It means the employer has to offer a sufficiently generous benefit so that enough of the company’s lower income employees sign up for it, such that it passes non discrimination testing rules. Which means the health insurance benefit must be good enough that even the lower paid employees find it makes sense to sign up for it.
No, exactly the opposite. ERISA is a Federal law that strictly regulates how plan fiduciaries can operate employer-sponsored health plans. A key element of ERISA is that an employer cannot offer more generous benefits to some employers over other; everyone in the company must be offered the same plans, and within each plan, every beneficiary must be treated the same.
prior to the No Surprises Act just signed (and maybe after too?) ERISA allowed for balance billing. Which means not even California laws against balance billing would apply.
For anyone not living in the permanently-fucked US, an explanation: your health insurance covers you for "in network" doctors at an "in network" hospital. If you go to an "in network" hospital you would assume (wrongly) that you are fully covered. But no. Some random anesthesiologist can come into your room, provide their service for 20 minutes, and stick you with a $5,000 bill because they are "out of network". And you have ERISA insurance and you are just plain fucked.
Anyone getting health services in the US must hang a sign on their door saying "In Network Only". I'm 100% serious. Every person that walks in your room must be vetted. And good luck if they can't find an "in network" surgeon for that emergency service or whatever.
Full disclosure: I work in this industry and am a claims adjuster on fiduciary plans that fall under ERISA
Everything you're saying is partially correct, but it heavily depends on the specifics of the plan. FAANG companies, in particular, typically have extremely generous PPO plans that offer 0 co-insurance and broad networks. You're correct that, out-of-network, balance billing may occur, but Amazon's plans have networks so broad that this is unlikely to happen.
In addition, if you look at Amazon's plan documentation, they also offer a Kaiser HMO for which none of this applies.
There's a lot that can be improved around price transparency, but Amazon is one of the few companies that offers Cadillac gold-standard insurance, and because ERISA requires that all employees receive the same benefits, this extends to their full-time warehouse workers too.
> but it heavily depends on the specifics of the plan
> Amazon's plans have networks so broad that this is unlikely to happen
I mean, this doesn't sound reassuring you know. "unlikely" and "depends on the specifics". That's kind of the problem. No one knows what is covered and what is not. Billing in the US is this labyrinthine thing where hospitals, doctors, and insurance all seem to be making it up as they go along in conjunction with whatever they feel are the laws and whatever they feel like they can get away with. Leaving it up to the patient to appeal after appeal after appeal on a flood of bills they will receive, depending on their operation or service.
You can't even get a detailed bill out of some of these places. The doctors vanish and you're literally stuck talking to one of those robocalling bill collector agencies, which probably has a PO Box in fucking Alaska. It's shady as hell. All of it.
Believe me, you're preaching to the choir. I personally adjudicate claims, and some of the stuff I see is downright asinine.
All that being said...
> I mean, this doesn't sound reassuring you know. "unlikely" and "depends on the specifics". That's kind of the problem. No one knows what is covered and what is not.
"American healthcare in short:
~60% (in good employer plans, generous state Medicaid, or M.Adv/Medigap) have the best healthcare in the world.
~30% have insurance with gaps/risk of big bills.
~10% uninsured must rely on uncompensated care, go without treatment, or risk bankruptcy
The strength of M4A proposals is that they begin with an understanding that the 40% exist and need things fixed.
Their weakness is that they pretend that the 60% don't, and threaten to take away what they have."
Amazon is, pretty reliably, part of that 60%; it offers some of the best employer health coverage out there. Like, it doesn't even compare to public health plans in a lot of the world.
All of the problems you brought up (labyrinthine systems, appeal processes, bill collector agencies in Alaska) are real problems that you and I agree need to be solved, but they're also problems that don't afflict beneficiaries of generous plans paid for by rich companies, and that's what we're talking about in the context of Amazon Warehouse workers.
Most FAANG companies cover all of the premium amount. The only difference is in the deductible. Some engineers might choose a higher deductible plan so that they can take advantage of an HSA and enjoy the triple tax advantage. Warehouse workers are probably better off choosing the $0 deductible HMO plan that Amazon offers.
