Health Insurance

Discussion in 'Business Operations' started by upsondown, Mar 3, 2004.

  1. upsondown

    upsondown LawnSite Senior Member
    Posts: 251

    Would like to know if anyone else has run into a similar situation. I have an employee who has been with me for 16 years. I provide a full benefit package to my employees which includes paid health insurance. Eight years ago he was diagnosed with melanoma (for those that don't know - it's one of the most serious forms of skin cancer)... and received prompt diagnosis and treatment. Over the years he has had followup visits and last year was listed as "cancer free" by his attending physicians - who provided documentation to our insurance carrier. Here's the problem: At the time of his diagnosis his premium was $245 monthly. Since that time it has steadily risen because of the treatments he received to where I now pay $875.00 per month for his insurance. I have spent many hours on the phone with our attorney and the insurance carrier - BCBS.... and the only advice I was given to decrease the cost of insurance would be to drop him from our policy or fire him. To me - neither one of those are options. This man has been an empoyee that every employer dreams of being able to find.......even when having chemotherapy - he showed up and wanted to work, never calls in sick - and works as many hours overtime as I need him to do. I think it's a lousy day in America when it would come down to rewarding such faithfulness of an employee in the way that the insurance company suggests - and I won't have any part of it !! I got quotes from other carriers - Aetna, State Farm, among others - and they would love to have our business - BUT - the policy that they would write for him - would exclude any coverage for his "pre-existing" condition - even though the doctors determined and documented that he is cancer free. I have appealed to the insurance commissioner in Virginia - and got no results. I wrote to elected officials and got the standard jargon that politicians tell their constituents. So unless any of you guys have suggestions of how to deal with this - we'll just keep paying the high cost of his health insurance - cause I sure as hell ain't gonna fire him !!!! Your thoughts?
  2. GreenMonster

    GreenMonster LawnSite Silver Member
    from NH
    Posts: 2,702


    Sorry, I don't have any experience with providing health insurance so I can't offer a lot. However, loyalty seems to be a forgotten trait nowadays. Kudos to you!

    Do your employees pay a portion of their health cost? Maybe a slight increase in their contribution could soften the blow and still allow you to offer this benefit?

    When are we as a country going to make health care insurance an important requirement of a candidate's platform?
  3. longslawn

    longslawn LawnSite Member
    Posts: 201

    I know your pain. I am in a simuliar situation myself, execpt I am the one with the high premium. My wife takes a medicine that cost $1175 a month. While the insurance company pays 100% of this, the premium is $913 a month. I've talked to other insurance companys and I to can get a cheaper premium, but, they will only pay 30% of the medicine cost and the premium is around $650. I'm stuck between a rock and a hard place.
    Something has got to be done about healthcare! And people wonder why millons have no health insurance.
    My wife is on disability, yet she receives no help on Rx. She is not intitled to any plan because we are married and don't qualify because of the wage limits.
    Good Luck. If you have any sucess please let me know.
  4. upsondown

    upsondown LawnSite Senior Member
    Posts: 251

    I pay the full ride for the insurance. When he first came to work for me - that was a deal I made with him on a handshake to get him to come to work for me....... I've never regretted that decision - and I was raised believing that a man's word is his bond....... old fashioned by today's standards I know.......but I'd rather go broke than to go back on my word. He is well aware of the costs and has offered to absorb some of the cost of the insurance - but again - it's about placing my integrity on the line and backing out of a deal I made. Too bad most politicians dont' know the meaning of integrity and trust heh?
  5. GreenMonster

    GreenMonster LawnSite Silver Member
    from NH
    Posts: 2,702

    Yeah, qualities that are hard to come by.


    I respect and agree with where you're coming from. It very honorable of you to stick to your word, especially in such a difficult position.

    You made this handshake deal 16 years ago. That says a lot about you as a person. But look at what health care costs have done over just the past 5 years! Things have definately escalated at a pace that you never could have predicted -- even without his cancer.

    Remember, if you go broke, your employee is out of a job too. That doesn't do him any good either. Just some food for thought.

    Good Luck. I have a feeling you'll do the best thing, which just might be a compromise.
  6. Bigfoot

    Bigfoot LawnSite Member
    Posts: 167

    Health insurance is likely the number one problem for small companies and sole operators. The companies that provide this insurance need some regulation because they act like a gang of thugs in dealing with their clients. Better yet, a good national medical plan. Example- $1000 deductible per person, national insurance kicks in and pays 80% of everything above the deductible. If you want supplemental insurance to cover your 20% then you can purchase it from a insurance company.
  7. Richard Martin

    Richard Martin LawnSite Fanatic
    Posts: 14,700

    You may have to go back on your word a bit and accept his offer to help pay "his" health insurance premiums.

    Since you shook hands 16 years ago things have changed quite a bit.

    Consumers have become extremely litigious.

    The US government is still over regulating prescription drugs.

    All doctors must live in million dollar homes.

    Prescription drug manufacturers are extremely greedy.

    It is still illegal to import prescription drugs for personal use (unless you're a state or local government).

    Hospitals and HMOs are run by "for profit" companies.

    Insurance companies are now emphatic about making profits not only on investments (the old way) but now insist on making money on premiums vs. payouts.

    Greed is the driving force behind the US economy today. It is completely ridiculous that you can buy prescription drugs from Canadian drug stores for 45%+ less than American drug stores. The Canadian businesses aren't giving the drugs away, they're making a profit. It is because of Canada's price controls on medicines that allows them to sell them for less.

    Don't get me started on health insurance. It is a complete ripoff and they make it too hard just to get them to payout a freaking dime.
  8. GreenMonster

    GreenMonster LawnSite Silver Member
    from NH
    Posts: 2,702

    Oh man, you know what buttons to push!

    I'll be right back.... where did I put that soapbox?
  9. TSM

    TSM LawnSite Senior Member
    from MA
    Posts: 707

    I would assume that the hand shake 16 years ago also included a rate of pay besides benefits? I also assume that that rate of pay has increased substantially in 16 years?

    My point....well you probably get my point.

    The handshake was with a healthy individual and at a pay rate most likely much less than he gets now. Things have changed. I'm sure you could work out something with him and he would be understanding.

    Tough situation, not sure what I would do. But I am answering you as an outsider with no emotional ties to you or him.

    Good luck and God Bless

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