2015 HDHP and CDHP Comparison Guide

Transcription

1 2015 HDHP and CDHP Comparison Guide Table of Contents 3 High-Deductible Health Plan vs. Consumer-Driven Health Plan 6 Health Savings Account 8 Health Reimbursement Account 10 HDHP and CDHP Coverage Examples Choose the Right Medical Plan Selecting a medical plan is one of the most important decisions you can make this year to ensure the physical, mental and financial health of yourself and your family. We provide this guide as a tool to help you compare our two main medical plans, the High-Deductible Health Plan (HDHP) and Consumer-Driven Health Plan (CDHP). Take a close look at each plan's options to determine which one works for you.

2 Comparing the Plans Shared Features The High-Deductible Health Plan (HDHP) and Consumer-Driven Health Plan (CDHP) share many of the same features. Both plans offer: Comprehensive medical and prescription drug coverage. In-network preventive care, such as yearly screenings and routine exams, covered at 100%. Accounts that can be used to pay for eligible healthcare expenses and roll over year to year. Coinsurance benefits after you meet your deductible. (Deductible amounts vary per plan and per coverage option.) Coinsurance is the percentage you pay toward eligible expenses once you satisfy your deductible. You pay a smaller percentage when using in-network providers. A safety net that limits how much you pay out of pocket in coinsurance for covered expenses each year. Once you meet your out-of-pocket maximum, the plan pays 100% of eligible in-network expenses for the rest of the calendar year. Prescription drug coverage, when using CVS Caremark's network pharmacies. Access to Condition Support Managers, who can help you better understand or identify health conditions. Access to a 24/7 nurse line to assist you with medical questions. Plan-Specific Features High-Deductible Health Plan Additional Benefits The lowest per-paycheck premiums of all medical plans in exchange for a higher deductible to meet if you need non-preventive care. NEW 100% coverage for preventive generic prescriptions without first having to meet your annual deductible. These include medications you take: - In response to risk factors for a disease* - To prevent the recurrence of a disease from which you have recovered - As part of procedures providing preventive care services, like smoking-cessation and weight-loss programs For a complete list of preventive generic medications, go to www2.caremark.com/mckesson and click the Check Availability and Cost tab, then under Available Drugs, select HDHP Preventive Therapy Drug List Generics.** The opportunity to contribute to a health savings account (HSA). An HSA is a tax-advantaged savings account that allows you to pay for eligible healthcare expenses with before-tax dollars (pp. 6-7). * In some cases, if risk factors are high enough, you may be given a preventive prescription although you have not been diagnosed with the disease or show symptoms of the disease. ** The HDHP Preventive Drug List Generics is updated in accordance with Internal Revenue Service (IRS) guidance. Consumer-Driven Health Plan Additional Benefits The ability to choose your medical plan carrier and coverage option Core, Premier or Premier Plus. Higher per-paycheck premium in exchange for a lower deductible to meet if you need non-preventive care. A -funded health reimbursement account (HRA). HRA dollars are used before you pay out of pocket to cover eligible healthcare expenses (pp. 8-9). The Condition Support Program, under which you may be eligible for chronic condition medication discounts. 2

3 Comparing the Plans High-Deductible Health Plan vs. Consumer-Driven Health Plan Let's look at how the HDHP and CDHP compare side by side. Feature HDHP CDHP Lowest premium*/highest deductible Highest premium*/lowest deductible No-cost in-network preventive care Coinsurance after meeting annual deductible Coinsurance out-of-pocket maximum Annual out-of-pocket maximum NEW No-cost generic preventive prescriptions In-network prescriptions for preventive generic medications on the HDHP Preventive Drug List Generics are covered at 100% (no deductible). Chronic condition medication discounts Lower coinsurance amount for certain prescriptions when you qualify for the Chronic Condition Medication Discount Program. Step Therapy Required to try cost-effective medications before purchasing or "stepping up" to more expensive drugs. Health savings account (HSA)** Health reimbursement account (HRA)*** Nurse line Get answers to your medical questions 24 hours a day, seven days a week. * Premium information is available on Your Benefits Resources during Annual Enrollment. ** HSAs are personal savings accounts. HSA account holders have sole responsibility for using funds in accordance with the requirements of the tax code. You can find information in IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans at *** HRA amounts are not converted to actual dollars until needed to pay eligible healthcare expenses. HDHP Carrier Cigna All states except Hawaii CDHP Carriers Aetna All states except Hawaii Anthem Blue Cross California, Florida, Michigan and Pennsylvania Cigna All states except Hawaii UnitedHealthcare Arkansas, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, Texas and Wisconsin Whether your choose the HDHP or CDHP, outpatient prescription drug coverage is provided by: CVS Caremark

