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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: Bill who wrote (479062)	3/27/2012 5:27:18 PM
From: sm1th	2 Recommendations Respond to of 793908

But the current system of mandated uniform coverage with widely varying prices (for the same service) doesn't work for half the population. Small business is subsidizing large groups. Bill, I have done a lot of consulting in healthcare, likely including your provider. Pricing is very complicated, and there is a lot of negotiating, especially for the larger employers. Often a company will come in with a number and tell the insurer to meet it. The sales team then goes through a lot of trade-offs, tweaking co-pays, adjusting the approved prescription lists, limiting various coverages etc until they can make the number work. I have seen this process played out for employers with as few as about 100 employees, but I assume there is some cut-off where they only offer standard packages. It should also be obvious that there are economies of scale when working with larger employers. I doubt that small businesses are actually subsidizing larger ones, you just don't have as many options available. Many larger companies are actually self insured, and the insurance company is just providing administrative and consulting services. Companies only do this if they have evidence that it lowers costs. That may not be practical for you.