How is my employer affected if I have expensive claims on my group health insurance?
Your employers insurance premiums will definitely go up if there are a lot of claims when it is time for them to renew their policy. It is also possible that if this happens the employer will pass along some of the additional cost to employees. The insurance company will not try to have you removed, it doesn't work that way with group policies. They just jack up the price as mentioned previously.  If you take a new job your cancer will affect the future employer in the same way. As to whether you should keep it a secret, I don't think it is something you have to disclose unless it affects your ability to perform your job, even then it may be protected under the Americans with Disabilities Act. It is true that some employers could exhibit some bias because of this, especially a small company that is likely to have a small group that is more likely to see price hikes because of a single employee making expensive claims. Bottom line: I wouldn't lie about it to a future employer, but I wouldn't volunteer that information either unless it is material to your job performance. Many big companies self insure. They pay the insurance company to manage the claims, and to have access to their network of doctors, hospitals, specialists, and pharmacies; but cover the costs on a shared basis with the employees. Medium sized companies use one of the standard group policies. Small companies either have expensive policies because they are a small group, or they have to join with other small companies through an association to create a larger group. The bigger the group the less impact each individual person has on the group cost. The insurance companies reprice their policies each year based on the expected demographics of the groups, the negotiated rates with the network of providers, the required level of coverage, and the actual usage of the group from the previo year.. If the insurance company does a poor job of estimating the performance of the group, it hits their profits; which will cause them to raise their rates the next year which can impact the number of companies that use them. Some provisions of the new health care laws in the US govern portability of insurance regarding preexisting conditions, minimum coverage levels, and the elimination of many lifetime cap. Prior to these changes the switching of employers while very sick could have a devastating impact on the finances of the family. The lifetime cap could make it hard to cover the person if they had very expensive illnesses.  If the illness doesn't impact your ability to work, there is no need to discuss it during the interview process. It won't need to be discussed except while coordinating care during the transition. There is one big issue though. If the old company uses Aetna, and the new company doesn't then you might have to switch doctors, or hospitals; or go out-of-network at a potentially even bigger cost to you. "I don't think so. There is a provision in ObamaCare called ""community rating"" that applies starting in 2014. Insurance companies must place individual and small group plans into a pool of people from the same geographical region. The same plan must cost the same for all small businesses from the same region. So having employees who have high costs will not significantly affect the company's cost; it will get factored into the cost for all people in the area; but the effect gets averaged out over all businesses and individuals who have plans."
While I can't say how it is in the Philippines, my wife the insurance broker leads me to believe that individual insurance is more expensive than group coverages in the US almost always.  So much so that people will go to great extents to form any sort of business just to insure themselves. If however it is cheaper, can't you simply opt out of your employer's plan?  If you can opt out, will your employer give you any of the money they aren't paying for your insurance? If you can't opt out, or if you paycheck doesn't grow, I can't see why you would want additional coverage especially at such a young age.  Should you lose your job in the near future and you worry about, go get the insurance then. EDIT One big advantage is if you get personal insurance, you might need to get an exam to qualify, and it is likely the younger you are the better you will qualify. But again, you already have insurance that covers you so I would advise keeping the group policy is probably better. There are several insurance products that I buy for legal reasons: Both of these protect me from lawsuits and fines. Many people buy similar products to protect their business operations. (e.g. medical malpractice insurance) There are some insurance products I buy for tax planning and financial planning purposes: I have a large amount of savings available, so I have several tricks to reduce my insurance costs, and I have several products that I avoid. Several of these reasons are mentioned in other answers, but I thought I would collect them into a single answer to demonstrate that