Gettysburg College Open Enrollment Decision Considerations Consideration #1 - Payroll Deduction Consider the difference in Payroll Deduction Premium-share for your salary band and coverage category. For example - I am in 'Less than $40k' salary band, and have single coverage My cost PPO 500 $ 73.88 per month PPO 1000 $ 35.54 per month Difference $ 38.34 per month Consideration #2 - Out-of-Pocket RISK $ 460 Annual Difference This is real dollar savings in what is deducted from your paycheck. Consider the difference in Plan Design for the benefits you may use during the year. This includes your willingness to take on the RISK of unexpected out of pocket cost. Difference $500 for Single UP TO $1,000 for Family ($500 per individual) Maximum Difference $500 for Single UP TO $1,000 for Family ($500 per individual) Copay Differences $10 per Specialist Office Visit Resources to help Gettysburg College's website - summaries of the plan design and out-of-pocket costs by service. Highmark's website - your Explanation of Benefit (EOB) history shows what you spent in 2017. THE FOLLOWING PAGES GIVE YOU S OF EMPLOYEES DETERMINING 'WHICH PLAN IS RIGHT FOR YOU?'
The following is only an Example based on the assumptions listed. You should carefully review your own situation prior to making your election. If you have questions, please call Human Resources. * EMPLOYEE ONLY - LIGHT USER/GOOD YEAR * Employee has 2 General Practitioner Office Visits during the year (Discounted Cost of $100 each) * Employee has $200 of lab work once during the year * Employee has one preferred generic prescription per month (4 total Mail Order, $60 per script) $500 individual $1,000 individual $200 $200 10% up to $1,500 maximum 10%, up to $2,000 maximum $0 $0 $40 $40 Retail: $0 $0 Mail Order: $80 $80 $320 $320 Consider the Flexible Spending Account to pay the above expenses with PRE-TAX dollars! $1,217 $756 TOTAL COST $1,537 $1,076 SAVINGS $460 PPO 1000 Savings over the PPO 500
The following is only an Example based on the assumptions listed. You should carefully review your own situation prior to making your election. If you have questions, please call Human Resources. * EMPLOYEE ONLY - HEAVY USER/BAD YEAR * Employee has 24 Office Visits during the year - 12 General and 12 Specialists (Discounted cost of $100 General, $150 Specialist) * Employee has $2,400 of lab work done monthly during the year * Employee has 2 Major surgeries costing a total of $100,000 * Employee has three Preferred brand prescriptions per month (8 total Mail Order at $450 per script, 12 total Retail at $20 per script) $500 individual $1,000 individual $500 $1,000 10% up to $1,500 maximum 10%, up to $2,000 maximum $1,500 $2,000 $600 $720 Retail: $240 $240 Mail Order: $640 $640 $3,480 $4,600 Consider the Flexible Spending Account to pay the above expenses with PRE-TAX dollars! $1,217 $756 TOTAL COST $4,697 $5,356 Additional Cost $660 PPO 1000 Additional Cost over the PPO 500
The following is only an Example based on the assumptions listed. You should carefully review your own situation prior to making your election. If you have questions, please call Human Resources. * FAMILY - MEDIUM USER * Family consists of Employee, Spouse & 2 Children * Employee & Spouse have 2 General Practitioner Office Visits each during the year ($100 per visit) * Children have 4 General Practitioner Office Visits each during the year ($100 per visit) * Employee has $100 and Spouse $250 of lab work once during the year * Spouse has minor surgery costing $500 * Employee & Spouse each have one generic prescription per month (8 total Mail Order, $200 per script) * Children have total of 6 generic prescriptions during the year (Retail Pharmacy - Cost of Rx is $15 each) $500 per Individual/ $1,000 Family Max $1,000 per Individual/ $2,000 Family Max $600 $850 10% up to $1,500 maximum per Individual, $3,000 Family Max 10% up to $2,000 maximum per Individual, $4,000 Family Max $25 $0 $240 $240 Retail: $60 $60 Mail Order: $160 $160 $1,085 $1,310 Consider the Flexible Spending Account to pay the above expenses with PRE-TAX dollars! $7,019 $5,547 TOTAL COST $8,104 $6,857 SAVINGS $1,247 PPO 1000 Savings over the PPO 500
The following is only an Example based on the assumptions listed. You should carefully review your own situation prior to making your election. If you have questions, please call Human Resources. * FAMILY - WORST CASE - ENTIRE FAMILY * Family consists of Employee, Spouse & 2 Children * Employee & Spouse have 4 Office Visits each during the year (2 General Practitioners, 2 Specialists each) (Discounted cost of $100 General, $150 Specialist) * Children have 8 General Practitioner Office Visits each during the year ($100 per visit) * Employee has $250, Spouse $250 of lab work during the year * Each family member has multiple surgeries totating $200,000 (inpatient) * Employee & Spouse each have one preferred brand prescription per month (8 total Mail Order, $450 per script) * Children have total of 6 generic prescriptions during the year (Pharmacy - Cost of Rx is is $15 each) $500 per Individual/ $1,000 Family Max $1,000 per Individual/ $2,000 Family Max $1,000 $2,000 10% up to $1,500 maximum per Individual, $3,000 Family Max 10% up to $2,000 maximum per Individual, $4,000 Family Max $3,000 $4,000 $520 $560 Retail: $60 $60 Mail Order: $640 $640 $5,220 $7,260 Consider the Flexible Spending Account to pay the above expenses with PRE-TAX dollars! $7,019 $5,547 TOTAL COST $12,239 $12,807 Additional Cost $568 PPO 1000 Additional Cost over the PPO 500