Another COBRA vs ACA question

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blaugranamd
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Another COBRA vs ACA question

Post by blaugranamd »

Hey all,

So we recently had a lay off in the family and lost our employer coverage, both of us are currently unemployed but we are blessed to have planned ahead and saved aggressively. I have been dragging my feet on selecting our next healthcare plan since I know I have that 60 day COBRA window if anything came up. Well to make matters more interesting, on the very last day of our employer sponsored coverage we found out we might be having an unexpected new family member... I have never done ACA plans or COBRA before as we were on Tricare prior to our most recent employer plan. Our area only has 3 ACA plan providers on the marketplace: Oscar, AmBetter, and BCBS. Our family is young (38, 35, 7, 2) and healthy other than a very likely pregnancy (all the previous ones were healthy, uneventful). None of us gets routine care other than some counseling and a kid with stable ADHD who just needs a quick doc visit and Rx every 3 months. I'm a little overwhelmed with the decision now that we've got more going on than I expected so I would appreciate some talk through with all this.

We're already in talks with our next positions, these will require a move to another state. If everything goes well, I would expect to regain employer coverage in a new state around July or August of this year, so we're probably looking at 3-5 months of insurance.

We got our COBRA letter and, as expected, costs are high, about $2400/month. It's a company "self-funded" plan through UHC/UMR. But we don't have to find any new docs, coinsurances are around 25% for most in-network, and deductibles are relatively low. There are plenty of in-network providers in the community here and where we would be moving to.

ACA plans for our family start around $1400/month, only one of which lets us stick with the docs are already use. Deductibles for individuals and family as well as copays are about 2-3x higher. Total out of pocket max is slightly higher. The "having a baby" estimated cost is about $4k more (but I don't expect we would be under ACA/COBRA at delivery).

My understanding is COBRA is portable while an ACA plan is not, so we'd need to go through this all over again after we move for another month or two of coverage. Even comparing numbers, etc, it's obviously impossible to know how any health issues in that window will play out and even if they do how each insurer will actually handle and reimburse claims...

I'm not even sure what I'm asking here, should I just take the simpler route and pay the extra $1k/month for the COBRA?



On a separate, similar note, I was under the impression COBRA couldn't exceed 102% of the total cost (employer and employee paid) plan. Our W2 indicates employer cost for 4 months of coverage last year was $7,069, we paid $356/month, which would be about $2,123 in cost + 2% = $2,166???
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samsoes
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Re: Another COBRA vs ACA question

Post by samsoes »

I'm sure the cost of the plan has risen for 2024. Mine did, substantially. That's why your COBRA cost is greater than 102% of the 2023 cost.
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Re: Another COBRA vs ACA question

Post by mhc »

I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
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Re: Another COBRA vs ACA question

Post by blaugranamd »

mhc wrote: Mon Apr 01, 2024 11:32 am I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
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Re: Another COBRA vs ACA question

Post by Watty »

Keep in mind that if you switch to ACA you will need to start your 2024 deductible all over again.
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Re: Another COBRA vs ACA question

Post by blaugranamd »

Watty wrote: Mon Apr 01, 2024 11:59 am Keep in mind that if you switch to ACA you will need to start your 2024 deductible all over again.
yep, but we're really low utilizers, I think 3 copays of $40 is our only out of pocket expense this year.
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Re: Another COBRA vs ACA question

Post by EricGold »

blaugranamd wrote: Mon Apr 01, 2024 11:38 am
mhc wrote: Mon Apr 01, 2024 11:32 am I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
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Re: Another COBRA vs ACA question

Post by RyeBourbon »

EricGold wrote: Mon Apr 01, 2024 1:47 pm
blaugranamd wrote: Mon Apr 01, 2024 11:38 am
mhc wrote: Mon Apr 01, 2024 11:32 am I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
I'm sure the SLCSP is much more than $1400 per month for a family of 4. For 2 people here in DE is $2400/month. But it does vary by state. ETA: I forgot that age is a significant factor and we are 60.
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Re: Another COBRA vs ACA question

Post by blaugranamd »

EricGold wrote: Mon Apr 01, 2024 1:47 pm
blaugranamd wrote: Mon Apr 01, 2024 11:38 am
mhc wrote: Mon Apr 01, 2024 11:32 am I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
Good to know. Even with 4-6 months of unemployment we will probably be well in excess of the limit this year as both of our careers (hers more than mine) will likely a modest signing bonus
-- Don't mistake more funds for more diversity: Total Int'l + Total Market = 7k to 10k stocks -- | -- Market return does NOT = average nor 50th percentile, rather 80-90th percentile long term ---
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Re: Another COBRA vs ACA question

Post by HomeStretch »

If you elect COBRA, you cannot switch to ACA coverage until the next open enrollment period. Your ACA coverage application must be approved by the 15th of the month in order to have coverage effective on the 1st of the following month.

