Health Insurance Enrollment

[Bob Owens]

In 2011, AA had approximately 66,000 employees and spent about $544 million on employee health care:
 

Brief in support of 1113 motion, page 63 (page 71 of .pdf file)

AA was self-insured as to some of its insurance plans:
 

Brief in support of 1113 motion, note 45, page 62 (page 70 of .pdf file)

$544 million (AA's 2011 out of pocket cost above and beyond the employee contributions) was equal to an average of $8,242 per employee.

When management refers to "employee contributions" they are referring to the deductibles, copays and the 20%, not what they pay for the coverage. So that $544 million would have likely been offset by as much as 50% from employee payments for the coverage.
 
Did that figure also include what AA was paying for retiree medical? 
 
Are you disputing my claim that AA does not pay 80% of total costs? 

 

[WeAAsles]

From the Texas Dept of Insurance website:


Self-funded plans are governed by the federal Employee Retirement Income Security Act (ERISA). They are often called self-insured plans or ERISA plans.  Employers who self-fund their health plans pay the costs of their employee's health care themselves, rather than buying coverage from an insurance company or HMO.  Coverages may vary by plan and employer. Employers who self-fund their health plans may require employees to contribute to the cost of the plan.

The U.S. Department of Labor regulates self-funded plans, so TDI has very limited authority over them. These plans have their own procedures for complaints and dispute resolution.  It's important to read your benefits handbook carefully. Questions and unresolved complaints should be directed to the Labor Department's Employee Benefits Security Administration (EBSA). For more information, callEBSA at 1-866-444-EBSA (3272) or 972-850-4500.

Self-funded plans often use insurance companies to help administer the plan.  For example, the plan may use an insurance company’s provider network or claims processing system.  To know if your health plan is self-funded and governed by ERISA or fully insured and regulated by TDI, check your insurance card.  Fully insured plans must include “TDI” or “DOI” somewhere on the insurance card.  You won’t see this if your plan is self-funded.

 

[bob@las-AA]

When management refers to "employee contributions" they are referring to the deductibles, copays and the 20%, not what they pay for the coverage. So that $544 million would have likely been offset by as much as 50% from employee payments for the coverage.
 
Did that figure also include what AA was paying for retiree medical? 
 
Are you disputing my claim that AA does not pay 80% of total costs? 

 
Yes!
 
You're trying to make a statement saying that American pays little to nothing to have HC for its employees.

 

[WeAAsles]

My question is this:
We pay a certain amount per check towards our coverage.
In my case the amount adds up to roughly $2000 for the year.
Is that $2k 20% of the total amount of premium due for coverage with AA paying the other 80%?
Or, is that $2k 100% of the premium due for coverage?

Maybe it's time to make health insurance premiums more based on life style and life choices which have a direct effect on the amount of medical costs each individual generates.

They're already doing that as they give you cash back if you participate in wellness programs. You have to finish the programs though to actually get paid.

 

If you want to find out if AA is ripping us off or not my suggestion would be to go on the Healthcare.gov website and run the comparables for what type of coverage you are currently enrolled for. Compare both the monthly cost and the out of pocket deductibles.

If you're paying $2000 per year then according to AA you're FULL cost would be $10,000 per year or $833.00 per month. Find a plan under the ACA that's worth about $833.00 per month and compare it to yours. (Make sure to read the fine print in your comparison though for both)

https://www.healthcare.gov/
 

 

[Traymark]

If you want to find out if AA is ripping us off or not my suggestion would be to go on the Healthcare.gov website and run the comparables for what type of coverage you are currently enrolled for. Compare both the monthly cost and the out of pocket deductibles.
If you're paying $2000 per year then according to AA you're FULL cost would be $10,000 per year or $833.00 per month. Find a plan under the ACA that's worth about $833.00 per month and compare it to yours. (Make sure to read the fine print in your comparison though for both)https://www.healthcare.gov/

Well, if Bob is correct , and he might be, I don't know, then AA is in no way shape or form paying $10,000 per year to cover me.
I go to the doctor once a year, everything is always fine, and I generate no other costs towards health care.
Over the last 25 years, AA has benefitted greatly from my premiums paid for the very little health costs generated.
At some point, shouldn't we benefit for working from a company that can self insure and pay less for health care coverage?
Instead, it seems from your post, you want to lump all of us into the same boat as previously uncovered folks, be it legal or illegal citizens, and let's just all be thankful we don't have to purchase a ACA plan.

I believe we rate better than that. I got my A&P because I wanted to get a better deal in life than the folks that just waited for the government to provide it for them.

I think Bob brings up some very interesting points about health care costs and how the company couch's the issue to its employees.

Certainly seems like there should be more transparency on the actual costs and outlays of the company and also the monies they receive from employees to supplement those costs.

