Real Life Case Study on Health Care Reform

BlueCross BlueShield of NC is raising our health insurance premium by 26%!!

When we asked why and wanted to change some of the provisions of our plan, we were provided with the following explanation:

“If you like your health plan, you can keep it” --- we were told this on many occasions.

The Affordable Care Act of 2010 included a “grandfathering’ clause. Has nothing to do with age but allows you to keep your current plan and be exempt from SOME of the new health care provisions.

It is clear to me that the new health care provisions as outlined by BlueCross BlueShield will increase costs but a “grandfathered” plan will be exempt as the new provisions are phased in from 2010 – 2014.

If you change your health care plan in any of following ways, your plan will no longer be protected under the “grandfather” status:

• Elimination of benefits to diagnose or treat a particular condition
• Any increase in cost-sharing percentage requirements --- coinsurance
• Increase in fixed-amount cost-sharing requirements (deductibles, out-of-pocket limits or copayments)
• Employer contributions reduced by more than 5%
• Any decrease in the dollar amount of the overall annual limit

BlueCross BlueShield cites the Administration as predicting that by 2013, only 55% of large employers and 34% of small employers will maintain grandfathered plans. As a sole proprietor, we must evaluate the monthly cost, “grandfather” provisions, and health status while GUESSING what Congress will do about the new health care legislation.

  

Reality: Current monthly cost of $681 will increase to next year’s rate of $858.

  

We want to increase our deductible to lower the monthly cost but this will result in a loss of the “grandfather” status which will result in an increase of health care costs. It seems to me the health care reform law, at least for my family, only increases my monthly cost without an improvement in health care.

Oh by the way, what about your health care plans?