states may say that if you want to participate in the health insurance market within our state, you need to participate in all of the market. In other words you cannot come in here and just cherry pick the healthiest population. That kind of activity hurts the whole state. Also, remember these insurers are not being forced to take losses for more than one year. Each year they can reset their rates. It is only when they make errors in setting their rates that they have trouble (this is another source of questions about Aetna's true intent).

 

The other fix, and my preferred at this point especially for under 65 fulltimers, would be to have a public option offered by the federal government structured somewhat as an early buy in to medicare. This would make sure there is always at least one option available in every county.

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It looks like a great place for a public option. We do know the motivation, Aetna's CEO stated that if

they were not allowed to merge then Aetna would pull out of the exchange. When the merger was not

permitted do to anti-competiveness that is what they did, no surprise.

I am retiring on September 1st and I am the CEO for a company with 427 employees. Providing

health care has been a big problem. Until the past two years we had United Health Care as our insurer.

But even though our claims were less then 60% of what we paid to them they wanted to renew with an 11%

increase. They tried to blame the ACA but our plan already had all of those ACA required provisions well before

the ACA. We were paying over $900 per month per employee. We ended up with a self funded plan with re-insurance

for large claims and a stop gap of 125% of premium. So far over the past two years we have saved more then $600,000.

The problem is that if we have a lot of big claims over the year it will cost us more. But at least that amount is limited to 125% of premiums

which is still less then the $900 per month that we were paying.

They only thing that we are not paying is the profit that United Health Care made off of our plan. United Health Care had to refund money to us over

the last two plan years because they didn't pay the required % for medical claims.

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