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Work benifits and how it works ?

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Prospect
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Posted: #1
I just got accepted into a job
and on my job description paper has a section for what my benefits are.

one thing I'm confused about is that it says..

Benefits: Health & Dental coverage for employee & any combination of employee & Children/spouse, to be paid predominately by the company with subsidy by the employee paid weekly from payroll deduction.

Does this mean my company will be paying more than half of the bill ?
and can I just start going to the dentist & doctors as soon as I start working ?
do they also cover for braces and what not ?




 
Legend
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Posted: #2

Does this mean my company will be paying more than half of the bill?

The days of a company paying 100% Health Coverage are long gone.  Most companies pay at least 50% and usually up to 75 or 80%.   Your weekly cost will depend upon the type of plan you select (Single or Family) and the coverage and deductibles you desire.



Can I just start going to the dentist & doctors as soon as I start working?

Usually not.  There is typically a waiting period as little as 30 or as many as 90 days.



Do they also cover for braces and what not?

It depends on the plan you select.  If you need this coverage, be certain the plan you select will cover your needs.  Of course your weekly deduction cost will be higher for the best plans.



There are many other factors involved including co-pay amounts.  Make sure you understand all your policy limits.  For example, certain medical proceedures may only be covered up to 80% leaving you to pay the last 20%, Dental may only be 50% coverage or have a higher deductible, prescriptions will have a co-pay every refill, etc.
~~~~~ZOSO~~~~~
 
Legend
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Posted: #3
Proves my point.  

I've hired people internally who are college grads who have a tough time understanding health and dental plans (co-pays, co-insurance, max out of pocket, in-network, out of network, deductibles, etc., etc.).  
How would a person such as the original poster understand their options under Obamacare?  

And good luck to you MPChino.  This stuff is complicated so find the person at your company responsible for benefits and sit down with them so they can explain your options.  

Good luck with the new job.  Congrats.  
 
Veteran
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Posted: #4
Both Excellent answers...

As Hutch said Congrats.   and find the person who is suppose to know the answers.

My added thought is write down your questions ahead of time and take notes.

Again Congrats...
 
Prospect
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Posted: #5
thank you guys appreciate it.
 
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Posted: #6
Quote Originally Posted by HutchEmAll:

Proves my point.  

I've hired people internally who are college grads who have a tough time understanding health and dental plans (co-pays, co-insurance, max out of pocket, in-network, out of network, deductibles, etc., etc.).  
How would a person such as the original poster understand their options under Obamacare?  

And good luck to you MPChino.  This stuff is complicated so find the person at your company responsible for benefits and sit down with them so they can explain your options.  

Good luck with the new job.  Congrats.  

ObamaCare has "Navigators" who can help you.  The main things ObamaCare is doing is making it illegal to sell a really bad plan, so the consumer can't get burned too badly. 

Here is the basics for figuring out which plan is best

Pick a plan with a good network.  If you have a Doctor you want to keep, is he in the network?  Is the hospital nearby in network. 

Then add up the premiums plus the cost of all prescription drugs and specialist visits you plan on incurring for the year (based on deductible, copays, coinsurance and max out of pocket) .

For a young healthy guy with no prescriptions, this means picking the plan with the lowest premiums, which is what he'd do anyways.

If you have 4 or 5 prescriptions and see a shrink every week, then you probably want a plan with higher premiums if it has a good Pharmacy and Mental Health Benefit,


 
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Posted: #7
Quote Originally Posted by thorpe:


ObamaCare has "Navigators" who can help you.  The main things ObamaCare is doing is making it illegal to sell a really bad plan, so the consumer can't get burned too badly. 

Here is the basics for figuring out which plan is best

Pick a plan with a good network.  If you have a Doctor you want to keep, is he in the network?  Is the hospital nearby in network. 

Then add up the premiums plus the cost of all prescription drugs and specialist visits you plan on incurring for the year (based on deductible, copays, coinsurance and max out of pocket) .

For a young healthy guy with no prescriptions, this means picking the plan with the lowest premiums, which is what he'd do anyways.

If you have 4 or 5 prescriptions and see a shrink every week, then you probably want a plan with higher premiums if it has a good Pharmacy and Mental Health Benefit,



Yeah for health im pretty much on the lowest premium plan but for dental im look to get my teeth straightened out and what not so i guess i would be picking the highest plan for dental ?
 
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Posted: #8
Make sure the dental plan includes orthodontics....
 
Captain
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Posted: #9
I don't know the size of your organization but most large ones would have a person who deals with just benefits.  Usually part of your orientation is going through this.  It is important that you understand everything because usually you can't change once you select a certain coverage except for change of life things like marriage or having a kid. 

I'm in Canada so we don't have the same level of medical benefits but we have things like prescription, dental, life insurance, long term disability, eye coverage, physio type coverages, private or semi private hospital coverage ..... all things that aren't covered under standard provincial medical care.  I do a lot of labour contract costing as part of my job so I know how much these cost, i can't imagine what the premiums must be for family coverage that includes standard medical care as well.  
 
Prospect
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Posted: #10
Yeah the company I got accepted to is pretty big i start my first day/Training on December 2nd which is the orientation. i just want to know some knowledge of what I'm getting into and what to put down.

Really looking to get my teeth getting take care of and wanted to know the amount they would be cutting off my check and how much they would be able to cover. i guess no one will really know until i actually get there. 
 
Captain
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Posted: #11
Varies by employer obviously.  My wife and I both have similar benefits but the difference is my employer covers 100% of mine, hers she has to pay a portion of the premiums for certain things and dispensing fees for her prescriptions.  She's opted out of hers for that reason because she's covered under mine.  
 
