UPDATE #3: BIG h/t to MartyM (from the comments)... HE went there!!!
I called the company, Simonetta's spoke with a nice lady....they have 7 employees and have purchased small group insurance through a broker for years - but THIS YEAR he didn't tell them about the LOWER premiums available on the Exchange - which would negate HIS usefulness.Those poor people, used and abused like pawns for ideological purposes. I hope Mr. Moore enjoys the publicity from this stunt. I am so happy they are getting the information they need and deserved to get from their 'broker', and hope they either sue or shame him into refunding them any money he needlessly caused them.
No telling how much he's making by ADDING HIS commission to their premiums!
She said they were looking into the Exchange, but some employees had already paid the HIGH deductible which they'd never get back.
I also just posted this to Simonetta's Facebook page: (right before I read about MartyM's fantastic phone call)
Did your broker inform you that if your premium cost exceeds 9.5% of your pay, you are eligible to get individual insurance from the Obamacare exchange? Including being eligible for subsidies? For example, Judy and one child could get a 500/1000 Platinum policy with 10% copays and $3,300 max family OOP, with $50,000 income for $725/month. Please, for your own sakes, do some research, reach out to help, go on the Exchanges, it probably isn't as bad as you thought.Yet another successful group effort. Now I'm on to looking at 'Emilie with Lupus' who AFP is pushing as yet another Obamacare victim. Guess what? The truth is a bit different..... surprised?
UPDATE #2: I'm deleting my request that the players in this issue not be contacted, because the story has gotten plenty of attention from outside dKos.
Also, I haven't had the pleasure of a reply from the TV news anchor.
And I'm deleting my negative jab at local Faux stations, after being rightly informed that they aren't necessarily related to the national Faux news. Thanks for that.
Have at 'em, kossaks!
URGENT: PLEASE do not go off on your own and contact any of the people involved in this diary. You are probably as upset as I am about this, but our chances of helping these folks will be greatly increased if we present a united front and don't deluge them. Thanks.
Last night, in a comment to my previous ACA-relateddiary, I noticed a comment from chrisirob with this link in it: (sorry, haven't figured out embedding video yet)
My ACA-dar started alerting as soon as the broker handed out 'private' premium notices, and when the people began telling what they were being made to pay in premiums, it went on full active mode, ACA-con 5. When Judy sadly told us that the premium for herself and her child was raising from $929 to $1316, I wanted to scream at the screen 'STOP! THAT CAN'T BE!'.
As usual, it took less than 5 minutes on healthcare.gov to collect data that validates my ACA-dar. Here is what I found and posted in a comment last night:
I went to healthcare.gov and found that in the small business exchange, a company with 6 employees aged like the people in the video, a Gold plan with 1,500/3,000 deductible and 2,200/4,400 OOP would cost a TOTAL of $2,036/month, for a per-person cost ofThen I traced the video back to TV station WTAE in Pittsburgh, found the storythat accompanied it, and sent this e-mail to the reporter who wrote it:
$339 per month per person
There is absolutely no reason why a 53 year old mother of 1 - identified as 'Judy' in the video - should be paying $1316 per month. If she went on the individual market - which I believe she could do because that amount is certainly more than the 9.5% cap for 'affordable' premium - she would get 1,500/3,000 deductible policy for her and her child for about $550 depending on her income level.
This is ridiculous. My first take is that the broker is taking that company for a ride, but even if that's not it, something isn't right here.
I am going to attempt to contact the reporter who did the story, try politely to open a conversation and offer to provide her with some better information on what is available.
Thanks for the head's up.
Hi Wendy,No response yet, but Wendy Bell does all the evening news, so she works until midnight.
I saw a clip of your visit to Simonetta’s and I am concerned that the employees of this company are not being given correct information about what their health-care insurance costs should be.
Small-business health insurance is available through the ACA on-line exchange, and while I don’t know the particulars of this business, here is an example of what is available:
For a company of 20 people, there is a policy called Small Business Advantage Premium Platinum 40. It features $0 deductible, $1,000/2,000 out-of-pocket maximum, $10 primary doctor co-pay and $8 generic prescriptions. The cost for 20 employees is $8,276 per month, or $414 per person. This figure doesn’t count dependents, but children don’t cost much to insure.
Here is a link to the page on healthcare.gov that has this information on it: (you can easily go to the site and search for plans yourself, and I’d be happy to assist you in doing that as well)
How can Judy in your video clip be forced to pay $1,316 for herself and one child? That’s just not right. Even without a subsidy, on the ACA exchange, Judy can get a Platinum policy, with $500/1,000 deductible and 1,650/3,300 out-of-pocket max, for $725 per month. And because Judy’s company plan premium is certainly more than 9.5% of her income, she most likely will be able to get a subsidy on the exchange.
