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[COLOR=black] I need professional help deciding if my company's insurance plan will be worth paying over $300 per month. Many people have told me my ...
Need help deciding if my company insurance is worth it!!Go to Top
[COLOR=black]I need professional help deciding if my company's insurance plan will be worth paying over $300 per month. Many people have told me my company's plan seems expensive and I am concerned about getting enough value for my pricey monthly cost. I am extremely lost when it comes to insurance and the main thing I am concerned about is value and coverage. Is there a plan out there that I could purchase outside of my company with more or equal coverage for less? I have pasted my coverage summary. I am a 27 year old male, my wife is 25 and we have a 5 year old son. We are all in excellent health. I will submit the dental as a sub-post since this was too long with it included.[/COLOR]
[COLOR=black]ADMINISTERED BY: Great-West Life and Annuity Insurance Company[/COLOR] [COLOR=black]DEDUCTIBLE ELECTION FORM[/COLOR] [COLOR=black]Please elect one of the following deductible options for the 2007 Plan Year.[/COLOR] [COLOR=black]CALENDAR YEAR OPTION OPTION OPTION[/COLOR] [COLOR=black]DEDUCTIBLE: ONE TWO THREE[/COLOR] [COLOR=black]Per Person $300 $500 $700[/COLOR] [COLOR=black]Maximum Per Family $900 $1500 $2100[/COLOR] [COLOR=black]MONTHLY COST[/COLOR] [COLOR=black]FOR COVERAGE:[/COLOR] [COLOR=black]Employee Only $ 53.56 $ 47.58 $ 39.29[/COLOR] [COLOR=black]Employee and Spouse Only $284.35 $268.11 $245.51[/COLOR] [COLOR=black]Employee and Child or Children Only $277.49 $261.54 $239.39[/COLOR] [COLOR=black]Employee and Spouse and Child or Children $366.79 $346.89 $319.17[/COLOR]
[COLOR=black]AARON RENTS, INC.[/COLOR] [COLOR=black]GROUP HEALTH INSURANCE SUMMARY[/COLOR] [COLOR=black]ADMINISTERED BY: Great-West Life and Annuity Insurance Company[/COLOR] [COLOR=black]COMPREHENSIVE MAJOR MEDICAL COVERAGE[/COLOR] [COLOR=black]CALENDAR YEAR DEDUCTIBLE OPTIONS[/COLOR][COLOR=black]:[/COLOR] [COLOR=black]Option One Option Two Option Three[/COLOR] [COLOR=black]per Person $300 $500 $700[/COLOR] [COLOR=black]max. per Family $900 $1500 $2100[/COLOR] [COLOR=black]You must elect one of the above three deductible options. You can only change your election on January 1st, the[/COLOR] [COLOR=black]plan anniversary date.[/COLOR] [COLOR=black]CALENDAR YEAR COVERAGE OPTIONS:[/COLOR] [COLOR=black]• [/COLOR][COLOR=black]Employee Only Coverage[/COLOR] [COLOR=black]• [/COLOR][COLOR=black]Employee and Spouse Only Coverage[/COLOR] [COLOR=black]• [/COLOR][COLOR=black]Employee and Child or Children Only Coverage[/COLOR] [COLOR=black]• [/COLOR][COLOR=black]Employee and Spouse and Child or Children Only Coverage[/COLOR] [COLOR=black]You must also elect one of the above four coverage options. You can only change your election on January 1st, the[/COLOR] [COLOR=black]plan anniversary date. The following plan provisions are the same regardless of the deductible and coverage[/COLOR] [COLOR=black]options you elect.[/COLOR] [COLOR=black]This plan includes a "carry-over provision" If you or your dependent incured Covered Medical Expenses during the[/COLOR] [COLOR=black]last three months of the calendar year and they were applied to meet that year's Deductible, those same expenses[/COLOR] [COLOR=black]may be used again, "carrier over" to help meet the Deductible Requirement of the next year.[/COLOR] [COLOR=black]EMERGENCY ROOM: [/COLOR][COLOR=black]A separate $100 deductible applies to each hospital emergency room visit unless the[/COLOR] [COLOR=black]Treatment is for an accidental injury or you are admitted to the hospital following the[/COLOR] [COLOR=black]emergency room visit.