This post was going to have a more benign title of something like "benefits enrollment" since I didn't really have anything more creative to use in an analysis of our employer healthcare options. But I'll go ahead and do that post before getting my possible idiocy.
Actually, I'm not sure that's possible, since the premise of that analysis is based entirely on the aforementioned lack of intelligence.
This is the deal: We've always used Joanne's health coverage from Motorola/Freescale rather than what I could get from ASU. This was largely based on the direct cost of the plan to us--the monthly premium was cheaper on her plan for the two of us, than it was for each of us individually on our own plans. Or at least that's what I recall to be the case.
We sat down tonight to explore shifting from a no deductible/no copay coverage to a high deductible/small copay coverage, or something in the middle. This is the pricing of Freescale's options (this isn't quite comprehensive--I deleted options I knew we wouldn't consider):
Last year we had essentially the max coverage. I considered for a brief time reducing that, but in the calculation tools, child birth made it a moot point. I also pondered shifting it after Owen was born as I though the middle deductible plan was a sweet spot, but wasn't sure how a new deductible would work, so I stuck with the plan (0 deductible/90%/no copays), with the intention of doing a better analysis for 2009, which would be made easier with better knowledge/expectations of the medical needs of a child.
So I tested various expected service needs: primary visits, specialist visits, immunizations, lab work, general checkups, ER visits, out patient surgery, the Hale family plan, etc. In most scenarios, the high deductible plan was the winner. When it lost, it was because of extended stay hospital visits, but even then it wasn't that much. The main reason was because with the copay option, that covered all general office visits, so the deductible did not apply. But with a 0 deductible/no copay option, it goes straight to coinsurance, which isn't always cheaper than the copay.
We settled on the $1500 deductible/80% coinsurance/$10-$50 copay plan since it seemed to offer the highest liklihood of being the cheapest, not only for monthly deductions ($15/month!) but for overall annual medical expenses. In most of the models we tested, we never did max out the deductible, since so much ended up being covered by the copay. We also found that the lower coinsurance was likely to be better, since we'd have to have nearly $4000 in bills beyond the deductible to have it cost more. Admittedly, that is certainly possible--one extended stay in the hospital would be enough. But much like our other insurance policies, we can afford a certain amount of risk because we have the resources to self insure to an extent. The likelihood is that we are more likely to save $300 than spend an extra $500, and if the latter happens, well, we can deal with that.
After we got the medical portion done, we started looking at vision and dental and whether it was time to add Owen to both. That's when I got out my ASU benefits booklet for a point of comparison to the family costs of Freescale's vision/dental benefits. I then looked at the costs of the medical coverage. Or more specifically the coverages of the available plans.
ASU/State of Arizona offers an HMO plan, 2 EPO plans and a PPO plan. The PPO plan is a lot more than Freescale's (also a PPO) best coverage. The HMO is 30% more. The EPO plans are about the same. But the coverages! Everything is covered! There's a small copay ($10-20), but outside of that, nada!
No deductible, no coinsurance, no nothing.
I'm looking at it and thinking to myself "wait, this isn't what I remember". I recall the plan all costing significantly more than Freescale's options. In that regard, the PPO held true, but the EPO? That seems like a good deal at $150/month for a family, with a token amount out of pocket on top of that. The only thing I can think of is that I rejected the EPO option long ago because there is no out-of-network benefit. But don't you think it would have been smart to look into the extensiveness of the network? Or way the liklihood of needing to go outside of the network? I did a brief search this evening and our pediatrician, Joanne's OB/GYN and Banner Desert and Chandler Regional are all in network.
As the subject says, I might just be a moron.
The only other point in my defense is that ASU's enrollment period is 6 weeks before Freescale's, so a direct comarison isn't possible. But you'd think with 4 years of practice/having to make these elections, I would have noticed that ASU's benefits deserved much more scrutiny than I ever game them.
On a tangetial point: If we had family coverage through ASU, that would be an $1100/month benefit Im not receving. Just at the individual level, it is $461/month. It'd be nice if there was some way to get that $5000-$13,00 that ASU/State of Arizona is willing to spend on me to, you know, just give it to me.
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