For many people it’s open enrollment for 2009! My DH got a packet in the mail reminding us of the open enrollment period. We’ve discussed it and will be making a few changes. Also in the packet it told us about changes to our benefits, many which helped us. I think I’ll share though a couple of really interesting things.
We have a HMO and it costs my DH $40/pay period going up to $42/pay period. That means we pay $1040/year for medical coverage but it’s going up to $1092/year for the two of us! Crazy. A family will pay $71/pay period in 2009 = $1846/year.
What does this cover? We have no annual deductible, no out of pocket maximum, unlimited lifetime benefit, 100% of all hospital services including semiprivate room, surgeries, inpatient visits, aumbulance, etc. We only have $75 co-pay for an ER visit, which I haven’t even seen yet. We have $10 office co-pays and 100% on everything else. 100% for well baby care, 100% maternity care, $10 copay for infertility treatment but 100% coverage for IVT/GIFT/ZIFT to a $20k lifetime. 100% of all medical supplies and equipment, 24 chiropractic visits with $10 copay, and 100% on home/hospice care. Pretty much we pay nothing out of pocket, which after my foot injury is true. I had 3 x-rays, MRI, and 2 different casts and paid nothing but the office visit. Prescriptions are $10 for generics and $15 for non-generics.
My DH pays 10% of the cost for us to be insured. That means the company is shelling out $9k/year to cover us. Yep, that $5k tax break isn’t worth it. We’re getting a way better deal with the employer provided plan. I can’t imagine what it would cost to price out individually.
The best change to our benefits is our unused dental coverage will rollover to 2009! That is fantastic. I didn’t have major work done this year, so we are doing great. I am hopeful this will help to decrease the costs when we need work done next year or future years.
So I hope you are looking over your benefits and figuring out changes for next year. I need to decrease our flexible spending account.
12 responses so far ↓
1 fengshui // Nov 2, 2008 at 1:52 pm
You have similar coverage as I do, which I consider to be EXCELLENT. Although my plan doesn’t cover infertility, I don’t think…. and we don’t hae office visit co-pays, only co-pay is for the ER. We used to pay $32 a month for the same plan, but now it is going up to $68 a month (for family). Single coverage used to be free, now it is $32 a month. However, we have a $2 million lifetime maximum benefit. Unlimited is almost unheard of anymore. I’m with a new employer now, which is still government, and where I just came from was unlimited, and now this new employer is a $2 million max. I have concerns about this, because $2 million doesn’t go far in a trauma unit or neonatal intensive care unit. I wonder what people do when they hit the max or are close to hitting the max? Can they switch during open enrollment to a different HMO group and “start over”, but with all new doctors, etc? I’m calling HR to ask about this…..
2 savvysuzie // Nov 2, 2008 at 1:55 pm
WOW. That’s a really good plan. We pay $85 per week for a family HMO ($20 office visits, $20 copay for prescriptions, no out of pocket for hospital stays as long as it’s within our network)…but they just announced it’s going up 13% for 2009. We actually need to increase the FSA a little bit, but it is SO worth it. I saved about a hundred and fifty dollars in taxes this year using the program!
3 Meredith // Nov 2, 2008 at 9:40 pm
Be thankful for the insurance you have! Our drug plan for our insurance just went up to $15 for generics, $35 for some brand name, and $50 for other brand names. Problem is, most of the medications we are on are the $50 ones and we can’t switch to generics for various reasons. So again, you’re lucky!
4 Beth // Nov 3, 2008 at 12:40 am
Actually, that $5000 tax credit is to cover the taxes you would pay on the $9000 health insurance benefit you get from your husband’s employer. If you’re in the 25% tax bracket, you would pay $2250 in taxes which is LESS than the tax credit. The balance of the tax credit would go into a health savings account, for your future use!
5 LivingAlmostLarge // Nov 3, 2008 at 12:00 pm
Beth, I guarantee you that if we had a tax credit the employer would not be providing medical. It’s too expensive. They would just drop the medical insurance and give us a raise.
But who cares about the raise? We couldn’t buy the insurance we have. It’s AWESOME insurance. Did you see what it covers? Unlimited, infertility, etc. Not many plans get that deal.
They have it because it’s a larger company and they pay a lot for it. I also did not include our vision and dental benefits which are ridiculous!
We get free contacts AND glasses every year! Not either or! I got glasses and contacts this year again. We get $2k in dental benefits with rollover! Crazy, insane benefits. And we pay $200/year for both of us to get vision and dental.
Try and cover everything we get and no way does it work. The $5k credit would barely cover an HDHP, which is what we would get when the company drops the plan.
Our insurance is superior to most people’s coverages.
6 Kristy // Nov 3, 2008 at 1:56 pm
LAL, I don’t have insurance like yours which is why the $5,000 tax credit would be beneficial to me. I pay $380 per month for a high deductible HSA and this is with my employer contributing $250 a month. There are a lot of people who would benefit by the $5,000 tax credit.
When I give birth next year I will pay $2,400 out of pocket deductible. Then all routine stuff is fully covered.
7 LivingAlmostLarge // Nov 3, 2008 at 3:15 pm
I don’t think so Kristy. It would only benefit those who are younger and healthier. Anyone older or with many children would not find it cheaper. Also anyone with preexisiting conditions would find it impossible to get insurance. Under McCain’s plan an extra 30 million people would be uninsurable, which is why the NEJM and AMA have called it unfeasible as a plan.
Because you don’t account for people unable to get HDHPs. What do you do with them? Government plan? Then you end up spending more trying to insure them as employed provided coverage vanishes.
Don’t get me wrong, I know we have great insurance. But that’s because that’s what we chose for our career. We make less money than other fields because of the benefits. Much like state, government, non-profit employees. Sometimes the pay is lessened because of the bennies.
But the feasibility of pushing so many people into not being able get insurance, I bet your premiums would go up. You’d have to deal with people who can’t get or can’t afford insurance not provided by employers, much like how the uninsured now cause a rise in costs.
Also Beth, it’s $20k benefit because the employer pays $10,840 for each person on the plan. I am looking at the booklet. So we’re be right at the $5k tax credit, if we could buy the plan as individuals for only $20k.
8 LivingAlmostLarge // Nov 3, 2008 at 3:17 pm
The way to make it work like what McCain is suggesting is to go completely free market. Without insurance, that will make people very cost conscious, health aware, AND force doctors and hospitals to price accordingly. People will not pay for anything extra. And they will refuse to pay full price.
Basically it will be pay for what you can afford for everyone. That theoretically, never been done, drive all prices down low enough because of competition for people to afford care.
It’s been proposed but no one has actually tried it.
9 Kristy // Nov 3, 2008 at 3:25 pm
What about the people that work for small businesses and self employed people? You don’t think they would benefit from a tax credit for health insurance? I know that I am not the only one that would benefit.
10 Stacey // Nov 3, 2008 at 4:10 pm
Kristy,
The self-employed already receive a tax credit – without itemizing. It’s on the long form 1040.
11 LivingAlmostLarge // Nov 6, 2008 at 7:58 pm
Wow, thanks stacey, and Kristy let us know what happens when you investigate it.
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