The individual health insurance marketplace

[SHRED]

I've been in employer-based health insurance and now in the individual marketplace.

Employer-based, in my experience, is way better.
Far less out of pocket for procedures and less for copays.

Why is this do you think?

[BigmanPigman]

1. When I was teaching we paid into a group plan.

After I got sick and had to stop and looked into insur I was told that they have a discount rate due to the large group. Of course we paid into it but we also were told by the district for over five years that we could have health insur OR a cost of living increase (this was NOT a raise by the way). The younger teachers always wanted the insurance but older teachers knew that when they retired their pension would be based on the last few years of your income and that would hurt their retirement.

[MousePlayingDaffodil]

2. I think you'll find that most large employers . . .

. . . self-insure. That is, such employers don't actually provide or purchase (e.g., by subsidizing a large percentage of the premiums) health insurance coverage to their employees. Rather, the employers themselves directly pay the medical costs incurred by their employees, although the employers will utilize the services of a health insurance company like Cigna, Kaiser, Anthem, etc., to administer the program.

[MineralMan]

3. From the 80s to 2004,

I had a group policy through my college alumni association in California as a freelance writer. When I moved to Minnesota, it wouldn't transfer, even though Blue Cross operates in both states. I had to buy individual coverage at a much higher rate.

[guillaumeb]

4. As a Federal retiree, I am covered by an FEHBP participant.

A Federal Employee Health plan that is offered and administered by my Union. Low co-pays and excellent overall coverage. Economy of scale.

[Igel]

5. They pick up part of the tab.

They negotiate for a better group rate.

They have a generally less-sick pool of people they insure.

And usually your part of the insurance is pre-tax, so you can afford more.

[Demsrule86]

6. Well my experience has been different than yours...8000 dollars out of pocket and a 6000

dollar deductible before the the company pays one dime. I longed to go on the ACA but would have received no subsidies. Hubs has a job with better insurance which will begin in November. We have spent thousands in the last four years.

[MineralMan]

7. Depends on the employer, in many cases.

Still, the individual health insurance marketplace is a minefield, to be sure.