La Mesa business owner feels overburdened by Obamacare
Joseph Seiley says his rates will go up 93 percent
Last Updated: 40 days ago
LA MESA, Calif. - A La Mesa business owner initially believed no changes would be made to his health care plan with the Affordable Care Act in place, but he said he now knows that is not the case.
It was a promise heard around the nation made by President Barack Obama in several speeches.
"If you like your plan, you can keep your plan," Obama said of the ACA, also known as "Obamacare."
However, it's a promise that business owner Joseph Seiley said has not been kept, at least not without increased costs.
"We feel like we're being told that we don't know what's good for our family," said Seiley, who co-owns Davis & Seiley Wealth Management in La Mesa.
Seiley contacted 10News after his insurance broker received a surprising letter from Kaiser Permanente that said Seiley's health coverage for himself, his wife and five children will be canceled or go up 93 percent.
"This is a nearly $8,000 annual increase for myself," Seiley added.
It was a similar letter that Obama said may be coming to the nearly 15 million Americans who might lose the inexpensive and limited coverage plans they currently have.
"If you get one of these letters, just shop around in the new marketplace. That's what it's for. You're going to get a better deal," the president said in a speech.
"They are saying, 'Well, go shop around on the exchanges, you'll find something more competitive," Seiley said. "We're not finding that."
Seiley showed 10News the letter he received and the explanation he received from Kaiser Permanente.
Starting in February, his monthly premium will go up to $1,335 per month -- up from the $690 a month he pays now.
10News also sat with him as he navigated the Covered California website.
While he could see the comparable rates for individual plans, he has to wait another seven to 10 days to even see the small business rates, since he had to apply as a business owner first.
"You can't blame the insurance companies. They are following the law," said health insurance agent Craig Gussin.
Gussin said health care companies are now the scapegoats. They are doing what the law says.
"If you are a business owner and you have no employees on the plan but your family, then you won't qualify as a one-person group for health insurance with almost every company in California as of January 1st," Gussin added.
But before then, Seiley will have a lot of work ahead and crucial options to consider.
"I like my doctor and I like my coverage, and I can keep neither if we switch away from Kaiser," Seiley added.
10News contacted Kaiser Permanente about the increase in coverage for Seiley and others. In a prepared statement, Kaiser Permanente told 10News:
"First, family coverage in small group plans in priced differently under health reform rules. This customer's current plan offered three standard rates for 'employee only,' 'employee and spouse,' 'employee and children' and 'employee and family.' The Affordable Care Act requires plans to take family size and ages of family members into account. So as we see in the individual market, premiums for younger people will increase and premiums for older people will decrease. Under the new rules, larger families are likely to see premium increases because each member is now counted in the rate and covered dependents tend to be young people. Smaller families will likely see premium decreases.
The ACA also established regulations for the minimum 'essential' benefits offered in any plan. This new benefit plan includes Pediatric Dental & Vision, which were not part of the customer's prior coverage.
Finally, insurers have been able to adjust premiums for small groups based on their utilization of medical services, similar to medical underwriting in the individual market in which healthier people benefitted from lower premiums. Health reform no longer allows health plans to discount premiums based on the experience of the small group, so healthier groups will pay more and less healthy groups will pay less.
We encourage this customer to work with their Kaiser Permanente agent or broker to find the best option for them and their employees.
Socorro Serrano, MA"
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