[/COLOR] [COLOR=black]OTHER THAN[/COLOR] [COLOR=black]COINSURANCE: [/COLOR][COLOR=black]PREFERRED PROVIDER: PREFERRED PROVIDER:[/COLOR] [COLOR=black]INPATIENT/OUTPATIENT[/COLOR] [COLOR=black]HOSPITAL SERVICES[/COLOR][COLOR=black]: 90% after deductible 60% after deductible[/COLOR] [COLOR=black]PHYSICIAN SERVICES[/COLOR] [COLOR=black]AT HOSPITAL (SURGERY[/COLOR] [COLOR=black]AND VISITS): [/COLOR][COLOR=black]90% after deductible 60% after deductible[/COLOR] [COLOR=black]PHYSICIAN OFFICE OR [/COLOR][COLOR=black]100% after a separate 60% after deductible[/COLOR] [COLOR=black]HOME VISITS[/COLOR][COLOR=black]: $20 per visit copayment[/COLOR] [COLOR=black](Calendar year deductible[/COLOR] [COLOR=black]does not apply to these services.)[/COLOR] [COLOR=black]OTHER MEDICAL[/COLOR] [COLOR=black]SERVICES[/COLOR][COLOR=black]: 90% after deductible 60% after deductible[/COLOR] [COLOR=black](OVER)[/COLOR]
[COLOR=black]AARON RENTS, INC.[/COLOR] [COLOR=black]GROUP HEALTH INSURANCE SUMMARY[/COLOR] [COLOR=black]EFFECTIVE JANUARY 1, 2007[/COLOR] [COLOR=black]Page 2 of 3[/COLOR] [COLOR=black]COINSURANCE[/COLOR] [COLOR=black]STOP LOSS LIMIT[/COLOR][COLOR=black]: IN NETWORK EXPENSES: Usual & Customary expenses are paid at 100%[/COLOR] [COLOR=black]after $2,000 has been paid out of pocket, per person, up to $4,000 per Family.[/COLOR] [COLOR=black]OUT OF NETWORK EXPENSES[/COLOR][COLOR=black]: Usual & Customary expenses are paid at[/COLOR] [COLOR=black]100% after $6,000 has been paid out of pocket, per person, up to $12,000 per[/COLOR] [COLOR=black]Family. [/COLOR][COLOR=black]These expenses do not include those that were applied toward your[/COLOR] [COLOR=black]deductible, spinal manipulation, mental or nervous disorders, or[/COLOR] [COLOR=black]alcoholism/drug abuse.[/COLOR] [COLOR=black]PREADMISSION[/COLOR] [COLOR=black]TESTING: [/COLOR][COLOR=black]Covered like any illness.[/COLOR] [COLOR=black]HOME HEALTH CARE[/COLOR][COLOR=black]: Covered like any illness to a maximum of 40 Home Health Care visits per[/COLOR] [COLOR=black]calendar year.[/COLOR] [COLOR=black]MATERNITY: [/COLOR][COLOR=black]Covered like any illness; a pre-natal care program is available to all covered[/COLOR] [COLOR=black]expectant mothers.[/COLOR] [COLOR=black]PREVENTIVE CARE [/COLOR][COLOR=black]Well baby care, routine nursery, routine physicals/pediatric visits,[/COLOR] [COLOR=black]PACKAGE[/COLOR][COLOR=black]: immunization and vaccinations, and birth control pills are covered like any[/COLOR] [COLOR=black]illness.[/COLOR] [COLOR=black]HOSPITAL PREADMISSION[/COLOR] [COLOR=black]AUTHORIZATION, PRE[/COLOR][COLOR=black]- Required for all hospital admissions and surgical procedures.[/COLOR] [COLOR=black]SURGERY REVIEW & [/COLOR][COLOR=black]GREAT-WEST PRE-CERTIFICATION HOTLINE:[/COLOR] [COLOR=black]BENEFIT ADVICE LINE: [/COLOR][COLOR=black]800-445-2336[/COLOR] [COLOR=black]PRESCRIPTION DRUGS[/COLOR][COLOR=black]: The prescription drug program provides the following options:[/COLOR] [COLOR=black]Generic Preferred Brand Name Non Preferred Brand Name[/COLOR] [COLOR=black]Mail Order (90-day supply) $15.00 $30.00 $45.00[/COLOR] [COLOR=black]Network Pharmacy (30-day) $15.00 $30.00 $45.00[/COLOR] [COLOR=black]Non-Network Pharmacy(30-day) $25.00 $40.00 $55.00[/COLOR] [COLOR=black](Dollar amounts are copayments and the annual deductible does not apply.)[/COLOR] [COLOR=black]LIMITATIONS[/COLOR] [COLOR=black]TREATMENT of MENTAL[/COLOR] [COLOR=black]HEALTH CONDITIONS,[/COLOR] [COLOR=black]ALCOHOLISM or DRUG ABUSE[/COLOR][COLOR=black]: OTHER THAN[/COLOR] [COLOR=black]PREFERRED PROVIDER PREFERRED PROVIDER[/COLOR] [COLOR=black]While a patient is NOT confined Deductible Applies; Deductible applies;[/COLOR] [COLOR=black]as a Hospital inpatient, limited to payable at 50% payable at 50%[/COLOR] [COLOR=black]20 visits per calendar year.[/COLOR] [COLOR=black]While a patient is confined Deductible Applies; Dedcutible applies[/COLOR] [COLOR=black]as a Hospital inpatient, limited to payable at 90% payable at 60%.[/COLOR] [COLOR=black]15 days per calendar year[/COLOR] [COLOR=black]-------------------------[/COLOR] [COLOR=black]PHYSICAL MEDICINE[/COLOR] [COLOR=black](CHIROPRACTIC & [/COLOR][COLOR=black]Paid 50% after deductible to a maximum benefit of $500 per calendar year.[/COLOR] [COLOR=black]SPINAL TREATMENT):[/COLOR] [COLOR=black]INFERTILITY: [/COLOR][COLOR=black]Not covered.[/COLOR]