4 Comparing the Plans HDHP Coverage Annual Deductible You Pay - Employee - Employee + Spouse/Domestic Partner or Employee + Child(ren) - Family Coinsurance Percentage you pay toward eligible expenses Coinsurance Out-of-Pocket Maximum The most you pay in coinsurance during the year - Employee - Employee + Spouse/Domestic Partner or Employee + Child(ren) - Family Maximum Out-of-Pocket Amount Annual Deductible + Coinsurance Out-of-Pocket Maximum - Employee - Employee + Spouse/Domestic Partner or Employee + Child(ren) - Family HDHP In- Network $3,500 $5,250 $7,000 Out-of-Network 20% 40% $2,750 $4,125 $5,500 $6,250 $9,375 $12,500 $5,500 $8,250 $11,000 $9,000 $13,500 $18,000 You can make tax-free withdrawals from your HSA to pay for eligible medical, prescription drug, dental and vision expenses. Payments made using HSA dollars count toward your deductible. 4

5 Comparing the Plans CDHP Coverage Core Premier Premier Plus CDHP HRA * + Member = Annual Responsibility Deductible CDHP HRA * + Member = Responsibility Annual Deductible CDHP HRA * + Member = Responsibility Annual Deductible Annual Deductible You and share the cost - Employee $750 + $1,375 = $2,125 $750 + $875 = $1,625 $750 + $750 = $1,500 - Employee + Spouse/ Domestic Partner or $1,100 + $2,075 = $3,175 $1,100 + $1,325 = $2,425 $1,100 + $1,125 = $2,225 Employee + Child(ren) - Family $1,500 + $2,750 = $4,250 $1,500 + $1,750 = $3,250 $1,500 + $1,500 = $3,000 In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network Coinsurance Percentage you pay toward eligible expenses after deductible is met 20% 40% 20% 40% 20% 40% Coinsurance Out-of-Pocket Maximum The most you pay in coinsurance during the year - Employee $2,500 $5,000 $1,450 $3,000 $1,425 $2,425 - Employee + Spouse/ Domestic Partner or $3,750 $7,500 $2,175 $4,500 $2,125 $3,625 Employee + Child(ren) - Family $5,000 $10,000 $2,900 $6,000 $2,850 $4,850 Maximum Out-of-Pocket Amount The most you pay for all eligible expenses during the year (member responsibility PLUS coinsurance out-of-pocket maximum) - Employee $3,875 $6,375 $2,325 $3,875 $2,175 $3,175 - Employee + Spouse/ Domestic Partner or $5,825 $9,575 $3,500 $5,825 $3,250 $4,750 Employee + Child(ren) - Family $7,750 $12,750 $4,650 $7,750 $4,350 $6,350 * The CDHP HRA is funded by each year, and unused HRA dollars roll over from year to year as long as you remain continuously enrolled in the plan. 5

