Huge Difference in Health Insurance Premiums Forum

[Anonymous User]

I’m a senior who hasn’t paid a dime in insurance throughout my biglaw tenure courtesy of a high deductible plan the firm covered. Very fortunate to be in good health and haven’t had a need to use health insurance in years.

My firm is now in open enrollment, and I learned the same (cheapest) plan is now going to cost $400/mo. This is basically a car payment I didn’t expect. I asked benefits, and they curtly said premiums have risen.

I’m genuinely curious if this is true and if other firms are jacking up health care costs. It hardly seems like a benefit when I could sign up for similar insurance plan on the private market.

[Bramwell]

That’s actually relatively inexpensive compared to the high deductible plan at my firm, which ratchets up the premium based on salary level. It was lower at my prior firm, but still higher than your cost. Does firm contribute to your HSA?

[Anonymous User]

I’m a senior who hasn’t paid a dime in insurance throughout my biglaw tenure courtesy of a high deductible plan the firm covered. Very fortunate to be in good health and haven’t had a need to use health insurance in years.

My firm is now in open enrollment, and I learned the same (cheapest) plan is now going to cost $400/mo. This is basically a car payment I didn’t expect. I asked benefits, and they curtly said premiums have risen.

I’m genuinely curious if this is true and if other firms are jacking up health care costs. It hardly seems like a benefit when I could sign up for similar insurance plan on the private market.

One way to tell would be to look at your paycheck. It probably says what the employer contribution is. For example, for my high-deductible BCBS PPO plan for a spouse and children, I pay $650 and my employer pays $1,050. Assuming they pay the same fraction of the cost if I had no kids, then the total actual cost of insurance for a single person on my plan is $360 (and $385 in 2023).

[rshackleford123]

I’m a senior who hasn’t paid a dime in insurance throughout my biglaw tenure courtesy of a high deductible plan the firm covered. Very fortunate to be in good health and haven’t had a need to use health insurance in years.

My firm is now in open enrollment, and I learned the same (cheapest) plan is now going to cost $400/mo. This is basically a car payment I didn’t expect. I asked benefits, and they curtly said premiums have risen.

I’m genuinely curious if this is true and if other firms are jacking up health care costs. It hardly seems like a benefit when I could sign up for similar insurance plan on the private market.

I don't suppose you're a senior who made partner effective next year, are you? Partners end up covering the employee and employer portion of health premiums, so that could be it. (Or it could just be that the costs have risen and the firm is subsidizing less.)

[Anonymous User]

I’m a senior who hasn’t paid a dime in insurance throughout my biglaw tenure courtesy of a high deductible plan the firm covered. Very fortunate to be in good health and haven’t had a need to use health insurance in years.

My firm is now in open enrollment, and I learned the same (cheapest) plan is now going to cost $400/mo. This is basically a car payment I didn’t expect. I asked benefits, and they curtly said premiums have risen.

I’m genuinely curious if this is true and if other firms are jacking up health care costs. It hardly seems like a benefit when I could sign up for similar insurance plan on the private market.

One way to tell would be to look at your paycheck. It probably says what the employer contribution is. For example, for my high-deductible BCBS PPO plan for a spouse and children, I pay $650 and my employer pays $1,050. Assuming they pay the same fraction of the cost if I had no kids, then the total actual cost of insurance for a single person on my plan is $360 (and $385 in 2023).

Wow what plan is that and where? My firm's BCBS PPO high-deductible family plan in 2023 will be nearly $3k/mo, and my firm pays less than half of that.

[Anonymous User]

lol I pay $2,000 per month out of pocket, no firm subsidy, and it’s an extremely high deductible (I think I pay the first $10,000 out of pocket).

[Anonymous User]

I’m a senior who hasn’t paid a dime in insurance throughout my biglaw tenure courtesy of a high deductible plan the firm covered. Very fortunate to be in good health and haven’t had a need to use health insurance in years.

My firm is now in open enrollment, and I learned the same (cheapest) plan is now going to cost $400/mo. This is basically a car payment I didn’t expect. I asked benefits, and they curtly said premiums have risen.

I’m genuinely curious if this is true and if other firms are jacking up health care costs. It hardly seems like a benefit when I could sign up for similar insurance plan on the private market.

One way to tell would be to look at your paycheck. It probably says what the employer contribution is. For example, for my high-deductible BCBS PPO plan for a spouse and children, I pay $650 and my employer pays $1,050. Assuming they pay the same fraction of the cost if I had no kids, then the total actual cost of insurance for a single person on my plan is $360 (and $385 in 2023).