Meh. I went to an Ivy league, as did my sister. My wife was a grad student at Stanford. My classmates were clever, but they weren't that smart! The standardized test scores can be improved with work.
As for standing out with your essay and CV, I remember a talk from an admissions officer from Harvard. His take was that it's easy to stand out from 99% of students just by actually doing real, substantive work. He wasn't talking about the stuff that's designed to be a student CV stuffer to impress admissions. Do actual, substantive work.
Something like a substantive contribution to a scientific field. Amateurs can still do this. Maybe run a real business. The example this admissions officer gave was someone who dropped out of High School, got a GED, then started repairing motorcycle engines. Then, you also need to make sure your essay is well written, which is another skill which can be learned. Relate your experience back to the academic opportunity, and how this would enable you to benefit society.
There is a problem with this way of thinking of admissions: If you do pursue it in earnest, you might well decide to skip university entirely.
To some extent, I wonder if the perception that your peers aren't that smart is just due to getting adapted to your environment.
I went to an Ivy coming from an inner city public school and I found it a big culture shock in terms of both how well behaved people were in classrooms and also how quick/smart people were to grasp what I was saying and build on it. By the time I was a senior, I had lapsed to the "people here actually aren't that smart" line of thought - but I wonder if I just got used to being around more intelligent people.
I did not go to an Ivy, but I went to the 1-2 ranked public institution in the US (for CS). The baseline is definitely higher, but there is a big gap between people who got there by their own grit and determination and people who got there almost helplessly due to a tidal wave of fortunate circumstances (e.g. parents were in sweng, went to cushy private schools that inflated grades, "did" a bunch of charity work / extracurriculars to pad their resume for college).
The "not smart" people are the latter category: they can still pick things up quickly, but they viewed getting into the institution as the last hurdle they'll have to go through in order to be set for life. They just coasted and got Cs and didn't really care about learning new stuff because they knew the university's name on their degree alone would land them some cushy PM job where they wouldn't need that pesky coding ability every again).
It was actually infuriating because I really enjoy CS and getting paired up with these folks who were born with a silver spoon in their mouths but didn't care was disappointing. Most of them were uncomfortable with the mental struggle of doing difficult group projects, often just showing up for the "design session" but skipping out on most of the coding. I made a lot of enemies out of them when I told the profs to look at my (GPG-signed) git commits and consider how they want to distribute grading points.
> I made a lot of enemies out of them when I told the profs to look at my (GPG-signed) git commits and consider how they want to distribute grading points.
In most cases it did: I even wrote a python script to use matplotlib to generate a few "contribution graphs" like one sees on github. That visual was usually enough to tell the profs to not give my teammates any credit when they didn't do diddly squat for code.
I learned most of the "defensive git" tricks during this time because I caught one of these guys trying to rewrite history to claim credit for my commit. That guy got referred to the university's "ya dun messed up bigtime" committee (I forget the actual title) and I think he was kicked out for academic dishonesty. Ever since then I gpg sign all my commits!
I was in a group project for a Psychology of Business class. This 4th string quarterback/son of a politician or some such just told us on the 1st day, "Well, considering we're graded as a group, I want to tell you I don't care what grade I get, so you guys are doing all of the work!"
To some extent, I wonder if the perception that your peers aren't that smart is just due to getting adapted to your environment.
I've met people who I would describe as "bonkers smart", as the comment I was replying to had it. That is, people who are literally 2-3 times faster at getting to the next step, and just leave the entire room behind, when the room contains a dozen graduate students. They are not that common, even in a place that's supposed to be populated by the intellectual elite.
how well behaved people were in classrooms and also how quick/smart people were to grasp what I was saying and build on it
The same is true at the in-state universities. At that salary, your kid can study at University of Alabama (a perfectly fine institution with great campus life) basically for free.
The University of Alabama also has surprisingly good merit scholarships for students who are from out of state. I was considering going there and they offered me full tuition + 2 years of housing covered + some other grants (and I wasn't even that good of a student, definitely not Ivy caliber).