6 Comparing the HSA and HRA Health Savings Account The HDHP and CDHP offer unique ways to help you pay for eligible healthcare expenses. If you enroll in the HDHP, you may be eligible to open a health savings account (HSA). If you enroll in the CDHP, funds a health reimbursement account (HRA) that helps to pay your initial eligible expenses. What's an HSA? An HSA is an interest-bearing savings account you fund either with before-tax paycheck deductions through WageWorks 's HSA administrator or with tax-deductible contributions to an outside HSA vendor, such as your bank. You own your HSA and can make tax-free withdrawals to pay for eligible medical, prescription drug, dental and vision expenses now or anytime in the future. Eligible expenses include: Medical care Prescription medications Dental exams and procedures Vision exams and glasses/contact lenses You can also choose to use your HSA dollars for non-eligible healthcare expenses. However, withdrawals used for non-eligible healthcare expenses before age 65 are subject to a 20% penalty tax in addition to normal income tax. Once you're age 65, withdrawals for non-eligible expenses are only subject to normal income tax. Health Savings Account (HSA) Maximum Annual Contribution* Employee $3,350** Employee + Spouse/Domestic Partner or Employee + Child(ren) $6,650** Family $6,650** * HSAs are personal savings accounts and are not a part of any ERISA plan established or maintained by. HSA account holders have sole responsibility for using funds in accordance with the requirements of the tax code. ** If you re age 55 or older, you can contribute an additional $1,000 annually in catch-up contributions. 6

7 Comparing the HSA and HRA HSA at a Glance Advantages HSAs save on taxes. Save on taxes three different ways: your contributions reduce your federal and state income taxes, interest earned on the account is tax-free and money withdrawn for qualified medical expenses is not taxed. Some states have restrictions. For more information on HSAs, visit HSAs earn interest. Account balances earn interest, and you can choose among investment options once your balance reaches a specified amount. ($1,000 if you're making contributions through WageWorks.) You're in control. Because these funds are not automatically applied to eligible expenses, you decide when and how to use them. HSA funds cover dental and vision. You can use your money to pay for eligible dental and vision costs, in addition to medical and prescription drug expenses. HSAs can be used for dependents. HSA dollars can be used to pay healthcare expenses for eligible dependents. HSA dollars roll over. Unused HSA dollars roll over yearly and continue earning interest as long as there's money in the account. You own your HSA. If you leave, change medical plans or retire, your HSA is yours to take with you. Save for retirement. Similar to a 401(k), an HSA can be used to save for retirement. You can choose to use your HSA funds for non-healthcare expenses; however, HSA dollars used for non-eligibile expenses are subject to normal income tax and a 20% penalty if you're under the age of 65. Disadvantages doesn't contribute to your HSA. You fund your account 100%. Funds aren't automatically applied to eligible healthcare expenses. You must take action when using your HSA dollars. Your carrier doesn't automatically apply them to your expenses. You can only spend what you have. Your HSA works like a standard banking account. HSA dollars become available as you make contributions. Not everyone is eligible. You're eligible to contribute to an HSA for the period of time that you: Are covered by a high-deductible health plan (HDHP). Do not have any other health coverage, such as non-hdhp medical coverage or a standard healthcare flexible spending account (for example, under plans available through your spouse/domestic partner s employer). Are not enrolled in Medicare or Veterans' benefits (TRICARE). Are not eligible to be claimed as a dependent on another person s tax return. As you know, wherever there are tax advantages available, there are corresponding government regulations. Visit to learn more about HSAs, including eligibility requirements, state tax rules and more. If you plan to contribute to an HSA for 2015, be sure the balance of any healthcare FSA you participate in (including your own FSA and your spouse/domestic partner's FSA) is $0 on December 31, 2014.* Otherwise, you won't be allowed to make HSA contributions (including before-tax contributions to your WageWorks HSA) until April Please consult your tax advisor if you have questions about the tax laws that apply to HSAs. If you or your spouse/domestic partner are enrolled in a 2014 HSA-compatible (or "limited purpose") FSA, the balance of that FSA does not need to be $0 on December 31, 2014 for HSA contributions to start January 1, * Based on your balance on December 31 without taking into account expenses that have not been reimbursed as of that date. Pending claims, claims submitted, claims received or claims under review that have not been paid as of December 31 are not taken into account. 7