 

[Traymark]

No AA is self insured, they do pay a fee to have companies manage the claims. 
AA claims that they pay 80% of the Total cost, its simply not true, they pay 80% of the claim submitted subject to a variety of conditions, such as ;
-whether or not they consider the charge covered, if the Doctor that AA sent you to prescribes treatment that AA considers experimental or simply decides they dont pay for it you pay 100%.
-whether or not they agree with the amount charged, lets say your doctor charged you $100 fpr a proceedure, AA says they should have only charged you $500, AA only pays 80% of the $500 or $400 instead of $800, you have to pay the rest. In other words you would be paying 60% not 80%. Many of their rates are based on charges in the cheapest areas of the country, so if you live in NY or LAX every submission is a battle. 
-That you used a doctor in their plan
 
 
 

 

 Once again, AA is self insured, the money you pay goes to American Airlines, not an Insurance company. What you dont use AA uses to pay for what others use. But you are funding it and AA uses your money as part of their claim. AA pays much much less than companies that buy insurance coverage for their employees, thats another part of the big lie. Look at FWAAA numbers. AA brought in around $25billion in 2011 and spent $550 million on Health Benefits. Health benefits consumed less than .002 % of AA's revenue. Most companies spend much more than that, especially smaller companies that are not big enough to be self insured. So when AA says "compared to other companies our size" they are misleading people. Larger companies pay less per person than smaller companies generally. 
 

 
So you are going to force workers to work night shift then charge them more for insurance because of the negative health effects night shift causes? Please, don't give them any ideas.

Bob, thank you for all of your input on this issue, very enlightening.

To your last remark, I never mentioned anything about what shift a person works.
I said life style " choices " and specifically mentioned smokers vs non smokers.
You sometimes can't choose what shift you work, but you choose to smoke or not.
It makes a huge difference when purchasing life insurance, and that's just one example, there are many others.

 

[Traymark]

If you want to find out if AA is ripping us off or not my suggestion would be to go on the Healthcare.gov website and run the comparables for what type of coverage you are currently enrolled for. Compare both the monthly cost and the out of pocket deductibles.
If you're paying $2000 per year then according to AA you're FULL cost would be $10,000 per year or $833.00 per month. Find a plan under the ACA that's worth about $833.00 per month and compare it to yours. (Make sure to read the fine print in your comparison though for both)https://www.healthcare.gov/

Forgot to mention, I do the cash back thing every year. It's pennies on the dollar and it's a pain in the arse.
Why can't they just refund me a large portion of my premium if I don't generate any more health costs on the company thru the year?
The simplicity of that makes way more sense, and gives employees large incentive to live as healthy as possible.

 

[WeAAsles]

Forgot to mention, I do the cash back thing every year. It's pennies on the dollar and it's a pain in the arse.
Why can't they just refund me a large portion of my premium if I don't generate any more health costs on the company thru the year?
The simplicity of that makes way more sense, and gives employees large incentive to live as healthy as possible.

Because medical insurance is sort of like a Ponzi scheme. We who are (currently) healthy subsidize those who are not.

Later down the road it may begin to benefit us having it? The young healthy kids will pay for us old crows.

 

[700UW]

Do you get a refund from your car insurance when you dont use it?

 

[bob@las-AA]

No AA is self insured, they do pay a fee to have companies manage the claims. 
AA claims that they pay 80% of the Total cost, its simply not true, they pay 80% of the claim submitted subject to a variety of conditions, such as ;
-whether or not they consider the charge covered, if the Doctor that AA sent you to prescribes treatment that AA considers experimental or simply decides they dont pay for it you pay 100%.
-whether or not they agree with the amount charged, lets say your doctor charged you $100 fpr a proceedure, AA says they should have only charged you $500, AA only pays 80% of the $500 or $400 instead of $800, you have to pay the rest. In other words you would be paying 60% not 80%. Many of their rates are based on charges in the cheapest areas of the country, so if you live in NY or LAX every submission is a battle. 
-That you used a doctor in their plan
 
 
 
 
 Once again, AA is self insured, the money you pay goes to American Airlines, not an Insurance company. What you dont use AA uses to pay for what others use. But you are funding it and AA uses your money as part of their claim. AA pays much much less than companies that buy insurance coverage for their employees, thats another part of the big lie. Look at FWAAA numbers. AA brought in around $25billion in 2011 and spent $550 million on Health Benefits. Health benefits consumed less than .002 % of AA's revenue. Most companies spend much more than that, especially smaller companies that are not big enough to be self insured. So when AA says "compared to other companies our size" they are misleading people. Larger companies pay less per person than smaller companies generally. 
 
 
So you are going to force workers to work night shift then charge them more for insurance because of the negative health effects night shift causes? Please, don't give them any ideas. 

 
Sorry Bob, that 2.2% not .2%
 
and to remind you that AA took a Net Loss of $286 million.
 
and how did you come up with the figure of $550 million AA spent on HC?

 

[Traymark]

Do you get a refund from your car insurance when you dont use it?

What I get is the lowest cost for car insurance due to perfect driving record.

The way our health insurance is set up, it's the equivalent of charging me the same as the driver that has 2 DUIs on his record.

 

[WeAAsles]

What I get is the lowest cost for car insurance due to perfect driving record.
The way our health insurance is set up, it's the equivalent of charging me the same as the driver that has 2 DUIs on his record.

That's a good point but do we really want Government or the insurance companies dictating to us how we should live our lives totally? Sounds dystopian to me.

One hour per day on the treadmill, don't smoke or drink, tasteless food and cut out ALL sugar.

Nah. That ain't living.

 

[jcw]

that is the point behind ACA there is no benefit for healthy living etc - everyone pays the same in the same coverage levels

 

[WeAAsles]

that is the point behind ACA there is no benefit for healthy living etc - everyone pays the same in the same coverage levels

And because of that many people (who can afford it) will opt to stay with private insurance. The ACA (affordable) is a boon for those who can't and don't have insurance like we have.

 

[700UW]

People dont realize that before the ACA your high premiums and high cost of healthcare was subsidizing the uninsured.