

How to Offer Google's Health Benefits on a Small Business Budget - xiaosun
http://blog.simplyinsured.com/how-to-offer-google-health-benefits-on-a-small-business-budget/

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tptacek
I'm a little dubious.

A significant fraction of our candidates demand a discussion of health
benefits before accepting offers. They compare plans and copays with other
jobs. They care about the level of benefits we provide, meaning that this
pitch involves us (the employer) selling our candidates on the value of
reduced health insurance benefits.

As I understand it, the full package of HSA benefits only kicks in if you're
also on a high-deductible insurance plan. Meaning, to pitch a candidate on the
idea of us funding an HSA, we also need to sell them on high-deductible
insurance.

I have no doubt that most employees are better served by high-deductible +
HSA. But that might not be a winning pitch for a candidate with a family; even
if it's rationally the right move for those employees, it's still a
complicated proposal.

Meanwhile, I'm very much not in love with compensation packages tailored for
23-year-olds.

Where am I going wrong here?

~~~
toomuchtodo
I'm actually in the middle of a job search right now (in Chicago). Employers
ask what my current medical is (100% covered, myself and my wife, BCBS PPO).
If potential employers don't offer a comparable plan, I ask them to make up
the difference with cash (and, of course, cash costs the employer more vs
something you can expense like health insurance).

The problem is that the game is rigged until health insurance can be
completely decoupled from employment.

EDIT: Keep in mind, I can still want excellent healthcare but not be a
wasteful healthcare consumer. I needed a non-controlled substance prescription
that was very expensive in the US, even with insurance, but its offered
inexpensively over the counter in Canada, Mexico, etc. Guess where I bought it
from.

~~~
timjahn
"The problem is that the game is rigged until health insurance can be
completely decoupled from employment."

This is the biggest problem in the US.

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philsnow
"Want to discourage people who aren't healthy and 21 years old from joining
your small business? Pick 'budget' health insurance!"

The difference in premium vs out of pocket expenses makes sense _in
aggregate_. It wouldn't think it would be convincing to an individual who has
the slightest current health complication, who has a family history of
complications, or who has a family or is thinking about starting a family.

Of course if you allow employees to choose which health plan (and thus which
premium) is appropriate for them, that is different.

~~~
xiaosun
We do analyze the options from the perspective of individuals as well.

The most basic insurance plan available caps out of pocket expenses at $6350,
which while is still significant but likely won't cause medical bankruptcy.
Even the most "premium" plan only caps out of pocket expenses at ~$3000, yet
would cost $3000-5000 more in premiums.

A premium plan would provide a nice sense of security, but might be the best
option to minimize expenses for an employee.

~~~
philsnow
> The most basic insurance plan available caps out of pocket expenses at
> $6350, which while is still significant but likely won't cause medical
> bankruptcy. Even the most "premium" plan only caps out of pocket expenses at
> ~$3000, yet would cost $3000-5000 more in premiums.

are those caps per year ? per incident ?

even if they are per year, that doesn't make sense. you're asking me to
believe that people have been paying $3000 more to cap their risk for the year
at a number $3000 lower. It can't be that simple, or else people have been
leaving money on the table.

~~~
hamburglar
It's not quite this simple, but I can tell you that people have been leaving
money on the table. This year I finally sat down and worked out the
spreadsheets and last year my family paid nearly $12k in premiums + out of
pocket and yet we had only $6k in actual costs. We are now on an HDHP that
costs $1500/year and pays for hardly anything initially, but caps our annual
out-of-pocket at around $12k. The upshot is that we save $5-6k in a
typical/easy year and in a worst case year we pay an additional thousand or
two. Seems like a pretty good trade-off to me.

The part I don't like about it is I've been raised in a world where you DO NOT
ask the cost of a service when your health is on the line -- you just do what
the doc says -- but now it's sensible for me to concern myself with the cost
since they are coming out of my pocket directly (until I hit the cap). Doctors
in the US are not typically prepared to discuss specific costs with you. This
patient attitude and doctor attitude are each partially responsible for our
health costs bring so out of control, in my opinion, and it is going to be a
while before I can ask, "how much is this procedure for my child going to
cost, and just how necessary is it?" without getting a dumbfounded stare in
response and feeling like a crazy penny pincher.

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r0m4n0
In case anyone is wondering, Google uses Blueshield of CA to process their
insurance claims but internally pay with their own funds. Google ultimately
has the final say on how claims will be paid (although they rarely deviate
from Blueshield's plan configurations). A rare hybrid approach...

~~~
dkoch
Self-funded health insurance plans are very common with employers. Third-party
administrators (TPAs) that provide the claim processing are big business.

~~~
carlosrt
SafeWayHealth is one of those. They sell the, cash, price of healthcare
procedures to large employers that self insure. This DRASTICALLY reduces the
cost of healthcare (e.g. a company pays $800 cash for a colonoscopy, vs.
$7,000 via insurance). The problem is they only sell this info to companies
with 10,000+ employees.

This service needs to exist for everybody.

[http://safewayhealth.com/](http://safewayhealth.com/)

Source: [http://www.quora.com/Medicine-and-Healthcare/What-are-
some-o...](http://www.quora.com/Medicine-and-Healthcare/What-are-some-of-the-
most-mind-blowing-facts-about-US-healthcare/answer/Carlos-Tobin)

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run4_too
This is an ad.

It's only vaguely disguised as a how to, even if it is something many HN'ers
are dealing with.

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puppetmaster3
How much does google/apple/top tier corps pay their top engineers? I have some
data points but I want to hear others.

------
walshemj
Spam Spam Spam

