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The End of Employer-Provided Health Insurance: Why It's Good for You and Your Company

Book Description

How to save 20 to 60 percent on health insurance!

The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. This book is written to ensure that you, your family, and your company get your fair share of the trillions of dollars the U.S. government will spend subsidizing individual health insurance plans between now and 2025. You will learn how to navigate the Affordable Care Act to save money without sacrificing coverage, and how to choose the plan that offers exactly what you, your family and your company need.

Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. The purpose of The End of Employer-Provided Health Insurance is to show you how to profit from this paradigm shift while helping you, your family, and your employees get better and safer health insurance at lower cost. It will help you save thousands of dollars per person each year and protect you from the greatest threat to your financial future—our nation's broken employer-provided health insurance system.

We are at the beginning of a paradigm shift in the way businesses offer employee health benefits and the way Americans get health insurance—a shift from an employer-driven defined benefit model to an individual-driven defined contribution model. This parallels a similar shift in employer-provided retirement benefits that took place two to three decades ago from defined benefit to defined contribution retirement plans.

Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans. Using the techniques outlined in this book, you and your employer will save money on health insurance by migrating from employer-provided health insurance coverage to employer-funded individual plans at a total cost that is 20 percent to 60 percent lower for the same coverage. That's $4,000 to $12,000 in savings per year for a family of four for the same hospitals, same doctors, and same prescriptions.