Wow what plan is that and where? My firm's BCBS PPO high-deductible family plan in 2023 will be nearly $3k/mo, and my firm pays less than half of that.

I work at a university that owns (or is closely affiliated with, anyway) its own health system, which probably helps. (The deductible at university hospitals is also cut in half -- $1.5k individual, $3k family, 10% copay).

In terms of unicorn jobs, universities are pretty high up there...

[Anonymous User]

Thanks, all, OP here. This is really informative (and honestly shocking). The firm will contribute a grand total of $600 to an HSA under the new plan.

I’m not up for partner yet. I never have given insurance a single thought during my 6 years at the firm other than checking the box for the cheapest option.

My firm currently contributes about $800 per month according to my paycheck. The only time I have used the insurance during my career was showing it to get my COVID vaccines; I do not even have a PCP. But I get the chance to exercise a lot, and the worst issue I’ve had since law school is a stye in my eye.

I know I’m extremely lucky and fortunate to be in my position. I just wish the firm offered something like a state minimum car insurance option where I could at least have insurance but not pay $5k a year for it.

[Spider2YBanana]

This is an area of hidden comp. I switched firms, and at Firm X, the HDHP cost the same as the Cadillac health plan at Firm Y. I saved $1,000/mo in premiums.

[Anonymous User]

In-house, unmarried, at a family-owned business. I pay no employee contributions whatsoever for a United Healthcare health plan with a $2,000 annual individual deductible and a $4,000 individual out-of-pocket maximum. My first firm set up an HSA to which they funded around $800 each year and I max that out with post-tax $.

My previous firm was charging me around $450/mo for benefits all-in.

[Pneumonia]

This and other hidden extractions are a major way that firms outside of NYC and outside of Vault's upper end are able to match NYC sticker salaries. In Texas, for example, my contribution to the premium was about $1,500/mo for a me, spouse, and kids. And I paid $200/mo for parking. And my cell phone wasn't subsidized. Etc.

[trebekismyhero]

In-house now. Insurance with a $1,000 deductible and covers my child costs me $350 a month and is getting bumped up to $380 a month next year. Before my child was born, as an individual it only cost me $150 a month, whereas I was spending way more than that 5 years ago at the firm. Insurance is one area where big law firms generally trail in-house

[Anonymous User]

I pay under $75/month for my firm’s high deductible plan. Our regular plan for single coverage costs less than some of your guys’ high deductible plans. Non-market AmLaw200 in NYC.

[Anonymous User]

This is all interesting to me, especially the comment about how hidden costs like these are how non-NY firms can present “market” salaries.

For what it’s worth, I work at a mid-size firm in a secondary/tertiary market. Salaries generally run from about $180 to $225 (pre bonus) for associates. We have a single health insurance option. A firm self-funded plan with backstop coverage. It is an absolute Cadillac plan. Annual deductible is like $300, with like a 10% copay after that, but a lot of stuff is considered preventive and covered at 100%. A lot of other stuff is covered under the plan that is rarely covered elsewhere (eg acupuncture). There is exactly $0 cost to the employee for coverage. Add spouse is like $600/month. Add kids and the total is like $1,000/month.

So while some firms may use benefits as hidden costs, that’s not universally true.

[Anonymous User]

At K&E and my high deductible, HSA plan costs me $162/month. I'm the only person on the plan. And I thought we were getting jipped - damn, you guys are getting fleeced.

[Anonymous User]

At K&E and my high deductible, HSA plan costs me $162/month. I'm the only person on the plan. And I thought we were getting jipped - damn, you guys are getting fleeced.

OP here. Apparently this is common practice nowadays. Benefits’ curt response yesterday rubbed me the wrong way, so I responded and said I wish I had a little more notice before having a car payment equivalent sprung on me, should I choose to use the firm’s insurance at all instead of finding something else or doing a health share. They responded that it is no longer industry practice to have a $0 premium, and what they offer is not that bad compared to other firms.

[Anonymous User]

My insurance is fully subsidized by my firm (tertiary market), and there's even an option that's so cheap the firm pays you for picking it

[Anonymous User]

I pay roughly $1k a month at DLA for the most expensive healthcare plan that covers me, my wife and my children. A single, high deductible plan is around $200 per month.

No other hidden costs at DLA in my office, so no complaints given the payment is from pretax income. Some colleagues are on their spouse’s healthcare plan though.

[flyingeye]

I can't remember the exact numbers, but I think I had to pay $300ish per pay period for the cheapest PPO plan at my last firm and there was no HDHP option. At my current firm, the cheapest PPO is 5 or 10% of that -- can't remember if that premium number is monthly or per pay period. The HDHP is $0 and the firm puts money into HSA.