there are reasons other than the rational calculation of what the payout will be for the insurance products vs. the premium paid. If I gain access to a tax advantaged Health savings account, that is a bigger benefit to me than avoiding the premium, especially when my employer is paying the majority of the premium. Perhaps it makes no sense to buy insurance given sufficient savings (like the products I listed that make no sense for me given my finances) but not everyone can self-insure; it does require a certain level of wealth. Unfortunately, the tax system in the U.S. is probably more complicated than it looks to you right now. First, you need to understand that there will be taxes withheld from your paycheck, but the amount that they withhold is simply a guess.  You might pay too much or too little tax during the year.  After the year is over, you'll send in a tax return form that calculates the correct tax amount.  If you have paid too little over the year, you'll have to send in the rest, but if you've paid too much, you'll get a refund.  There are complicated formulas on how much tax the employer withholds from your paycheck, but in general, if you don't have extra income elsewhere that you need to pay tax on, you'll probably be close to breaking even at tax time. When you get your paycheck, the first thing that will be taken off is FICA, also called Social Security, Medicare, or the Payroll tax.  This is a fixed 7.65% that is taken off the gross salary.  It is not refundable and is not affected by any allowances or deductions, and does not come in to play at all on your tax return form. There are optional employee benefits that you might need to pay a portion of if you are going to take advantage of them, such as health insurance or retirement savings.  Some of these deductions are paid with before-tax money, and some are paid with after tax money. The employer will calculate how much money they are supposed to withhold for federal and state taxes (yes, California has an income tax), and the rest is yours. At tax time, the employer will give you a form W-2, which shows you the amount of your gross income after all the before-tax deductions are taken out (which is what you use to calculate your tax).  The form also shows you how much tax you have paid during the year. Form 1040 is the tax return that you use to calculate your correct tax for the year.  You start with the gross income amount from the W-2, and the first thing you do is add in any income that you didn't get a W-2 for (such as interest or investment income) and subtract any deductions that you might have that are not taxable, but were not paid through your paycheck (such as moving expenses, student loan interest, tuition, etc.)  The result is called your adjusted gross income. Next, you take off the deductions not covered in the above section (property tax, home mortgage interest, charitable giving, etc.).  You can either take the standard deduction ($6,300 if you are single), or if you have more deductions in this category than that, you can itemize your deductions and declare the correct amount. After that, you subtract more for exemptions.  You can claim yourself as an exemption unless you are considered a dependent of someone else and they are claiming you as a dependent.  If you claim yourself, you take off another $4,000 from your income. What you are left with is your taxable income for the year.  This is the amount you would use to calculate your tax based on the bracket table you found. California has an income tax, and just like the federal tax, some state taxes will be deducted from your paycheck, and you'll need to fill out a state tax return form after the year is over to calculate the correct state tax and either request a refund or pay the remainder of the tax.  I don't have any experience with the California income tax, but there are details on the rates on this page from the State of California. "Also within Germany the tax offices usually determine which tax office is responsible for you by asking where you were more than 180 days of the year (if e.g. you have a second flat where you work). That's a default value, though: in my experience you can ask to be handled by another tax office. E.g. I hand my tax declaration to my ""home"" tax office (where also my freelancing adress is), even though my day-job is 300 km away.  So if you work mostly from Poland and just visit the German customer a few times, you are fine anyways. Difficulties start if you move to Germany to do the work at your customer's place. I'm going to assume that this is the situation as otherwise I don't think the question would have come up.  Close by the link you provided is a kind of FAQ on this EU regulation About the question of permanent vs. temporary they say: The temporary nature of the service is assessed on a case-by-case basis.  