Table of Contents

  1. Title Page
  2. Copyright
  3. Preface
  4. Executive Summary—Why You Should Read This Book
  5. Introduction—The End of Employer-Provided Health Insurance
    1. History of U.S. Employer-Provided Health Insurance
    2. The Decline of Employer-Provided Health Insurance
    3. How This Book Is Structured
    4. Additional Materials Available at HealthInsuranceRevolution.org
  6. Part I: The Problem and the Solution
  7. Chapter 1: The Disadvantages of Employer-Provided Health Insurance
    1. What Happens After You Lose Your Job with Employer-Provided Health Insurance
    2. 10 Reasons Employer-Provided Health Insurance Is Bad for You, Your Family, and Your Company
  8. Chapter 2: The Advantages of Individual Health Insurance
    1. 10 Reasons Individual Health Insurance Is Good for You, Your Family, and Your Company
    2. The Obvious Solution—Employer-Funded Individual Health Insurance
  9. Chapter 3: The Solution—Employer-Funded Individual Health Insurance
    1. The Coming Revolution—Defined Contribution Health Benefits
    2. Tax-Free versus Taxable Defined Contribution Programs
    3. The Regulatory Crisis of 2013 over Reimbursement Plans for Individual Health Insurance
    4. What Should Employers Do Now to Reimburse Employees Tax-Free for Individual Health Insurance?
    5. Conclusion
  10. Part II: How to Make Individual Health Insurance Work for You and Your Family
  11. Chapter 4: What Is Individual Health Insurance?
    1. The Advantages of Individual Health Insurance
    2. What Is Health Insurance?
    3. What You Learned
  12. Chapter 5: How Much Does Individual Health Insurance Cost?
    1. How Individual Health Insurance Premiums Are Determined
    2. Personal Factors Influence Your Individual Health Insurance Premium
    3. Sample Individual Health Insurance Rates
    4. What You Learned
  13. Chapter 6: Premium Tax Credits: Are You Eligible for the Subsidy?
    1. Are You Eligible for Premium Tax Credits?
    2. Determining the Amount of Your Premium Tax Credit
    3. Using Your Premium Tax Credit
    4. Receiving Your Premium Tax Credit
    5. What You Learned
  14. Chapter 7: When Can You Buy Individual Health Insurance?
    1. Annual Enrollment Period
    2. Special Enrollment Periods
    3. Special Enrollment Periods—Act Fast or Pay
    4. You Must Buy Health Insurance—Or Pay a Tax Penalty
    5. What to Do If You Miss Your Enrollment Period
    6. What You Learned
  15. Chapter 8: Where Can You Buy Individual Health Insurance?
    1. On-Marketplace or Off-Marketplace—Which Is Better?
    2. What Is a Health Insurance Marketplace?
    3. Working with Health Insurance Brokers
    4. Buying Directly from the Health Insurance Company
    5. What You Learned
  16. Chapter 9: How to Choose Your Coverage—Bronze, Silver, Gold, or Platinum
    1. Choosing a Plan Category
    2. Picking the Right Out-of-Pocket Exposure
    3. Understanding the Benefits Covered
    4. What You Learned
  17. Chapter 10: Networks—Choosing Your Doctors and Medical Providers
    1. How Provider Networks Started
    2. Different Types of Health Plans
    3. Choosing between a PPO and an HMO
    4. How to Choose a Medical Provider Network
    5. Beware of Products That Are Not Health Insurance
    6. What You Learned
  18. Chapter 11: How to Select the Right Plan for You and Your Family
    1. Estimating Your Future Healthcare Spending
    2. Comparing Policy Features
    3. Selecting the Plan and Buying
    4. What You Learned
  19. Chapter 12: How to Reduce Your Individual Healthcare Costs
    1. 1. Ask Your Employer to Reimburse Your Individual Premium
    2. 2. Shop for a New Health Insurance Plan Annually
    3. 3. Open a Health Savings Account (HSA)
    4. 4. Speak to Your Doctor about Spending Your Money as if It Were His or Her Own Money
    5. 5. How to Save 10 to 75 Percent on Your Prescription Drugs
    6. 6. Change Your Lifestyle (Diet and Exercise)
    7. What You Learned
  20. Part III: How to Switch to Defined Contribution Healthcare
  21. Chapter 13: What Is Defined Contribution Healthcare?
    1. The Problem—Employer-Provided Health Insurance Costs Are Unsustainable
    2. The Solution—Reimburse Employees for Individual Health Insurance
    3. Three Reasons Individual Health Insurance Is Better for Your Company
    4. How Defined Contribution Works
    5. Three Ways to Offer Defined Contribution Healthcare
    6. How Much Will Your Company Save with a Defined Contribution Program?
    7. What You Learned
  22. Chapter 14: How to Conduct a Defined Contribution Financial Analysis
    1. What You Learned
  23. Chapter 15: How to Implement a Defined Contribution Solution
    1. Is Your Company Ready for Defined Contribution?
    2. 5. Communicate Your New Program to Employees
    3. 6. Help Employees Buy Individual Health Insurance
    4. What You Learned
  24. Chapter 16: How to Choose a Defined Contribution Solution Provider
    1. Best Practices for Defined Contribution Healthcare
    2. Features to Look for in a Defined Contribution Solution Provider
    3. 10 Questions to Ask Defined Contribution Solution Providers
    4. What You Learned
  25. Chapter 17: How to Communicate Defined Contribution to Employees
    1. Communicate Early and Frequently
    2. Announcing Your Defined Contribution Program
    3. Custom Employee Welcome Packets
    4. How to Help Employees Purchase Individual Health Insurance Plans
    5. Using Your Defined Contribution Program to Recruit New Employees
    6. What You Learned
  26. Appendix A: State-by-State Guide to Individual/Family Health Insurance Costs
    1. Methodology
    2. Individual Single Health Insurance
    3. United States
    4. Alabama
    5. Alaska
    6. Arizona
    7. Arkansas
    8. California
    9. Colorado
    10. Connecticut
    11. Delaware
    12. District of Columbia
    13. Florida
    14. Georgia
    15. Hawaii
    16. Idaho
    17. Illinois
    18. Indiana
    19. Iowa
    20. Kansas
    21. Kentucky
    22. Louisiana
    23. Maine
    24. Maryland
    25. Massachusetts
    26. Michigan
    27. Minnesota
    28. Mississippi
    29. Missouri
    30. Montana
    31. Nebraska
    32. Nevada
    33. New Hampshire
    34. New Jersey
    35. New Mexico
    36. New York
    37. North Carolina
    38. North Dakota
    39. Ohio
    40. Oklahoma
    41. Oregon
    42. Pennsylvania
    43. Rhode Island
    44. South Carolina
    45. South Dakota
    46. Tennessee
    47. Texas
    48. Utah
    49. Vermont
    50. Virginia
    51. Washington
    52. West Virginia
    53. Wisconsin
    54. Wyoming
  27. Appendix B: Is Your Company Required to Offer Employer-Provided Health Insurance?
    1. Is Your Company Subject to the Employer Mandate?
    2. What Is the Amount of Your Shared Responsibility Payment?
  28. References
    1. Introduction—The End of Employer-Provided Health Insurance
    2. Chapter 1: The Disadvantages of Employer-Provided Health Insurance
    3. Chapter 2: The Advantages of Individual Health Insurance
    4. Chapter 3: The Solution—Employer-Funded Individual Health Insurance
    5. Chapter 5: How Much Does Individual Health Insurance Cost?
    6. Chapter 7: When Can You Buy Individual Health Insurance?
    7. Chapter 13: What Is Defined Contribution Healthcare?
    8. Chapter 14: How to Conduct a Defined Contribution Financial Analysis
    9. Appendix A: State-by-State Guide to Individual/Family Health Insurance Costs
  29. Acknowledgments
  30. About the Authors
    1. Rick Lindquist
    2. Paul Zane Pilzer
  31. Index
  32. End User License Agreement