8 Comparing the HSA and HRA Health Reimbursement Account What's an HRA? An HRA is an account funds on your behalf with healthcare dollars that are used to help you pay your eligible medical and prescription drug expenses. These dollars apply to your deductible and are used before you pay anything out of pocket (except for your per-paycheck premium). When you enroll in the CDHP, automatically funds your HRA on January 1, or on the date your coverage begins. HRA amounts are the same regardless of the CDHP coverage option you choose (see p. 5). -Paid Health Reimbursement Account (HRA) Employee $750 Employee + Spouse/Domestic Partner or Employee + Child(ren) $1,100 Family $1,500 8

9 Comparing the HSA and HRA HRA at a Glance Advantages funds your HRA. funds your HRA on January 1 or on the date your coverage begins under the CDHP. The amount funded is limited and determined by your coverage option and who is covered. Funds are available for use immediately. pays first. -funded HRA dollars are used first to help pay your deductible. Account balances roll over yearly. The balance in your HRA rolls over each year, as long as you remain enrolled in the CDHP. HRA dollars are applied automatically. Your plan carrier will pay for your eligible medical and prescription drug expenses with HRA dollars until your account balance is zero. You don't have to take any action. HRA applies to dependents' expenses. HRA dollars can be used to pay eligible healthcare expenses for covered dependents. Disadvantages HRA dollars only cover eligible medical and prescription drug expenses. You can t use your HRA to pay for dental or vision expenses. Your HRA doesn't accumulate interest. An HRA is not an interest-generating savings account. You cannot contribute to your HRA. Once your HRA funds have been used, you won't receive additional funds until January 1. You can't add your own funds to this account. HRAs are non-transferable. You must remain enrolled in the CDHP to keep your HRA balance. 9

10 Plan Use Examples HDHP and CDHP Coverage Examples Use the following examples to help you compare how each plan works to cover your healthcare expenses. Member costs shown in the examples do not include annual premium amounts. Example 1 Low Healthcare Needs Laura Chooses the HDHP Laura enrolls in the HDHP with Employee Only coverage. She pays the lowest perpaycheck premium of any medical plan and can contribute before-tax dollars into an HSA. Laura is 35 years old and earns a salary of $65,000 per year. She is single and in good health. Laura's Healthcare Needs In-network preventive care screenings Generic prescription to prevent a recurrence of mild depression Has a treatable skin condition that requires one visit to the dermatologist and a non-preventive care prescription ointment HDHP Details HDHP (Employee Only) $4.30 monthly premium* $1,200 HSA dollars funded before-tax by Laura ($100 per month) $3,500 deductible $2,750 in-network coinsurance out-ofpocket maximum $6,250 in-network maximum out-of-pocket amount (deductible + coinsurance out-ofpocket maximum) HDHP Employee Only Medical Expense** 100% Coverage (in-network preventive care) Deductible Coinsurance Total Paid Laura (HSA) Laura (out of pocket) (80%) Laura (20%) Preventive screenings = $520 $520 N/A N/A N/A N/A $520 $0 Laura Preventive generic prescriptions*** = $360 $360 N/A N/A N/A N/A $360 $0 Dermatologist visit = $100 N/A $100 $0 N/A N/A $0 $100 Generic, non-preventive care topical ointment = $45 N/A $45 $0 N/A N/A $0 $45 Total expenses = $1,025 $880 $145 $0 N/A N/A $880 $145 Laura Laura s total expenses $145 Shared Expense Laura's annual premium (before-tax paycheck deductions) $51.60 Laura s Total Healthcare Cost $ * Laura participates in Vitality to earn savings on her medical premiums. She completes the Vitality Health Review (VHR) and achieves Gold Points Status to earn the most savings. ** In-network. *** Assumes medication is included in the CVS Caremark HDHP Preventive Drug List Generics. 10