Here's my German-Italian experience with this. Background: I had a work contract plus contracts for services and I moved for a while to Italy. Taxes and social insurance on the Italian contracts had to be paid to Italy. Including tax on the contract for services. Due to the German-Italian tax treaty, there is no double taxation. Same for Poland: this is part of EU contracts. By the way: The temporary time frame for Italy seemed to be 3 months, then I had to provide an Italian residence etc. and was registered in the Italian health care etc. system. Due to the German-Italian tax treaty, there is no double taxation. Same for Poland: this is part of EU contracts. Besides that, the German tax office nevertheless decided that my ""primary center of life"" stayed in Germany. So everything but the stuff related to the Italian contracts (which would probably have counted as normal work contracts in Germany, though they is no exact equivalent to those contract types) was handled by the German tax office. I think this is the relevant part for your question (or: argumentation with the German tax office) of temporary vs. permanent residence.  Here are some points they asked: There is one point you absolutely need to know about the German social insurance law: Scheinselbständigkeit (pretended self-employment). Scheinselbständigkeit means contracts that claim to be service contracts with a self-employed provider who is doing the work in a way that is typical for employees. This law closes a loophole so employer + employee cannot avoid paying income tax and social insurance fees (pension  contributions and unemployment insurance on both sides - health insurance would have to be paid in full by the self-employed instead of partially by the employer. Employer also avoids accident insurance, and several regulations from labour law are avoided as well). Legally, this is a form of black labour which means that the employer commits a criminal offense and is liable basically for all those fees.  There is a list of criteria that count towards Scheinselbständigkeit. Particularly relevant for you could be" "J Gruber's consulting reports for the various states (Minnesota, Wisconsin, etc).  * http://www.washingtonpost.com/blogs/ezra-klein/post/jon-gruber-on-the-premiums-in-health-care-reform/2011/08/25/gIQAN0TUWS_blog.html  ...and the article it addresses (which included some numbers from the reports):  * http://dailycaller.com/2012/02/11/obamacare-architect-expect-steep-increase-in-health-care-premiums/  Note that Gruber has made a whole spectrum of claims (from initially claiming that premiums would go DOWN for a consulting agreement with the Obama administration, to later ""revisions"" showing significant increases {to varying degrees depending on the individuals specific demographic}), to wit:  &gt;Gruber’s new reports are in direct contrast Obama’s words — and with claims Gruber himself made in 2009. Then, the economics professor said that based on figures provided by the independent Congressional Budget Office, “[health care] reform will significantly reduce, not increase, non-group premiums.”  &gt;During his presentation to Wisconsin officials in August 2011, Gruber revealed that while about 57 percent of those who get their insurance through the individual market will benefit in one way or another from the law’s subsides, an even larger majority of the individual market will end up paying drastically more overall.  &gt;“After the application of tax subsidies, **59 percent of the individual market will experience an average premium increase of 31 percent,”** Gruber reported.  &gt;The reason for this is that an estimated 40 percent of Wisconsin residents who are covered by individual market insurance don’t meet the Affordable Care Act’s minimum coverage requirements. Under the Affordable Care Act, they will be required to purchase more expensive plans.  &gt;Asked for his own explanation for the expected health-insurance rate hikes, Gruber told TheDC that his reports “reflect the high cost of folding state high risk pools into the [federal government's] exchange — without using the money the state was already spending to subsidize those high risk pools.”  Note: Emphasis added.    Note 2: To begin with, an ""average"" increase of 31% qualifies as ""significant"" (hell, it's a lot more than merely ""significant"", that's a HUGE increase); and secondly, that is an AVERAGE, meaning that while some of the people in that ""59%"" will probably not see such a high increase, a fairly large segment {and per the provisions of the Act versus current premium calculation methods, we KNOW these will be ""young healthy singles"", and especially males} will face increases that are substantially HIGHER than 31%, and in fact will probably be in the nature of double or triple previous premiums {as would be required in order to meet another provision of the act, that highest premiums for older/sicker pool members cannot be higher than 3x that of the youngest/lowest tier premiums -- and if the company is to balance the books, it can only ""bring down"" the one end if it makes a compensating increase at the other end.