Likely signing up for COBRA now is your best choice. No change of doctors, no resetting of deductibles, possibly pregnant spouse, better nationwide coverage. There can be a lot of out-of-pocket expense when utilizing ACA coverage that can cause the ACA total costs to come much closer to the COBRA total costs.

If you elect ACA coverage, check into the coverage outside of your home area. Some plans only have emergency coverage outside of your home area. So if you and your (pregnant) spouse are on vacation or fly out to a new area for job/home hunting, an ER visit for an emergency is covered but a hospitalization admittance for the issue may not be covered even for something that seems like an emergency to the average person.
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Re: Another COBRA vs ACA question

Post by DukeGordon »

If you elect COBRA, you *can* switch to ACA coverage as long as you are still within the Special Enrollment Period (SEP).

https://www.healthinsurance.org/faqs/im ... ake-cobra/
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Re: Another COBRA vs ACA question

Post by dcabler »

blaugranamd wrote: Mon Apr 01, 2024 2:19 pm
EricGold wrote: Mon Apr 01, 2024 1:47 pm
blaugranamd wrote: Mon Apr 01, 2024 11:38 am
mhc wrote: Mon Apr 01, 2024 11:32 am I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
Good to know. Even with 4-6 months of unemployment we will probably be well in excess of the limit this year as both of our careers (hers more than mine) will likely a modest signing bonus
In my opinion, plan for not working the rest of the year when thinking about premium tax credits, or having some small amount of income. Then when if/when you start working, ACA premiums stop and you go onto a new employer plan. At tax time next year, you end up paying back whatever premium tax credits apply for your particular situation/MAGI for the entire year. It's what I did the first year of the ACA.

I retired middle of last year and just went onto COBRA for the remainder of the year. Switched to ACA this year. We were in the middle of some things and wanted to make 100% sure we kept our providers, plus we had fully met the deductible for the year. It gave us more time to really look at all of the ACA plans for this year before choosing one.

Cheers.
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Re: Another COBRA vs ACA question

Post by blaugranamd »

dcabler wrote: Mon Apr 01, 2024 4:57 pm
blaugranamd wrote: Mon Apr 01, 2024 2:19 pm
EricGold wrote: Mon Apr 01, 2024 1:47 pm
blaugranamd wrote: Mon Apr 01, 2024 11:38 am
mhc wrote: Mon Apr 01, 2024 11:32 am I would go with COBRA for the short time period. It is probably a little more expensive, but it seems to be the route of least resistance. That can be valuable when you have a lot on your plate. We earn money to make our lives easier.

If you qualify for significant ACA premium tax credits, I would consider an ACA plan.
Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
Good to know. Even with 4-6 months of unemployment we will probably be well in excess of the limit this year as both of our careers (hers more than mine) will likely a modest signing bonus
In my opinion, plan for not working the rest of the year when thinking about premium tax credits, or having some small amount of income. Then when if/when you start working, ACA premiums stop and you go onto a new employer plan. At tax time next year, you end up paying back whatever premium tax credits apply for your particular situation/MAGI for the entire year. It's what I did the first year of the ACA.

I retired middle of last year and just went onto COBRA for the remainder of the year. Switched to ACA this year. We were in the middle of some things and wanted to make 100% sure we kept our providers, plus we had fully met the deductible for the year. It gave us more time to really look at all of the ACA plans for this year before choosing one.

