ASA CDHP going up $700 next year for families? Switch back to ppo?

[FishandFly]

Can someone smart run the numbers on if the high deductible plan is still a better deal?

 

[CFI2766]

Disclaimer:

Each individual person's situation will determine which is the better choice.


Conceptually (this is not unique to ASA), the CDHPs that are becoming the norm for benefits programs in America are fundamentally different than what I think of as 'insurance'.

From Dictionary.com:

in·sur·ance

  http://static.sfdict.com/dictstatic/dictionary/audio/luna/I02/I0218000.mp3 /ɪnˈʃʊərəns, -ˈʃɜr-/ http://dictionary.reference.com/help/luna/IPA_pron_key.htmlShow Spelled[in-shoor-uhns, -shur-] http://dictionary.reference.com/help/luna/Spell_pron_key.htmlShow IPA
noun 1. the act, system, or business of insuring property, life, one's person, etc., against loss or harm arising in specified contingencies, as fire, accident, death, disablement, or the like, in consideration of a payment proportionate to the risk involved.


My concept of insurance is that it is a product designed to reduce my financial harm in the event of an unexpected event. Unexpected is the key qualifier here. I have insurance because I make the safe assumption that I will require medical care on an unexpected basis throughout the year. I enjoy combative sports, and, historically worst of all, I play softball regularly.

My historical average of physician visits makes a clear case for the PPO. One fundamental difference between a PPO and a CDHP is the level of involvement that I am expected to shoulder in finding the cheapest option for my care. I want to enjoy my life and participate in the things that I enjoy doing. Shopping for the cheapest healthcare in my network of providers is not something that I enjoy doing.

Returning to the original question: IF the Company would contractually agree to both regularly increase their contribution by an inflation/COLA/indexed amount, and, guarantee regular contributions to my account, I would be more willing to participate in the CDHP. As neither of these things seem to be happening, I'm inclined to remain with the PPO option.

(In fairness, providing healthcare is an issue for every business in America. Our healthcare system was designed to serve the needs of the patients when the patients themselves aren't directly responsible supporting the margins of the healthcare industry. Historically, for better or worse, healthcare has been the responsibility of the employers here in America. While better than being the government's responsibility, it's clearly not in the best interests of corporate America to foot the bill for healthcare. Corporate America has determined that shifting the responsibility to the workforce will clean up the financials nicely. [Reference GM and the last few years of agreements with the UAW.])

YMMV...

 

[79%N1]

Look at the monthly premiums. The ppo has more than a $700/year difference. It's actually more than $2000 more in monthly premiums over the hdhc plan, at least for families, over the course of a year. Then the out of pocket max is the same anyway. When you add in the company contribution it is still a better deal.

 

[gator_hater]

CFI,

Healthcare in the US has historically been the responsibility of the individual. Employers only started kicking in when there were compensation regs implemented after WWII as we tried to get the troops back to work. It was a way to increase benefits without actual salary increases. So, only the last 65 years has it been on the employer prior to that it was the responsibility of the patient. In a sense were are returning to the old method.

I agree that every individual is different. My family of 4 has the CDHP and haven't changed drs or "shopped around" and we've accumulated $3500 in the HSA over the last three years. We bank the difference between of the premiums, my proformance plus, and the company contribution. We've added one to the family, we're pretty healthy, and pay all our medical bills, including dental, out of that account. Since we pay for dental, contacts and other stuff I would estimate that even if we were to have paid $2100 more in premiums the CDHP plan has saved us $2500-3000 after taxes are included.

Just my .02 but you are correct every family has their own set of issuses to deal with and not everyone will reach the same conclusion.

 

[MONKEY]

But I thought Obama had solved this issue. Free healthcare for everyone! Sorry, I couldn't resist. Now back to your regularly scheduled thread.

 

[PBRstreetgang]

Don't worry, SKYW has slashed ground personnel pay and limited it to 5 year pay scale with an overall pay decrease. That should increase the bottom line enough to enable managers a significant bonus.
TFAYD

 

[Nevets]

I probably wouldn't chose it unless I could afford to pay the full deductible the day after the plan takes effect. After that consideration, every family is different.

 

[FishandFly]

It is interesting. I played with excel a bit and it shows that you start off the year quite a bit ahead of the ppo. I guess then the main issue is that once you really need something serious, the cdhp side increases at light speed toward the deductible before you start getting 80% help from the plan.

However, this "worse case scenario" would still leave me pretty well protected considering the max out of pocket is close to the same like 79% said.

 

[FishandFly]

More specifically,
CDHP to PPO
Cost per year from paycheck not counting contributions to cdhp - 2357 to 4541
Company puts 1k into cdhp taking cost down to 1357

Deductible is 2600 vs 1k in the ppo
each is co-insured at 20 percent after deductible is met.

Office visits and prescriptions are obviously way cheaper, but it seems like even if you need a dozen of each you still barely exceed the $3200 initially saved.

 

[PapaSiera]

LXJT has different health plans than you. For example, I have a PPO that costs me $100 per month and has a $300 deductible. We also have a PPO that has a $1500 deductible and costs $65 per month.