How is my employer affected if I have expensive claims on my group health insurance?
Your employers insurance premiums will definitely go up if there are a lot of claims when it is time for them to renew their policy. It is also possible that if this happens the employer will pass along some of the additional cost to employees. The insurance company will not try to have you removed, it doesn't work that way with group policies. They just jack up the price as mentioned previously.  If you take a new job your cancer will affect the future employer in the same way. As to whether you should keep it a secret, I don't think it is something you have to disclose unless it affects your ability to perform your job, even then it may be protected under the Americans with Disabilities Act. It is true that some employers could exhibit some bias because of this, especially a small company that is likely to have a small group that is more likely to see price hikes because of a single employee making expensive claims. Bottom line: I wouldn't lie about it to a future employer, but I wouldn't volunteer that information either unless it is material to your job performance. Many big companies self insure. They pay the insurance company to manage the claims, and to have access to their network of doctors, hospitals, specialists, and pharmacies; but cover the costs on a shared basis with the employees. Medium sized companies use one of the standard group policies. Small companies either have expensive policies because they are a small group, or they have to join with other small companies through an association to create a larger group. The bigger the group the less impact each individual person has on the group cost. The insurance companies reprice their policies each year based on the expected demographics of the groups, the negotiated rates with the network of providers, the required level of coverage, and the actual usage of the group from the previo year.. If the insurance company does a poor job of estimating the performance of the group, it hits their profits; which will cause them to raise their rates the next year which can impact the number of companies that use them. Some provisions of the new health care laws in the US govern portability of insurance regarding preexisting conditions, minimum coverage levels, and the elimination of many lifetime cap. Prior to these changes the switching of employers while very sick could have a devastating impact on the finances of the family. The lifetime cap could make it hard to cover the person if they had very expensive illnesses.  If the illness doesn't impact your ability to work, there is no need to discuss it during the interview process. It won't need to be discussed except while coordinating care during the transition. There is one big issue though. If the old company uses Aetna, and the new company doesn't then you might have to switch doctors, or hospitals; or go out-of-network at a potentially even bigger cost to you. "I don't think so. There is a provision in ObamaCare called ""community rating"" that applies starting in 2014. Insurance companies must place individual and small group plans into a pool of people from the same geographical region. The same plan must cost the same for all small businesses from the same region. So having employees who have high costs will not significantly affect the company's cost; it will get factored into the cost for all people in the area; but the effect gets averaged out over all businesses and individuals who have plans."
"While COBRA premiums are not eligible to be a ""business"" expense they can be a medical expense for personal deduction purposes.  If you're itemizing your deductions you may be able to deduct that way.  However, you will only be able to deduct the portion of the premium that exceeds 10% of your AGI. Are you a full time employee now or are you a 1099 contractor?  Do you have access to your employers health plan?" Perhaps it's best to balance out how it works out for all, especially the most vulnerable, before setting yourself for or against a policy such as this.   You are lucky that you don't have any pre-existing conditions, while others aren't. You earn enough that you are able to afford insurance, even if you're not happy with the fact that you have to pay for it.   But you are unlucky to be working for a company with short-sighted dickheads that look more at the immediate bottom line than they do at their employees. To be honest, if they are scrapping by so much that they need to move everyone to part time to avoid health insurance costs that they already had before, you'd better start looking for another job right away. Because Individual insurance is vastly more expensive than per person business accounts  Hospital Costs are high because insurance will typically only pay out a fraction of that cost, while an individual is responsible for all  There are many things that contribute to the problem.  If we want to have a fourth world country with health care for only the super rich, that can be done, but that also has massive downsides. "In addition to the good answers already provided, I want to point out that many (most?) providers will handle filing your health insurance claim for you even though it's really your responsibility. So here's how medical bills ""you don't have to pay"" might come about: * It's possible that your balance is $4, or $20, or $65, or even still $100 depending on your particular insurance plan. Whatever is left at this step is what you pay." I've considered just calling the out-of-network hospital and asking   them to reduce the charges. Ideally they would send my health   insurance provider a smaller bill which I could just pay. However I   want to be careful about how I proceed. Yes, that's what you should be doing. They might give you a discount, but even if not - they will definitely be willing to work out a payment plan for you so that you could pay in installments and not in a lump sum. I have experience with the El Camino group in California, that did just that. It was several hundreds, so they didn't give a discount, but were able to work out an installment plan for several months without much hassle. That is something to do before you get to lawyers. I'm not sure I know how the lawyer could be useful to you, other than claiming bankruptcy or waiting for them to turn to collections and then fight those. You should also work with your insurance. How much is your deductible? If your deductible is so high that it exceeds the several thousands bill you got - do you have a HSA? FSA? These will allow you paying the bill with pre-tax money, saving quite a lot (depending on your brackets and how much you put there). I would expect the insurance to bill you for the deductible, and cover all the rest. Is it not what is happening? It's not mostly individually damaging, unfortunately. As the obese spend more on health insurance claims, we as the entire health insurance policy holders pay the price with higher premiums, since no health insurance company will pay that difference out of their pockets. With that said, instead of a ban, I'd rather see a soda tax, similar to cigarette taxes. You drink more, you pay more so when you start looking for health care related to your obesity, at least you contributed to a fund that can benefit everyone. 1)  When you apply for insurance you indicate your expected income, they figure the subsidy based on this.  Note that while this data isn't checked it's only an estimate, any errors will be fixed at tax time so lying is just going to gain you an unpleasant tax bill come April 15. 