Cheers.
What's the advantage of over claiming on ACA tax credits? Less up front cost and paying more later?
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Re: Another COBRA vs ACA question

Post by dcabler »

blaugranamd wrote: Tue Apr 02, 2024 8:33 am
dcabler wrote: Mon Apr 01, 2024 4:57 pm
blaugranamd wrote: Mon Apr 01, 2024 2:19 pm
EricGold wrote: Mon Apr 01, 2024 1:47 pm
blaugranamd wrote: Mon Apr 01, 2024 11:38 am

Good point, we are relatively high earners (when employed, lol!) and will not get any ACA credits as far as I know. I do, personally, place a high value on simplicity (hence my love of Boglehead investing). Two professionals job hunting, moving cross country, new schools, maybe pregnancy, etc is feeling like a lot.
,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
Good to know. Even with 4-6 months of unemployment we will probably be well in excess of the limit this year as both of our careers (hers more than mine) will likely a modest signing bonus
In my opinion, plan for not working the rest of the year when thinking about premium tax credits, or having some small amount of income. Then when if/when you start working, ACA premiums stop and you go onto a new employer plan. At tax time next year, you end up paying back whatever premium tax credits apply for your particular situation/MAGI for the entire year. It's what I did the first year of the ACA.

I retired middle of last year and just went onto COBRA for the remainder of the year. Switched to ACA this year. We were in the middle of some things and wanted to make 100% sure we kept our providers, plus we had fully met the deductible for the year. It gave us more time to really look at all of the ACA plans for this year before choosing one.

Cheers.
What's the advantage of over claiming on ACA tax credits? Less up front cost and paying more later?
To be clear, I'm not suggesting that one tries to game the system. Instead, if one is unemployed, concerns about cash flow can quickly become paramount and I found it best to be very conservative about one's immediate job prospects.

In my case, I actually didn't know if I would be re-employed in the year I was previously on an ACA plan. In my estimates for that year's MAGI, I even made a assumption that I might be doing some consulting work and made my MAGI estimate accordingly. In the end, no consulting work was forthcoming and it was beginning to look like I had overestimated my MAGI. Instead, employment came along mid year and the opposite happened and I ended up paying back all of my premium tax credits at tax time. Before I went back to work, we lived only on unemployment, while it lasted, my severance package and whatever was in the checking account. We pretty much emptied all of that out about a week before I started working and had to dip into the portfolio a little bit to tide us over.

We're on an ACA plan this year and despite my best efforts at estimating MAGI, it does seem that I might have overestimated this time. I retired last year (and did COBRA till December) and didn't start withdrawing from the portfolio until this year, so it's something of a test case...

Cheers. 
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Re: Another COBRA vs ACA question

Post by blaugranamd »

dcabler wrote: Tue Apr 02, 2024 8:51 am
blaugranamd wrote: Tue Apr 02, 2024 8:33 am
dcabler wrote: Mon Apr 01, 2024 4:57 pm
blaugranamd wrote: Mon Apr 01, 2024 2:19 pm
EricGold wrote: Mon Apr 01, 2024 1:47 pm ,

ACA costs up to 8.5% of mAGI
If your chosen plan and the SLCSP are both $1,400 a month ($16,800 per year) then subsidy is eliminated at a mAGI of 16800/0.085 = $197K
Since you are going to be unemployed an estimated 4 -6 months, take that into account in your mAGI. Longer unemployment would increasingly favor ACA
Good to know. Even with 4-6 months of unemployment we will probably be well in excess of the limit this year as both of our careers (hers more than mine) will likely a modest signing bonus
In my opinion, plan for not working the rest of the year when thinking about premium tax credits, or having some small amount of income. Then when if/when you start working, ACA premiums stop and you go onto a new employer plan. At tax time next year, you end up paying back whatever premium tax credits apply for your particular situation/MAGI for the entire year. It's what I did the first year of the ACA.

I retired middle of last year and just went onto COBRA for the remainder of the year. Switched to ACA this year. We were in the middle of some things and wanted to make 100% sure we kept our providers, plus we had fully met the deductible for the year. It gave us more time to really look at all of the ACA plans for this year before choosing one.

Cheers.
What's the advantage of over claiming on ACA tax credits? Less up front cost and paying more later?
To be clear, I'm not suggesting that one tries to game the system. Instead, if one is unemployed, concerns about cash flow can quickly become paramount and I found it best to be very conservative about one's immediate job prospects.