The bigger hoot is that the deductible under the HDHP at my current firm is lower!! than the deductible under the PPO at my prior firm.

[Anonymous User]

This and other hidden extractions are a major way that firms outside of NYC and outside of Vault's upper end are able to match NYC sticker salaries. In Texas, for example, my contribution to the premium was about $1,500/mo for a me, spouse, and kids. And I paid $200/mo for parking. And my cell phone wasn't subsidized. Etc.

Subsidized cellphone? Sounds nice.

[Anonymous User]

$350/pay period (so $700/mo) for me and my spouse for low deductible and 0% co-insurance plan. Seems like the 0% co-insurance is a very important part of health insurance - my spouses work offers a plan that has 20% co-insurance for inpatient/surgery/etc.

[Wanderingdrock]

At K&E and my high deductible, HSA plan costs me $162/month. I'm the only person on the plan. And I thought we were getting jipped - damn, you guys are getting fleeced.

OP here. Apparently this is common practice nowadays. Benefits’ curt response yesterday rubbed me the wrong way, so I responded and said I wish I had a little more notice before having a car payment equivalent sprung on me, should I choose to use the firm’s insurance at all instead of finding something else or doing a health share. They responded that it is no longer industry practice to have a $0 premium, and what they offer is not that bad compared to other firms.

They're probably right, but you're still right to be upset. This sounds like a big jump in your costs.

My HDHP for myself, my spouse, and my kid is something like 800/month. I did the math and it made sense to go with the HDHP instead of the PPO option - there was only a very small sweet spot in terms of expected annual health spend where the PPO marginally made sense. In part, that's because my firm's plans are... not good. Most of my colleagues go on their spouse's plan when they have kids. But I think that's not uncommon in biglaw.

What I will say for our firm, though, is that they communicate clearly whenever costs go up, and they have signaled to us a couple of times in the past few years that they prevented costs from rising, or limited increases, by cutting coverage. That's not great, but at least they told us ahead of time. Costs haven't risen more than ~10% annually. Anybody would be annoyed at suddenly being told they're going to pay hundreds more per month.

[Anonymous User]

At K&E and my high deductible, HSA plan costs me $162/month. I'm the only person on the plan. And I thought we were getting jipped - damn, you guys are getting fleeced.

OP here. Apparently this is common practice nowadays. Benefits’ curt response yesterday rubbed me the wrong way, so I responded and said I wish I had a little more notice before having a car payment equivalent sprung on me, should I choose to use the firm’s insurance at all instead of finding something else or doing a health share. They responded that it is no longer industry practice to have a $0 premium, and what they offer is not that bad compared to other firms.

They're probably right, but you're still right to be upset. This sounds like a big jump in your costs.

My HDHP for myself, my spouse, and my kid is something like 800/month. I did the math and it made sense to go with the HDHP instead of the PPO option - there was only a very small sweet spot in terms of expected annual health spend where the PPO marginally made sense. In part, that's because my firm's plans are... not good. Most of my colleagues go on their spouse's plan when they have kids. But I think that's not uncommon in biglaw.

What I will say for our firm, though, is that they communicate clearly whenever costs go up, and they have signaled to us a couple of times in the past few years that they prevented costs from rising, or limited increases, by cutting coverage. That's not great, but at least they told us ahead of time. Costs haven't risen more than ~10% annually. Anybody would be annoyed at suddenly being told they're going to pay hundreds more per month.

OP here, you’re exactly right. The lack of communication is my biggest issue, something that’s not been uncommon at my firm.

If this truly wasn’t a cut off the nose to spite the face option, I’d not use any of their options. But their plans are still cheaper than even the garbage plans on the open market. At this point all I can do is troll benefits — I responded to an a reminder email about the open enrollment deadline by saying I’m still weighing whether I’ll go uninsured or take one of their options.

[bokampers]

lol I pay $2,000 per month out of pocket, no firm subsidy, and it’s an extremely high deductible (I think I pay the first $10,000 out of pocket).

This is big law???? That’s an enormous amount of money … like a student loan or a small mortgage

[bree]

I paid around $825/month for a HDHP for a family, with firm chipping in around $150/month into an HSA. Plan costs are going up a lot this year (~11-12%) and the firm contribution to the HSA is going down. Oddly enough, the low-deductible plan cost when up less (~5%) this year, though it's still $300-400 more per month than the HDHP.

I'm basically paying $10K per year in premiums to get physical checkups for my family and to guard against a medical catastrophe because a HDHP is absolutely worthless until you hit the deductible. I have a hard time complaining though because one year my family did have a medical catastrophe and I'm guessing we would have paid $200k-$300k if it weren't for insurance.