My son James started his own business last year. For the prior 15 years he'd been an employee and gotten medical insurance through his company. He decided to get some medical coverage as a self-employed person for 2023. Actually, I was somewhat of an influencer because he's 43 now and that's about the age things can come up. Besides, I'm his business manager.
When we've got coverage through work we usually don't pay much attention to its costs because we're not paying for it directly. When we're buying it ourselves, we do. So when James and I had the discussion he emphasized he doesn't want to pay a whole lot.
Because his business is only a year old, his income for 2022 was fairly low. So I checked out the state Exchange to see if he was eligible for a supplement for his insurance cost. He was.
My husband and I are insured with Kaiser Permanente in Washington, so that's where I started. Kaiser has really good coordination of services and we've had excellent care for many years. I went on their webpage to apply for James' coverage using the Exchange. The site said to enter the net taxable income. I subtracted the standard deduction amount from his net income and went to the Exchange site to order the insurance. The price on the Exchange was $300 more a month than on the Kaiser site!
I called Kaiser. They said the Exchange determined the price. I called the Exchange. They said Kaiser determined the price. I was pretty annoyed to be in the middle of two "it's not our problem" statements. I called our lawyer to make an appointment the next day to talk about possible "bait and switch" consumer fraud.
I called Kaiser the next morning and got a different customer service person. I explained my problem. They said if a person gets a W-2, they enter the net taxable income on the form. But if they're self-employed, they enter the net income (without the standard deduction amount). When I entered that amount and went to the Exchange, the numbers matched exactly. I ordered less expensive insurance. Then I called the lawyer and canceled the appointment.
I was in IT before I retired, and I knew the sentence on the Kaiser form was misleading for self-employed applicants. I called customer service and asked to speak to the technical department. They transferred me to sales. The man didn't understand what I was talking about. He said, "Well, you got the insurance, right?" I said yes, but I wanted the tech people to add a phrase to the form about self-employed people applying. He said, "I'll call someone and get back to you."
He didn't. Maybe he thought I was an unreasonable old person instead of a customer wanting to prevent other self-employed people from having the same problem.
Eight hours on the phone, on hold for much of it because "We're experiencing a higher than usual call volume." My son James is happy with the insurance I chose for him. But I feel bad for all the other confused self-employed people who thought they were getting good assistance, but ended up with insurance they couldn't afford.
10 comments:
I think that was a very productive time on the phone, even if you didn't get everything worked out. I am glad you think about people who are trying to get insurance and being willing to spend so much time going from one place to the next. You did what many people would not, and it's a good thing we have people like you willing to help!
Like DJan said, I'm glad you tried.
Today too many employees, and also administrators, just take the easy way out. Pursuing a problem they themselves have not encountered means little to them. It's too much work to figure out.
Thank you for trying.
OH my gosh, I had to remain on hold for an hour and a half to talk to someone about a problem I was having in ordering products through my Health Insurance program and I thought that was a long time. I kept telling myself to hang up but I called on Friday and the voice message said it was better to call either after hours or on the weekends when the call wait wouldn't be as long. I called back early on Saturday and received the same voice message but that's when I decided to stay with it as I needed IT tech support to fix the problem. I hope that the person you talked to is just waiting to hear back from someone on the issue you took the time to speak to him about. Wouldn't that be wonderful if he actually did get back to you? Thank you for being so persistent and for all the time you put into trying to help others in the same situation.
My husband, a former computer programmer, has tried to work with medical facilities we visit to get them to add a third line for insurance coverage. He knows it can be done. There has to be more people like us who have three insurances, and yet most medical offices only set up their computer screens to put in TWO. Therefore, many of our bills do not get paid on the first go-round because not all three insurances are billed. I spend so much time on the phone with billing departments going over this flaw. Even the ones who get it right most of the time suddenly drop one of insurances from their computer file and we are back to square one.
Insurance companies' "customer service" (and I use the term loosely) departments are black holes. Been there, done that. ;-)
I spent over two hours on hold waiting for a local government department with higher than normal call volumes. Grrrrrrrrr. Still not resolved.
Lately my mind just goes numb when I try to do any kind of business on a computer. Fortunately, Don is knowledgable and persistent like you. He has saved me a lot of money and aggravation. I do hate the fact that I find technology so hard though.
I had insurance through the market place (aka Obama Care) for part of last year when I went into semi-retirement. It wasn't too expensive, but also didn't cover much. The problem is that it's based on income and my income for 2022 was more than anticipated because I continued working more than planned. I'll keep working part-time and be covered by my employer's insurance until April, and then I'm not sure yet what I'll do. Health insurance is such a racket, and I hate feeling I am throwing money away by paying that monthly premium. But we all know that the alternative is like playing Russian roulette.
Good for you! You are always an excellent problem solver. I, on the other hand, am no longer able to. The wait times are so long that by the time I get a human on the line I've forgotten what I was calling about.
Don't you love it when the 'knowledgeable young person' treats you like a 'confused old person' because they don't understand? Possibly ask them if they want you to say it slower and louder....
Post a Comment