In my case, I actually didn't know if I would be re-employed in the year I was previously on an ACA plan. In my estimates for that year's MAGI, I even made a assumption that I might be doing some consulting work and made my MAGI estimate accordingly. In the end, no consulting work was forthcoming and it was beginning to look like I had overestimated my MAGI. Instead, employment came along mid year and the opposite happened and I ended up paying back all of my premium tax credits at tax time. Before I went back to work, we lived only on unemployment, while it lasted, my severance package and whatever was in the checking account. We pretty much emptied all of that out about a week before I started working and had to dip into the portfolio a little bit to tide us over.

We're on an ACA plan this year and despite my best efforts at estimating MAGI, it does seem that I might have overestimated this time. I retired last year (and did COBRA till December) and didn't start withdrawing from the portfolio until this year, so it's something of a test case...

Cheers. 
Gotcha! thanks for clarifying. We're fortunate to have an ample emergency fund and can tap other cash reserves we had set aside for upcoming purchases such that we shouldn't run into any issues for a long time.
-- Don't mistake more funds for more diversity: Total Int'l + Total Market = 7k to 10k stocks -- | -- Market return does NOT = average nor 50th percentile, rather 80-90th percentile long term ---
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Re: Another COBRA vs ACA question

Post by dcabler »

blaugranamd wrote: Tue Apr 02, 2024 9:01 am
dcabler wrote: Tue Apr 02, 2024 8:51 am
blaugranamd wrote: Tue Apr 02, 2024 8:33 am
dcabler wrote: Mon Apr 01, 2024 4:57 pm
blaugranamd wrote: Mon Apr 01, 2024 2:19 pm

Good to know. Even with 4-6 months of unemployment we will probably be well in excess of the limit this year as both of our careers (hers more than mine) will likely a modest signing bonus
In my opinion, plan for not working the rest of the year when thinking about premium tax credits, or having some small amount of income. Then when if/when you start working, ACA premiums stop and you go onto a new employer plan. At tax time next year, you end up paying back whatever premium tax credits apply for your particular situation/MAGI for the entire year. It's what I did the first year of the ACA.

I retired middle of last year and just went onto COBRA for the remainder of the year. Switched to ACA this year. We were in the middle of some things and wanted to make 100% sure we kept our providers, plus we had fully met the deductible for the year. It gave us more time to really look at all of the ACA plans for this year before choosing one.

Cheers.
What's the advantage of over claiming on ACA tax credits? Less up front cost and paying more later?
To be clear, I'm not suggesting that one tries to game the system. Instead, if one is unemployed, concerns about cash flow can quickly become paramount and I found it best to be very conservative about one's immediate job prospects.

In my case, I actually didn't know if I would be re-employed in the year I was previously on an ACA plan. In my estimates for that year's MAGI, I even made a assumption that I might be doing some consulting work and made my MAGI estimate accordingly. In the end, no consulting work was forthcoming and it was beginning to look like I had overestimated my MAGI. Instead, employment came along mid year and the opposite happened and I ended up paying back all of my premium tax credits at tax time. Before I went back to work, we lived only on unemployment, while it lasted, my severance package and whatever was in the checking account. We pretty much emptied all of that out about a week before I started working and had to dip into the portfolio a little bit to tide us over.

We're on an ACA plan this year and despite my best efforts at estimating MAGI, it does seem that I might have overestimated this time. I retired last year (and did COBRA till December) and didn't start withdrawing from the portfolio until this year, so it's something of a test case...

Cheers. 
Gotcha! thanks for clarifying. We're fortunate to have an ample emergency fund and can tap other cash reserves we had set aside for upcoming purchases such that we shouldn't run into any issues for a long time.
No problem. I actually thought I had an ample emergency fund but when unemployment went from 6 months to 10+ months, it was running dry. My only choice then became to dip my little toe into our investments - fortunately, I just had to cover a couple of weeks till my first paycheck... Things almost lined up perfectly...

Cheers.
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Re: Another COBRA vs ACA question

Post by Artful Dodger »

"I'm not even sure what I'm asking here, should I just take the simpler route and pay the extra $1k/month for the COBRA?"

Yes
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Re: Another COBRA vs ACA question

Post by trees »

Another vote for keeping it simple with COBRA. Note that if you have an HSA, COBRA payments actually qualify unlike most health insurance scenarios, so that might reduce a significant chunk of the difference as well.
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Re: Another COBRA vs ACA question

Post by blaugranamd »

Thanks all, I just but the bullet and paid for COBRA. :sharebeer
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