I'm looking for help in how to explain to an employer why their HDHP has a lower out of pocket max than their PPO. Running into questions about this, since generally HDHP's have higher out of pocket maxes.
One employer with such an arrangement is receiving many questions from employees about how to evaluate the plan options because of this. Do you have any guidance for me on what to say to the employer?
In this case the PPO has a $1k deductible and $5k out of pocket max. The HDHP has a $3k deductible and a $3750 out of pocket max. Monthly premiums for the PPO and HDHP are $172 and $94, respectively.
So, if a policyholder expects a major operation, they are better off selecting the HDHP, due to lower out of pocket max and premiums. If they do not, but expect regular specialist visits and Rx purchases for a chronic condition, they may be better off selecting the PPO, due to the lower deductible. If they have minimal healthcare needs, the HDHP is preferred.
One employer with such an arrangement is receiving many questions from employees about how to evaluate the plan options because of this. Do you have any guidance for me on what to say to the employer?
In this case the PPO has a $1k deductible and $5k out of pocket max. The HDHP has a $3k deductible and a $3750 out of pocket max. Monthly premiums for the PPO and HDHP are $172 and $94, respectively.
So, if a policyholder expects a major operation, they are better off selecting the HDHP, due to lower out of pocket max and premiums. If they do not, but expect regular specialist visits and Rx purchases for a chronic condition, they may be better off selecting the PPO, due to the lower deductible. If they have minimal healthcare needs, the HDHP is preferred.