})  None of that is ""rocket science"" and it is entirely predictable. (The only things that would be ""odd"" would be that anyone should expect anything different, and that Gruber's initial claims of across the board lower costs were ever accepted in the first place.)" "Michael McGowan's answer is correct. The HDHP is like conventional insurance -- it is not like a ""health care plan"" that we're all used to. I.e. you don't want to have it pay out -- if it pays out, something bad has happened to you. (Just like you hope to never make a claim on your homeowner's, disability, or AD&D insurance -- that means something bad happened to you.) There are minor exceptions -- some HDHPs may cover preventive care, immunizations, etc to some extent. The bonus in the case of the HDHP is that you get to put money to cover the deductible into a tax deferred account. The HSA is effectively a self insurance fund with the HDHP as backup. Here's a concrete example. Say you have an HDHP with a $2500 deductible. The monthly premium is $500. You put $3000 into your HSA. Scenario 1: You remain mostly healthy throughout the year. You have a single doctor's visit, the doctor's office submits a claim to your insurance. The insurance doesn't pay because you haven't met your deductible, and you get a bill for $150. You write the doctor a check for $150 out of your HSA. Here, you've spent $6000 on your HDHP premiums, contributed $3000 to your HSA, and spent $150 of that on health care. At the end of the year, your HSA balance is $2850. In the following year, assume you plan to contribute another $3000 to your HSA. You can increase your deductible on the HDHP to $5000 (since you'll have $6000 in your HSA to cover out of pocket costs) and your monthly premium might go down to $400. Scenario 2: You are hospitalized for a week. The hospital submits a $15000 claim to your insurance. The insurance pays $12500 since your deductible is met after $2500. The hospital sends you a bill for $2500 for the balance. You write a check to the hospital out of your HSA. Again, you've spent $6000 on your HDHP premiums and contributed $3000 to your HSA. At the end of the year, your HSA balance is $500. Scenario 3: You are hospitalized for two days in December 2011, and then again for two days in January 2012. Your deductible reset on January 1, 2012. The hospital submits two claims to your insurance: one in 2011 for $5000 and one in 2012 for $5000. The insurance company pays $2500 on the first one and you get a bill for the other $2500. Same thing for the second one -- you've got to meet the deductible all over again. You write the hospital a check from your HSA to pay the first one. Then you've only got $500 left in your HSA. But you were planning to make another $3000 HSA contribution for 2012 anyway, so you make the contribution, write a $2500 check to pay the second bill, and you've now got a balance of $1000 in your HSA -- and since you've met the deductible for 2012 you should have no more out of pocket expenses. (Assuming your plan doesn't have copays.)" "I am very late to this forum and post - but will just respond that I am a sole proprietor, who was just audited by the IRS for 2009, and this is one of the items that they disallowed.  My husband lost his job in 2008, I was unable to get health insurance on my own due to pre-existing ( not) conditions and so we had to stay on the Cobra system.  None of the cost was funded by the employer and so I took it as a SE HI deduction on Line 29.  It was disallowed and unfortunately, due to AGI limits, I get nothing by taking it on Sch. A.  The auditor made it very clear that if the plan was not in my name, or the company's name, I could not take the deduction above the line.  In his words, ""it's not fair, but it is the law!""" I am sorry for your troubles.  Presumably, you are feeling better which is the best possible outcome.  You project that you are an honest person and desire to seek a fair outcome although you were mistreated.  The insurance company should have paid a good portion of this bill. Because of this situation you will learn a valuable lesson.  Namely that collectors are scum.  They lie and manipulate to do their job.  They are trying to generate an emotional reaction out of you so you give in an put this bill on a credit card.  Do not fear them. My advice would be to ignore them.  You can educate yourself on collections law in your state.  They cannot call you at work and they probably cannot call you on a cell phone.  They will threaten to garnish your wages, tax return, and take away your birthday.  Just don't talk to them. When you can save up some money.  Once you have like $1200 attempt to settle in full for that amount.  Get it in writing ahead of time and do not give them access to your checking account.  Use a cashiers check or prepaid visa (that you then throw away).  If they say no, do not argue, hang up and call back when you have 1300.  Rinse, wash, repeat.   There is a decent chance that they have already violated some form of collections law.  If you have proof you can call the company's legal department and provide that proof.  You can then settle on having your collections waived.  In summary: This also presumes you have a lowish household income.  If you make like 70K, jut pay the bill.  I doubt that is the case though.