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Thread: Where Do You Get

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    Senior Member starjack's Avatar
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    Default Where Do You Get

    Where does the average american get to look at this health care bill

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    Senior Member tpaschal30's Avatar
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    SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.

    (a) In General- A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution--

    (1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

    (2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.

    (b) Special Rules for Small Employers-

    (1) IN GENERAL- In the case of any employer who is a small employer for any calendar year, subsection (a) shall be applied by substituting the applicable percentage determined in accordance with the following table for `8 percent':

    --------------------------------------------------------------------------------------------------------------------

    --------------------------------------------------------------------------------------------------------------------

    If the annual payroll of such employer for the preceding calendar year: The applicable percentage is:

    Does not exceed $250,000 0 percent

    Exceeds $250,000, but does not exceed $300,000 2 percent

    Exceeds $300,000, but does not exceed $350,000 4 percent

    Exceeds $350,000, but does not exceed $400,000 6 percent

    --------------------------------------------------------------------------------------------------------------------

    (2) SMALL EMPLOYER- For purposes of this subsection, the term `small employer' means any employer for any calendar year if the annual payroll of such employer for the preceding calendar year does not exceed $400,000.

    (3) ANNUAL PAYROLL- For purposes of this paragraph, the term `annual payroll' means, with respect to any employer for any calendar year, the aggregate wages paid by the employer during such calendar year.

    (4) AGGREGATION RULES- Related employers and predecessors shall be treated as a single employer for purposes of this subsection.
    With an 8% penalty(of total payroll) what employer will offer coverage?

    2005 percentages of payroll costs



    Step one to single payer!

    Remember Ford negotiated its way out of a lot of HC to the union. The union is needing another bailout!
    Last edited by tpaschal30; 08-12-2009 at 07:32 PM.

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    Senior Member YardleyLabs's Avatar
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    Do you have a different reference explaining the graph? I'm not sure what I'm looking at. One of the "Blue Dog" compromises is reportedly to eliminate penalties for companies with payrolls under $1 million. With respect to the size of the penalty, the theory was that the tax on employers, combined with the tax on employees, would total about 10,5% of payroll which was approximately equal to the cost of providing health benefits consistent with company averages and the cost of the minimum qualifying plan. Currently, small employers tend to pay much higher premiums than larger employers because they lack negotiating power. They also tend to pay more, assuming they are able to obtain coverage at all, because they cannot meet insurer requirements that all or virtually all employees be enrolled. The proposed plans help with both of these challenges and should significantly reduce the cost for small employers to buy coverage. As one who believes that employers should not be burdened with health insurance costs at all, I find this whole issue troubling, but still an improvement over what we have now.

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    Senior Member Buzz's Avatar
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    Quote Originally Posted by YardleyLabs View Post
    As one who believes that employers should not be burdened with health insurance costs at all, I find this whole issue troubling, but still an improvement over what we have now.
    Not only is it a huge burden on business to be in the business of providing health insurance, it just doesn't make sense to tie health insurance to employment. If you are the bread winner for your family and end up with cancer and get too sick to work, your family loses it's income, and on top of it you lose your health insurance when you need it most. We have a small family business, and health insurance premiums, after payroll, is our biggest expense.
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    Senior Member tpaschal30's Avatar
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    Quote Originally Posted by YardleyLabs View Post
    Do you have a different reference explaining the graph? I'm not sure what I'm looking at. One of the "Blue Dog" compromises is reportedly to eliminate penalties for companies with payrolls under $1 million. With respect to the size of the penalty, the theory was that the tax on employers, combined with the tax on employees, would total about 10,5% of payroll which was approximately equal to the cost of providing health benefits consistent with company averages and the cost of the minimum qualifying plan. Currently, small employers tend to pay much higher premiums than larger employers because they lack negotiating power. They also tend to pay more, assuming they are able to obtain coverage at all, because they cannot meet insurer requirements that all or virtually all employees be enrolled. The proposed plans help with both of these challenges and should significantly reduce the cost for small employers to buy coverage. As one who believes that employers should not be burdened with health insurance costs at all, I find this whole issue troubling, but still an improvement over what we have now.
    You are looking at the percentage of payroll for HC costs for 2005. If the penalty is only 8% and using you number of 10.5% why would any company not opt out. Limiting choice and getting Obama's ultimate goal, federally provided single payer insurance. Which he can't say outloud and is what the folks are screaming about in the townhalls. We don't want it.
    I'm all for HC reform. I want to end Medicare and Medicaid, , replace them by providing every family in the United States with catastrophic insurance (i.e., a major medical policy with a high deductible). Second, it would end tax exemption of employer-provided medical care. Remove the restrictive regulations that are now imposed on medical insurance—hard to justify with universal catastrophic insurance.

