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Old 06-29-2012, 12:25 AM
 
22,443 posts, read 15,427,166 times
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That Affordable Care Act rule requires insurance companies to spend at least 80 percent of subscriber premiums on health-care claims and quality improvement initiatives. The other 20 percent is left for administrative costs and profits.

Health insurance plans that don’t hit that threshold will send a rebate to consumers to cover the difference.

Health insurance plans owe $1.1 billion in rebates - The Washington Post

Sounds fair to me...
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Old 06-29-2012, 05:39 AM
 
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All I can say is that I am glad to see that now, the majority of our premiums paid in will actually be spent on healthcare, versus CEO bonuses, advertising, conferences, etc.
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Old 06-29-2012, 06:02 AM
 
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Funny thing is the 20/80 rule was already in place yrs before obycare. One of the reason HI is so expensive is because no one cares what HC costs. The patient dosnt , he isnt paying the bill. The hospital dosnt , higher bill more money. The ins co;s dont care . The more they pay out the more their 20% grows.
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Old 06-29-2012, 06:06 AM
 
Location: Great State of Texas
86,101 posts, read 68,393,085 times
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Quote:
Originally Posted by waterboy7375 View Post
Funny thing is the 20/80 rule was already in place yrs before obycare. One of the reason HI is so expensive is because no one cares what HC costs. The patient dosnt , he isnt paying the bill. The hospital dosnt , higher bill more money. The ins co;s dont care . The more they pay out the more their 20% grows.
You're right. 80/20 got wiped out when they started this co-pay scheme.
Pay your $15 bucks and you don't care what the actual costs are.
But, back then you had to pay 20% and you were aware of costs.
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Old 06-29-2012, 06:09 AM
 
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Quote:
Originally Posted by HappyTexan View Post
You're right. 80/20 got wiped out when they started this co-pay scheme.
Pay your $15 bucks and you don't care what the actual costs are.
But, back then you had to pay 20% and you were aware of costs.

I don't think that the 80/20 you are referring to is the same as what is being talked about for insurance companies.

And not every insurance plan has a co-pay structure. Mine does not. My husband's employer is self-insured and chooses to use an 80/20 plan. I can go to the most expensive doctor in town if I want, but my portion of payment (20%) will reflect that. I don't mind it. I like have the choice to decide if I want to afford a certain doctor or not.
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Old 06-29-2012, 06:12 AM
 
9,447 posts, read 10,976,801 times
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Quote:
Originally Posted by waterboy7375 View Post
Funny thing is the 20/80 rule was already in place yrs before obycare. One of the reason HI is so expensive is because no one cares what HC costs. The patient dosnt , he isnt paying the bill. The hospital dosnt , higher bill more money. The ins co;s dont care . The more they pay out the more their 20% grows.

I'm not quite sure you are getting the ruling.

If you pay $100 per pay period in premiums, the insurance companies are now required to take $80 of those $100 and use it toward paying claims. Not just your claims, everyone's. So for the $100 they collect from you, $80 will go into the "claim" account. $20 will go into the account for their salaries, bonuses, advertising, conferences, boondoggles, and similar costs. I, for one, think it is a great way to control these private companies from getting to slick or fancy that they forget to serve their customer base. I don't know what the numbers are now, but I am betting that for every $100 you put in, $80 of those dollars are NOT going toward actual healthcare.
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Old 06-29-2012, 06:16 AM
 
4,260 posts, read 2,788,853 times
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Quote:
Originally Posted by ChristineVA View Post
I'm not quite sure you are getting the ruling.

If you pay $100 per pay period in premiums, the insurance companies are now required to take $80 of those $100 and use it toward paying claims. Not just your claims, everyone's. So for the $100 they collect from you, $80 will go into the "claim" account. $20 will go into the account for their salaries, bonuses, advertising, conferences, boondoggles, and similar costs. I, for one, think it is a great way to control these private companies from getting to slick or fancy that they forget to serve their customer base. I don't know what the numbers are now, but I am betting that for every $100 you put in, $80 of those dollars are NOT going toward actual healthcare.

Im aware of that and that is the way it has been for a real long time. Ins is a rewgulated industry just like auto ins is.
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Old 06-29-2012, 06:18 AM
 
9,447 posts, read 10,976,801 times
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Quote:
Originally Posted by waterboy7375 View Post
Im aware of that and that is the way it has been for a real long time. Ins is a rewgulated industry just like auto ins is.
So, if the health care act is making this "law" and it's already "law" then what's up with that?
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Old 06-29-2012, 06:20 AM
 
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Hmmm...this is what I just read:


Quote:
Before health care reform, insurance companies routinely spent up to 40% of premiums on overhead and administrative costs. Today, thanks to Obamacare, insurance companies are required to spend at least 80% of your premium on your health care—and if they don’t, you get a rebate. This summer, nearly 12.8 million Americans will start receiving their rebate checks, averaging $151 per household—and totaling more than $1.1 billion.
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Old 06-29-2012, 06:20 AM
 
Location: Great State of Texas
86,101 posts, read 68,393,085 times
Reputation: 27488
Quote:
Originally Posted by ChristineVA View Post
I'm not quite sure you are getting the ruling.

If you pay $100 per pay period in premiums, the insurance companies are now required to take $80 of those $100 and use it toward paying claims. Not just your claims, everyone's. So for the $100 they collect from you, $80 will go into the "claim" account. $20 will go into the account for their salaries, bonuses, advertising, conferences, boondoggles, and similar costs. I, for one, think it is a great way to control these private companies from getting to slick or fancy that they forget to serve their customer base. I don't know what the numbers are now, but I am betting that for every $100 you put in, $80 of those dollars are NOT going toward actual healthcare.
Any data to back this up or is this just your opinion ?
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