I don’t know if your are familiar with the complexities of the Affordable Care Act and the exchanges, but I am, and something just smells wrong about this. I am very suspicious of the broker, and, as I stated above, am concerned that the employees of this company are not getting a fair shake.
They obviously don’t know anything about what might be available to them as an alternative to their broker’s offering.
I would be happy to discuss this issue with you, and perhaps help you understand better what options might be available to these people.
I’m bringing this to you first because you ran the story and I hope you feel a sense of responsibility to help these people if you can. If you’re not interested, I will certainly reach out to Gary Simonetta.
I look forward to hearing from you soon so we can work on helping these people.
I went to bed fairly convinced that something is seriously wrong at this company in McKeesport, and woke up to find this comment from chazbritfield:
Charles E. Moore, the gentleman presenting the new policies to the employees, is a rabid conservative... Here is a link to some of his writings:From Cardinal Fang, who corroborated my initial reaction:
Simonetta is contributing nothing to the employees' premiums, as far as I can tell.At this point it appears that we have an ideologically-motivated insurance broker setting up insurance policies with needlessly high premiums for unsuspecting - and trusting - employees..... but we don't know for sure.
It's unusual for a group policy to have different premiums for each employee. It looks like Simonetta & Moore just selected a Gold plan for each employee. Is this a group policy at all?
As was suggested (and worked so well) in the previous diary, this is a perfect issue for 'crowd-sourced investigated journalism', so I need your help, please.
Would some of you who read this diary please do some research to validate my findings, particularly on the approximate cost and eligibility for small business group health insurance on the Pennsylvania exchange? As a numbers and data guy, I always feel least confident in my numbers (I know, that's silly)
My next move is going to be to write another e-mail to the news reporter, informing her of what we found out about the insurance broker, in hopes of piquing her interest further in this story.
After that, I'm going to wait until I hopefully hear back from the news reporter. I believe that she is the absolute best person to deal with this situation, as long as she is fully cognizant of the situation, armed with facts, and sees this as a public-service opportunity.
I am also looking for suggestions, critiques, insights, etc. from all of you. This is a bothersome situation, with some scary bits to it. If somebody can show me that I am wrong about this, PLEASE do so.
I don't want to mess things up further for these employees, but every time I watch the video and look at their faces, I know I can't just sit here.
If any kossaks live in the Pittsburg area, there may be some point in this where live, in-person contact may be of use - but not yet, please.
Lastly, to reiterate my caution at the beginning: PLEASE do not contact any of the people involved. Let's do some research, (hopefully) get the news reporter involved, and plot out a good plan.
Thanks to all the comments so far.
As LookingUp pointed out, it is suspicious that the TV station had cameras there at that point in time. That could only have been due to the broker, and the more I watch that video, the more obvious it is that this is a setup by the broker. Consider these words by Mr. Moore:
"Here is the new plan we had to switch to that takes into account the Obamacare regulations.”Emphasis added. This is not like any company-sponsored inusurance I've been involved in - we always got a rate sheet, indexed by age, marital status, dependents, etc. There were also always choices, different plans with different premiums and deductibles. Where is ANY of that?
I just wrote a follow-up e-mail to Wendy Bell, the reporter/anchor for WTAE who ran this story:
Hi Wendy,I will give her a few more hours and if I don't hear from her I'll send one more request. After that, I think I'll reach out to the NBC and CBS local affiliates to see if they're interested.
I’m writing to follow up on my e-mail of last night, with some new information that has come to light.
It appears that the insurance broker shown in your video, Charles E. Moore, has a strong ideological hatred of the Affordable Care Act. Here is a link to some of his published writings:
I hope you agree with me that there is something seriously wrong with this situation and, at the very least, this company’s employees deserve to know that they may not be getting the best – and most affordable – health insurance available to them.
Several friends and I are continuing to research this case, and we are, of course, eager to assist you in following up on your story, in the interest of helping these employees get the health insurance they are entitled to.
I also encourage anyone else to send Wendy Bell an e-mail encouraging her to do some more research (or at least use ours after validating it) and follow up on her original story.
After all, as far as I can see, Wendy Bell got played badly for ideological purposes, and found herself as a (presumably) unwitting pawn in an unethical piece of business.
More updates will follow as the situation develops. Keep those comments coming!