Legend
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Posted: #12
Quote Originally Posted by thorpe:


ObamaCare has "Navigators" who can help you.  The main things ObamaCare is doing is making it illegal to sell a really bad plan, so the consumer can't get burned too badly. 

Here is the basics for figuring out which plan is best

Pick a plan with a good network.  If you have a Doctor you want to keep, is he in the network?  Is the hospital nearby in network. 

Then add up the premiums plus the cost of all prescription drugs and specialist visits you plan on incurring for the year (based on deductible, copays, coinsurance and max out of pocket) .

For a young healthy guy with no prescriptions, this means picking the plan with the lowest premiums, which is what he'd do anyways.

If you have 4 or 5 prescriptions and see a shrink every week, then you probably want a plan with higher premiums if it has a good Pharmacy and Mental Health Benefit,



Sounds nice.  It's not that simple.  

Have you researched the plans that are available yet and the costs?
 
Legend
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Posted: #13
The main things ObamaCare is doing is making it illegal to sell a really bad plan, so the consumer can't get burned too badly. 
__________________________

That's the main thing Obamacare is going to do?  

Sorry, but you are uninformed.  

So the person who can't afford healthcare now is going to be forced into buying healthcare....will probably choose the cheapest plan with a $10,000 deductible.  That's a good plan for a person with no money?  
 
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Posted: #14
Quote Originally Posted by HutchEmAll:

The main things ObamaCare is doing is making it illegal to sell a really bad plan, so the consumer can't get burned too badly. 
__________________________

That's the main thing Obamacare is going to do?  

Sorry, but you are uninformed.  

So the person who can't afford healthcare now is going to be forced into buying healthcare....will probably choose the cheapest plan with a $10,000 deductible.  That's a good plan for a person with no money?  


Nice straw man argument.  If a person can not afford healthcare, they should be getting some kind of government assistance, and not choosing one of these plans.

What your argument is, if I am too poor to afford to pay any money for health insurance, and too proud to ask for government assistance, why isn't Obamacare helping more?

 
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Posted: #15
Quote Originally Posted by HutchEmAll:


Sounds nice.  It's not that simple.  

Have you researched the plans that are available yet and the costs?

Yes, I will be saving a ton of money with Obamacare,  I am self-employed and I have been gouged on health insurance for 12 years.  Between 2005 and 2009 they raised my rates 20% a year.


 
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Posted: #16
Quote Originally Posted by MPChino:


Yeah for health im pretty much on the lowest premium plan but for dental im look to get my teeth straightened out and what not so i guess i would be picking the highest plan for dental ?

Dental plans are normally a rip-off, and they probably won't cover your orthodonitcs unless it is considered medically necessary.
 
Legend
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Posted: #17
Now Obama wants to extend plans for those who already have insurance for another year.  

MN's government (who is a liberal) won't even support that because the insurance companies have complained that they have already computed rates that do NOT take into account these outdated plans.  

And thorpe, this might help you.   But please don't pretend to know how this is going to affect the country as a whole.  
 
Legend
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Posted: #18
Quote Originally Posted by thorpe:



Nice straw man argument.  If a person can not afford healthcare, they should be getting some kind of government assistance, and not choosing one of these plans.

What your argument is, if I am too poor to afford to pay any money for health insurance, and too proud to ask for government assistance, why isn't Obamacare helping more?


Whether you are right depends on what you consider a "bad plan" is.  It's subjective.  What do you think constitutes a bad plan.  

And yes, I know why you are fired up....I will end up saving $175/month and be getting a better plan.  
But to say "all it does" is that?  Ridiculous.   

Do you know how this is being paid for?  Do you realize that companies that currently pay for premium health plans for their employees are going to have to pay a PENALTY if the plans cost more than a certain amount?  Do you realize that they are going to start taxing medical device providers?

Sure, it's great for certain people (you're a perfect example).  But try reading the 780 lines of fine print.  


 
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Posted: #19
Quote Originally Posted by HutchEmAll:

 
And thorpe, this might help you.   But please don't pretend to know how this is going to affect the country as a whole.  

I agree with you here 100%. 

And they haven't even written all the fine print you need to read.  Obamacare says health insurance plans have to cover basic services, but those services are not defined anywhere.


 
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Posted: #20
Quote Originally Posted by HutchEmAll:


Whether you are right depends on what you consider a "bad plan" is.  It's subjective.  What do you think constitutes a bad plan. 


A bad plan is one where there is no limit to how much you have to pay in a year.  For instance, a bad plan would have 30% coinsurance with no limit, ie, you get a $500,000 hospital bill and you have to pay $150,000 of it.  This plan will be cheaper than any ACA plan, but it does not protect you from catastrophe.







 
Legend
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Posted: #21
Quote Originally Posted by thorpe:


A bad plan is one where there is no limit to how much you have to pay in a year.  For instance, a bad plan would have 30% coinsurance with no limit, ie, you get a $500,000 hospital bill and you have to pay $150,000 of it.  This plan will be cheaper than any ACA plan, but it does not protect you from catastrophe.


Fair enough.  

But the point in my original post was just how complicated insurance is....even for people who have someone sit down and explain the 2 or 3 options the company offers.  Now throw out a TON of options. 

My 3 main beefs have been:

1. It's going to be a logistical nightmare to implement.
2. It's going to have ramifications that no one has probably even thought of as of yet.
3. No one seems to be concerned about how this is going to get paid for...ie. subsidies, taxes on medical device companies. Penalties for employers who provide premium plans (these companies will likely just pay the penalty to the government and not even offer their employees insurance....which pushes more people into the government pool).  

For a person who is self employed, this is like hitting the jack pot.  

We have two people on our small business group plan.  You have any sort of a bad year and you get pummeled as far as rates go. So I hear you there. 
 
 
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Posted: #22
Do not check the self-surgery box. Trust me.
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