11 Plan Use Examples Laura Chooses the CDHP Laura enrolls in the CDHP Premier Plus option with Employee Only coverage. She pays the highest per-paycheck premium of any medical plan. funds $750 into her HRA. Laura's Healthcare Needs In-network preventive care screenings Generic prescription to prevent a recurrence of mild depression Has a treatable skin condition that requires one visit to the dermatologist and a non-preventive care prescription ointment CDHP Details Premier Plus option (Employee Only) $ monthly premium* $750 HRA dollars funded by $1,500 deductible ($750 HRA + $750 member responsibility) $1,425 in-network coinsurance out-ofpocket maximum $2,175 in-network maximum out-of-pocket amount (member responsibility + coinsurance out-of-pocket maximum) Medical Expense** CDHP Premier Plus Employee Only 100% Coverage (in-network Deductible Coinsurance Total Paid preventive care) (HRA) Laura (member responsibility) (80%) Laura (20%) Preventive screenings = $520 $520 N/A N/A N/A N/A $520 $0 Preventive generic prescriptions = $360 N/A $360 $0 N/A N/A $360 $0 Dermatologist visit = $100 N/A $100 $0 N/A N/A $100 $0 Generic, non-preventive care topical ointment = $45 N/A $45 $0 N/A N/A $45 $0 Total expenses = $1,025 $520 $505 $0 N/A N/A $1,025 $0 Laura Laura s total expenses $0 Laura's annual premium (before-tax Shared Expense $2, paycheck deductions) Laura s Total Healthcare Cost $2, * Laura participates in Vitality to earn savings on her medical premiums. She completes the VHR and achieves Gold Points Status to earn the most savings. ** In-network. Laura Which plan works best for Laura? The HDHP works best for Laura because: Despite having to pay $145 out of her HSA, Laura saves $2, on her annual premium compared to the CDHP. With her low healthcare needs she doesn t pay the HDHP s high deductible. In this case, the CDHP s lower deductible is not useful to her. Under the HDHP, her premium savings outweigh her total out-of pocket expenses. She can choose to use her premium savings to increase the amount she contributes to her HSA. The funds remaining in her HSA roll over each year and continue to grow through tax-free interest and investment options. 11

12 Plan Use Examples Example 2 - Moderate Healthcare Needs The Johnsons Choose the HDHP The Johnson family enrolls in the HDHP with Family coverage. They pay the lowest per-paycheck premium of any medical plan and can contribute before-tax dollars into an HSA. The Johnson Family, married with two kids. The Johnsons earn a salary of $85,000 per year. The Johnsons' Healthcare Needs In-network preventive care screening and child wellness visits Generic prescriptions for Mrs. Johnson, who is at risk for diabetes Tonsillectomy for their daughter Care for their son s broken arm HDHP Details HDHP (Family) $22.40 monthly premium* $6,650 HSA dollars contributed before-tax by the Johnsons ($ per month) $7,000 deductible $5,500 in-network coinsurance out-of-pocket maximum $12,500 in-network maximum out-of-pocket amount (deductible + coinsurance out-ofpocket maximum) HDHP Family Coverage Medical Expense** 100% Coverage (in-network preventive care) Johnsons Pay (HSA) Deductible Coinsurance Total Paid Johnsons Pay (out of pocket) (80%) Johnsons Pay (20%) Johnsons Pay Preventive screenings and child wellness visits = $950 $950 N/A N/A N/A N/A $950 $0 Preventive generic prescriptions*** = $525 $525 N/A N/A N/A N/A $525 $0 Tonsillectomy = $4,500 N/A $4,500 $0 N/A N/A $0 $4,500 Broken arm treatment = $625 N/A $625 $0 N/A N/A $0 $625 Total expenses = $6,600 $1,475 $5,125 $0 N/A N/A $1,475 $5,125 Johnsons Pay The Johnsons total expenses $5,125 Shared Expense The Johnsons annual premium (before-tax paycheck deductions) $ The Johnsons Total Healthcare Cost $5, * The Johnsons participate in Vitaliy to earn savings on their premiums. Mr. and Mrs. Johnson both complete the VHR and achieve Gold Point Status to save the most on their premiums. ** In-network. *** Assumes medication is included in the CVS Caremark HDHP Preventive Drug List Generics. 12