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    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by tpaschal30 View Post
    You are looking at the percentage of payroll for HC costs for 2005. If the penalty is only 8% and using you number of 10.5% why would any company not opt out. Limiting choice and getting Obama's ultimate goal, federally provided single payer insurance. Which he can't say outloud and is what the folks are screaming about in the townhalls. We don't want it.
    I'm all for HC reform. I want to end Medicare and Medicaid, , replace them by providing every family in the United States with catastrophic insurance (i.e., a major medical policy with a high deductible). Second, it would end tax exemption of employer-provided medical care. Remove the restrictive regulations that are now imposed on medical insurance—hard to justify with universal catastrophic insurance.
    If the only reason employers have for providing health benefits is to avoid paying penalties, why do you think that they now pay more than 11% of payroll in health benefits when there are no penalties at all? The fact is that this provision is directed at employers such as Walmart which provides no employer paid healt benefits to half of its employees. Given that Walmart now pays about 5-6% of payroll for health benefits, but that these benefits are restricted to only some of their employees, I suspect that they will restructure their health plans if the law is passed.

    With respect to single payer coverage, there is no proposal to implement that. Why do opponents feel compelled to make up false claims to justify their positions. Are arguments against the actual proposals that weak?

    With respect to your proposals regarding universal catastrophic insurance, I believe those have merit. Would the catastrophic plan be a single payer plan? A pure high deductible plan, as distinct from a plan with significant co-pays and a high out of pocket maximum cost limitation as the tendency to encourage people to defer preventive care and treatment of problems before they become too serious. This actually ends up increasing total health care costs.

    With respect to regulation of the insurance industry, the principle sounds good. Unfortunately, the reality is that most buyers of insurance are not able to understand or evaluate policy language and typical marketing materials walk very close to the line of being criminally fraudulent. This is apparent in those segments of the insurance market that are not regulated where policies typically have loss ratios (percent of premium paid out for claims) of less than 50%. To put that in context, most state lottery programs have a higher payout than most unregulated insurance policies.

    This level of profit is typically sustained through a mix of gotcha language to exclude claims, cancellation provisions that are exercised as soon as you file a claim, and abusive claim management procedures designed to force claimants to give up and settle for lesser amounts. A policy of "buyer beware" is inadequate when it is not reasonably possible for a buyer to evaluate what they are buying. While it is neither possible nor desirable to protect the consumer fully, a certain level of protection is essential. That's why we have, for example, relatively universal standards governing merchandise saying that a good must be suitable and usable for the purpose for which it is advertised. Services such as insurance require similar csonsumer protections.

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    "To put that in context, most state lottery programs have a higher payout than most unregulated insurance policies."

    While I belive this is true, do you have any back up for this? Interesting.
    Tom Dorroh

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    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by Thomas D View Post
    "To put that in context, most state lottery programs have a higher payout than most unregulated insurance policies."

    While I belive this is true, do you have any back up for this? Interesting.
    Prizes across state lotteries average about 60-65% (http://www.ncsl.org/?TabId=12747)

    Loss ratios vary by line of insurance. Group Accident & Health policies are at the high end with loss ratios of about 69%. Medical malpractice policies, by contrast, average about 31% (remember that when blaming high rates on the court process) and title insurance, which is without doubt the most politically abused form of insurance in the world, has avrage loss ratios of under 12%. My insurance company clients focused most of their efforts on building lines where they could keep loss ratios under 45%. (See, for example, http://www.insurance.mo.gov/reports/lossratio/)

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    Quote Originally Posted by YardleyLabs View Post

    ......With respect to single payer coverage, there is no proposal to implement that. Why do opponents feel compelled to make up false claims to justify their positions......
    Here's a take on answering this question.http://correspondents.theatlantic.co...nal_belief.php

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