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Insurance Company Shenanigans – Part 1

Wednesday, September 5, 2012

In case you’re wondering why you don’t hear insurance companies complaining about Obamacare; it’s because they are big winners and don’t want to rock the boat. Insurance companies are “limited” to either paying out 80% of every dollar collected in the Individual and Small Group business market or 85% of every dollar collected in the Large Group business market. What this means is that they can keep 20% or 15% of every dollar respectively for themselves to cover their operational costs and create profits for them. Think about that… In the Individual and Small Group markets, they can keep 20% for themselves to pay their expenses and fill their pockets. Doesn’t seem like a big number; but, this means that the more expensive in dollars the health plan is; the more they make in profit. For example; if you buy a health plan that costs $400 per month with high co-payments; they can make $80 per month at-most at 20%. However; if you buy a health plan that costs $600 per month with lower co-payments; they can make $120 per month at 20%. Interesting, isn’t it… The more a health plan costs; the more profitable it can be for the insurance company. Tony Pinto
 
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