2)  It's not paid in installments, it's just a monthly premium.  It's quite possible for someone to be on the ACA for only part of a year. 3)  I can't address the issue of the fines.  However, you are wrong on who it's for--it's for anyone who doesn't have employer-provided insurance, whatever the reason.  I've been on it since it's inception because I have been self employed for most of that time--there's no employer to even offer me insurance. The answer likely depends a bit on which state you are in, but this should be true for most states.  I don't know anything about Pennsylvania specifically unfortunately. The Affordable Care Act created the SHOP marketplace, which allows small businesses to effectively form larger groups for group coverage purposes.  SHOP stands for Small Business Health Options Program, and requires only one common-law employee on payroll. This would effectively allow you to offer group coverage without having a group.  Talk to your tax accountant for more details, as this is still very new and not necessarily well understood. There are some other options, all of which I would highly suggest talking to a tax accountant about as well.  HRAs (health reimbursement accounts) allow the employer to set aside pre-tax funds for the employee to use for approved medical expenses; they're often managed by a benefits company (say, Wageworks, Conexis, etc.).  That would allow your employee to potentially pick a higher deductible health plan which offers poorer coverage on the individual marketplace (with after-tax dollars) and then supplement with your HRA. There are also the concept of Employer Payment Plans, where the employer reimburses the employee for their insurance premiums, but those are not compatible with the ACA for the most part - although there seems to be a lot of disagreement as to whether it's possible to have something effectively the same work, see for example this page versus this for example. How are home insurance companies going to pay for all the damage from the hurricanes? Are Allstate/Farmers/Etc. required to keep enough money liquid to pay 100+ billion in claims? Google results are  littered with angry articles related to healthcare companies, I'm struggling to find a legitimate answer on home insurance. It's not YOUR problem, but it is mine. every expense garnered from using insurance makes the cost go up. and as the article stated, that employer had 1/4 mil hit to his insurance due to drugs etc. that is sure to increase his insurance rates, thus he needs to be more mindful of whom he hires. thus, anyone who wants to get hired by a large experienced company needs to keep this in mind. people don't like to think how their freedoms can negatively impact other people. never could it be argued that freedom has a negative impact. Unfortunately I've seen every single example you've provided from the health care providers perspective.  Trust me, they aren't happy about the situation either - hence the reason they will demand up front payment from you based on who your insurance carrier is.  I could name a few of the top brand name insurance companies in this country that do all of this to their clients.   Medical billing is an incredibly over complicated beast.  One that insurance companies have been doing everything they can to make worse over the years.  The codes can change annually and there are MANY different codes which can cover the exact same situation.  Sure the insurance company might cover gallstones, but if you happen to be pregnant, well, that may not covered even though the treatment is the exact same. What can you do? Consider locating a new insurance company.  You do have options and don't have to go with the one your company uses.  The downside is that this is going to take quite a bit of research on your part and it will end up costing you more money on your monthly premiums simply because your company won't be footing part of the bill.   Talk to other co-workers and see if their experiences match yours.  If so, try to get a large enough group together to approach management and demand resolution.   A third potential avenue is to get politically involved - but I'm enough of a pessimist that I doubt that would do any good.  From what I've seen, neither major political party's current position actually does anything to solve the problem. A fourth option is suing the insurance company - but that is going to be incredibly expensive and take forever.  You might have better luck getting together with a bunch of local people and demand your attorney general review the billing/payment practices. Again, this is going to require a LOT of effort. A fifth option is to attempt to cash pay your bills and submit them yourself to the insurance company for reimbursement.  If you do this you can likely negotiate lower bills with the medical provider.  For anything less than about $2,000 I negotiate the amount prior to service.  Believe me when I say that providers are more than happy to give decent discounts if they know they won't have to deal with the insurance companies themselves.  Slightly more work for you, but could be far cheaper in the long run. (the average person doesn't care nor are they affected by how much their employer spends in healthcare) It may be true that the average person doesn't care how much their employer spends on healthcare, but it's not true that we aren't affected.  From an employer's perspective, healthcare, wages, and all other benefits are part of the cost of having an employee.  When healthcare goes up, it increases the total employee cost.   Employers can handle this in several ways.  They could reduce the amount they give investors (as dividends, stock buybacks, etc.).  But then the stock is worth less and they have to make up the money somewhere else.  They could pass the expense on to customers.  But then the loss in business can easily cost more than the revenue raised.  They can cut wages or other benefits.  Then the average person will start caring...and might get a different job.   (I found this article saying that 12M households spend >=50% of income on rent, so I'm assuming that an even greater number spend more than the recommended 30%, which means rent should be weighted as high as it is in CPI.) According to the census, that's only about 10% of households.  It also notes that 64.4% of households are owner-occupied.  They don't pay rent.  The CPI makes up a number called owner's equivalent rent for those households to get to the higher percentage.   The CPI is intended for things like wages.  This makes it a good choice for a cost of living adjustment, but it doesn't quite represent the overall economy.  And for investments, it's the broader economy that matters.  Household consumption is less important.   What the Fed says. I had better healthcare when I had a full time job and the company provided it until ACA came around and the company changed the majority of full time positions to part time. Now I have two part time jobs and ACA healthcare with a high premium and insanely high deductible. Is that supposed to be good? My father owns a small business that employees ~50 people. He's been in business for over thirty years as an agricultural establishment. Because the threshold on Obama care for small businesses to pay for employee coverage is 50+ employees we will have to fire people who don't deserve to be fired - all because we could not possibly afford an additional 50-60k per month expense for covering all employees healthcare I'd say the best course of action would be to call the card issuer and ask them. Converting can definitely be done, but you'll have to enquire about the bonus.