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EHA Early Retiree Options for Health Insurance for 2011-2012
How to make the best decision for you!
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How did you learn about today’s session?
• Article in EHA newsletter• Contact from school district• Contact from local education association• Contact from OSERS by email• Contact from EHA or Blue Cross personnel• Other
WHICH CONTACT WOULD YOU PREFER?
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Review of options
• Current $600 deductible PPO Plan– To maintain, do nothing!
• New plans– $1,500 deductible PPO Plan
• To start, call Blue Cross for application
– $2,850 HDHP Plan• To start, call Blue Cross for application• Consider enrolling in Health Savings Account
(HSA)
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How can you decide which EHA plan to choose?
• Consider what you paid for health care last year in:– Office visit co-pay– Deductible for medical care– Co-pay for medical care– Co-pay for prescriptions– Premium saving for making a change
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Example of Costs for 6 office visits, $600 in tests, and 2 drugs per month
$600 PPO $1,500 PPO $2,850 HDHP6 o.v. @$35
$210 6 o.v. @ $50
$300 6 o.v. @ $165
$990
Ded. for tests
$600 Ded. for tests
$600 Ded. for tests
$600
24 Rx @ $30
$720 24 Rx @ $35
$840 24 Rx @ $60 $1,440
Co-pay @ 80/20
$0 Co-pay @ 70/30
$0 Total charges of $3,030 exceed deductible of $2,850
Cost
Prem sav
Total
$1,530
$0
$1,530
Cost
Prem sav
Total
$1,740
$ -970
$ 770
Cost
Prem sav
Total
$2,850
$ -970
$1,880
No tax break No tax break
Tax break for $4,050
Net cost
$ -1,000
$ 880
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Comparison for single coverage
Feature $600 ded. $1,500 ded.
$2,850 ded. HDHP
Deductible $600 $1,500 $2,850
Max out of pocket w/ ded.
$2,600 $4,500 $2,850
Office visit $35 $50 Inc. in ded.
Coins. 80/20 70/30 Inc. in ded.
Drugs – % copay
$ minimums
25% / 50%
$5 / $30 / $60
30% / 50%
$7 / $35 / $60
Inc. in ded.
Routine care $500 subject to ded. and coins.
$500 subject to ded. and coins.
$500 not subject to ded.
Premium savings None $970 per year $970 per year PLUS tax break
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Example of out-of-pocket costHypothetical
out-of-pocket expense
$600
PPO
$1,500
PPO
$2,850
HDHP
$400 in covered charges
You pay entire amount
$400
You pay entire amount
$400
You pay entire amount
$400
$1,000 in covered charges
$600 applied to deductible; $400
paid 80/20%: You pay $680
You pay entire amount
$1,000
You pay entire amount
$1,000
$25,000 in covered charges
$600 applied to deductible; stop-loss at $2,000: member
pays $2,600
*Does not include Rx
$1,500 applied to deductible; stop-loss at $3,000: member pays
$4,500
*Does not include Rx
$2,850 applied to deductible; 100%
coverage after deductible:
member pays $2,850
*Does include Rx
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To make a change, do this:
• Call Blue Cross at 1-800-562-6394– Tell them you are with EHA– Ask for application to change policy– Have your Blue Cross ID number ready– Fill out application and return to Blue Cross
• If you want to open a Health Savings Account, contact Union Bank (or your financial provider) after you sign up for the HDHP– Go to EHA web site to sign up on-line
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Click on “Deposit Health Savings Account” – Single Coverage (or
Family Coverage), then scroll down and click “Next.”
16
Enter: “Educators
Health Alliance” as your employer
to get no-fee account, and say you are “Retired”
for occupation
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Last steps for HSA account
• Either submit application on-line, or print forms and mail to Union Bank
• Wait for your ID card to be issued (it is a debit card that can be used for office visit costs, drug costs, etc.)
• FUND your account by making check payable to Union Bank and mailing in deposit