Re: Need help deciding if my company insurance is worth it!!Go to Top
Dental Coverage
[COLOR=black]AARON RENTS, INC.[/COLOR] [COLOR=black]GROUP HEALTH INSURANCE SUMMARY[/COLOR] [COLOR=black]EFFECTIVE JANUARY 1, 2007[/COLOR] [COLOR=black]Page 3 of 3[/COLOR] [COLOR=black]DENTAL COVERAGE[/COLOR] [COLOR=black]PREVENTIVE &[/COLOR] [COLOR=black]DIAGNOSTIC[/COLOR][COLOR=black]: Paid at 100% with no deductible.[/COLOR] [COLOR=black]Cleanings, Fluoride,[/COLOR] [COLOR=black]Exam, Bitewing X-rays[/COLOR] [COLOR=black]BASIC: [/COLOR][COLOR=black]Paid at 80% of UCR* after deductible[/COLOR][COLOR=black].[/COLOR] [COLOR=black]Fillings, Root canals,[/COLOR] [COLOR=black]Extractions, Periodontics[/COLOR] [COLOR=black]MAJOR: [/COLOR][COLOR=black]Paid at 50% of UCR* after deductible[/COLOR][COLOR=black].[/COLOR] [COLOR=black]Crowns, Inlays,[/COLOR] [COLOR=black]Bridges, Partials[/COLOR] [COLOR=black]*[/COLOR][COLOR=black]UCR (USUAL & [/COLOR][COLOR=black]The most common or average charges for a procedure, based on the[/COLOR] [COLOR=black]CUSTOMARY RATES[/COLOR][COLOR=black]): rates charged by providers of a service in a particular geographic area.[/COLOR] [COLOR=black]DEDUCTIBLE: [/COLOR][COLOR=black]$50 per person/year - applies to Basic and Major services only.[/COLOR] [COLOR=black]MAXIMUM BENEFITS[/COLOR] [COLOR=black]PAYABLE PER YEAR: [/COLOR][COLOR=black]$1,000/Person/Year for all services collectively except orthodontia.[/COLOR] [COLOR=black]ORTHODONTIA: [/COLOR][COLOR=black]Paid at 50% with no deductible with a lifetime maximum of $1,000/person.[/COLOR] [COLOR=black]PRE-DETERMINATION: [/COLOR][COLOR=black]Any time expenses will exceed $200, it is recommended that you have the[/COLOR] [COLOR=black]dentist submit a pre-determination.[/COLOR] [COLOR=black]COMPANY PROVIDED LIFE INSURANCE BENEFITS[/COLOR] [COLOR=black](LIFE INURANCE IS PROVIDED BY THE COMPANY AT NO COST TO THE EMPLOYEE.)[/COLOR] [COLOR=black]LIFE INSURANCE: [/COLOR][COLOR=black]$10,000[/COLOR] [COLOR=black]ACCIDENTAL DEATH: [/COLOR][COLOR=black]$10,000, additional.[/COLOR] [COLOR=black]& DISMEMBERMENT[/COLOR]
Re: Need help deciding if my company insurance is worth it!!Go to Top
Sometimes you can get equivalent (or better) coverage for less expense by putting dependents on a separate individual/family plan.
But in your case, that's not so.
Two big factors; maternity coverage, and the rate they charge for your dependents is very reasonable. I see groups where the employee's share of the premium for this kind of plan is $700-$800 per month!
They are offering you a good plan at a very reasonable price. I would take "Option 3" if it were me.
Re: Need help deciding if my company insurance is worth it!!Go to Top
Originally Posted by moonlightandmargaritas
Sometimes you can get equivalent (or better) coverage for less expense by putting dependents on a separate individual/family plan.
But in your case, that's not so.
Two big factors; maternity coverage, and the rate they charge for your dependents is very reasonable. I see groups where the employee's share of the premium for this kind of plan is $700-$800 per month!
They are offering you a good plan at a very reasonable price. I would take "Option 3" if it were me.
Hope that helps, and Happy New Year!
You guys are probably right. Stibroker suggested comparing my plan at ehealthinsurance.com to get a feel for it's competativeness and I couldn't top it. Thank you guys for easing my worries. I think I will go with it. Happy Holidays!
Re: Need help deciding if my company insurance is worth it!!Go to Top
I have to wonder what the real cost is? Exactly how much of his wages that shall never be seen because of Group BS. I'm sure his employer may very well do a yearly contribution statement, be interesting to take that into account.
Need help deciding if my company insurance is worth it!!
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