13 Plan Use Examples The Johnsons Choose the CDHP The Johnson family enrolls in the CDHP Core with Family coverage. They pay a higher per-paycheck premium than the HDHP. funds $1,500 into their HRA. The Johnsons' Healthcare Needs In-network preventive care screening and child wellness visits Generic prescriptions for Mrs. Johnson, who is at risk for diabetes Tonsillectomy for their daughter Care for their son s broken arm CDHP Details Core option (Family) $ monthly premium* $1,500 HRA dollars funded by $4,250 deductible ($1,500 HRA + $2,750 member responsibility) $5,000 in-network coinsurance out-of-pocket maximum $7,750 in-network maximum out-of-pocket amount (member responsibility + coinsurance out-of-pocket maximum) Medical Expense** CDHP Core Family Coverage 100% Coverage (in-network Deductible Coinsurance Total Paid preventive care) (HRA) Johnsons Pay (member responsibility) (80%) Johnsons Pay (20%) Johnsons Pay Preventive screenings and child wellness visits = $950 $950 N/A N/A N/A N/A $950 N/A Preventive generic prescriptions = $525 N/A $525 $0 N/A N/A $525 $0 Tonsillectomy = $4,500 N/A $975 $2,750 $620 $155 $1,595 $2,905 Broken arm treatment = $625 N/A N/A N/A $500 $125 $500 $125 Total expenses = $6,600 $950 $1,500 $2,750 $1,120 $280 $3,570 $3,030 Johnsons Pay The Johnsons total expenses $3,030 The Johnsons annual premium (before-tax Shared Expense $3, paycheck deductions) The Johnsons Total Healthcare Cost $6, * The Johnsons participate in Vitaliy to earn savings on their premiums. Mr. and Mrs. Johnson both complete the VHR and achieve Gold Point Status to save the most on their premiums. ** In-network. Which plan works best for the Johnsons? The HDHP works best for the Johnsons because: At first glance, it appears the Johnsons pay more under the HDHP. However, when you factor in the $3, they save on their annual premium compared to the CDHP, the Johnsons pay less for their healthcare over the course of the year. Despite spending $5,125 out of their HSA, the Johnsons still have $1,525 dollars remaining in their HSA, which can continue to earn interest and be used for future expenses. 13

14 Plan Use Examples Example 3 High Healthcare Needs Steve Chooses the HDHP Steve enrolls in the HDHP with Employee Only coverage. He pays the lowest perpaycheck premium of any medical plan and can contribute before-tax dollars into an HSA. Steve is 45 years old and earns a salary of $115,000 per year. He is single and has medical issues that require regular care. Steve's Healthcare Needs In-network preventive care screenings Generic prescriptions to prevent a recurrence of blood clots Hospital stays and treatments related to Steve's high cholesterol and deep vein thromboses HDHP Details HDHP (Employee Only) $8.50 monthly premium* $3,350 HSA dollars funded by Steve $3,500 deductible $2,750 in-network coinsurance out-of-pocket maximum $6,250 in-network maximum out-of-pocket amount (deductible + coinsurance out-ofpocket maximum) HDHP Employee Only Medical Expense** 100% Coverage (in-network preventive care) Steve (HSA) Deductible Steve (out of pocket) (80%) Coinsurance Steve (20%) 100% Coverage (after reaching outof-pocket max.) Total Paid Preventive screenings = $850 $850 N/A N/A N/A N/A N/A $850 $0 Preventive generic prescription medication, which Steve uses to prevent $1,750 N/A N/A N/A N/A N/A $1,750 $0 blood clots*** = $1,750 Frequent office visits = $3,500 N/A $3,350 $150 N/A N/A N/A $0 $3,500 Two days of inpatient care related to his N/A N/A N/A $11,000 $2,750 N/A $11,000 $2,750 thrombosis = $13,750 Yearly supply of medications = $2,950 N/A N/A N/A N/A N/A $2,950 $2,950 $0 Total expenses = $22,800 $2,600 $3,350 $150 $11,000 $2,750 $2,950 $16,550 $6,250 Steve Steve s total expenses $6,250 Shared Expense Steve s annual premium (beforetax paycheck deductions) $102 Steve s Total Healthcare Cost $6,352 * Steve participates in Vitality to earn savings on his medical premiums. He completes the VHR and achieves Gold Points Status to earn the most savings. ** In-network. *** Assumes medication is included in the CVS Caremark HDHP Preventive Drug List Generics. Steve 14

15 Plan Use Examples Steve Chooses the CDHP Steve enrolls in the CDHP Premier with Employee Only coverage. He pays a higher per-paycheck premium than the HDHP. funds $750 into his HRA. Steve's Healthcare Needs In-network preventive care screenings Generic prescriptions to prevent a recurrence of blood clots Hospital stays and treatments related to Steve's high cholesterol and deep vein thromboses CDHP Details Premier option (Employee Only) $ monthly premium* $750 HRA dollars funded by $1,625 deductible ($750 HRA + $875 member responsibility) $1,450 in-network coinsurance out-of-pocket maximum $2,325 in-network maximum out-of-pocket amount (member responsibility + coinsurance out-of-pocket maximum) Medical Expense** 100% Coverage (in-network preventive care) CDHP Premier Employee Only (HRA) Deductible Steve (member responsibility) (80%) Coinsurance Steve (20%) 100% Coverage (after reaching outof-pocket max.) Total Paid Preventive screenings = $850 $850 N/A N/A N/A N/A N/A $850 $0 Preventive generic prescription medication, which Steve uses to prevent bloodclots = N/A $750 $875 $100 $25 N/A $850 $900 $1,750 Frequent office visits = $3,500 N/A N/A N/A $2,800 $700 N/A $2,800 $700 Two days of inpatient care related to his N/A N/A N/A $2,900 $725 $10,125 $13,025 $725 thrombosis = $13,750 Yearly supply of medications = $2,950 N/A N/A N/A N/A N/A $2,950 $2,950 $0 Total expenses = $22,800 $850 $750 $875 $5,800 $1,450 $13,075 $20,475 $2,325 Steve s total expenses $2,325 Steve Steve s annual premium (beforetax paycheck deductions) Shared Expense $1, Steve s Total Healthcare Cost $4, * Steve participates in Vitality to earn savings on his medical premiums. He completes the VHR and achieves Gold Points Status to earn the most savings. ** In-network. Steve Which plan works best for Steve? The CDHP works best for Steve because: The CDHP's lower deductible and out-of-pocket maximums protects Steve from the high cost of his healthcare expenses. Under the HDHP, Steve saves $1, on his annual premium compared to the CDHP. However, Steve ultimately pays $2, more for his total healthcare over the course of the year if he chooses HDHP coverage. If Steve's health improves and he no longer has high healthcare expenses, he could consider switching to the HDHP to save on his premiums. 15

16 Additional Resources to Help You Decide Access helpful enrollment tools on Your Benefits Resources during Annual Enrollment November 10-21, DecisionDirect Tool: Answer a few brief questions about your healthcare needs and receive personalized plan recommendations. Medical Expense Estimator: Estimate your total expenses including out-ofpocket costs and prices under each plan. Health Plan Comparison Charts: Compare plans side by side. We provide the tools you need to find appropriate healthcare coverage, along with wellness programs and advice to help you achieve better health. Find a Doctor: Find doctors and hospitals that participate in healthcare networks. Review detailed profiles of doctors, plus quality ratings for hospitals and nursing facilities. Summaries of Benefits and Coverage: Review these summaries to help you understand and compare all your coverage options. HR Support Center Your source for benefits information and gateway to a Personal Health Advocate. 855.GO.MCKHR ( ) Press 1 for Health, Vitality and Pension questions. Benefits experts are available 9 a.m. - 5 p.m. Central time, M-F. Your Benefits Resources Your source for benefit information and for making enrollment choices. Go to or click the link on the You. Even better. Healthcare Hub. You. Even better. Library Your source for valuable information about Annual Enrollment, your benefits, health and wellness programs and more. Hablamos español llama al centro de recursos humanos de para recibir ayuda en español. October 2014