Page 13 - GLG Benefits Guide
P. 13
Claim Comparison: Choosing the Right Plan (continued)
Claims Example
Jill needs to consider which GLG plan option will be the right it for her and her family. Jill will enroll in family
coverage and her salary is $130K a year. While Jill reviews the medical plan options, she notices that on the
HSA 1400 plan the whole family deductible must be met before beneits begin being paid. Jill, her son and
husband will all receive one preventive annual exam which is covered at 100% on all GLG plans. Jill sees a
specialist three times a year for her back. Her son is rushed to the urgent care with a stomach ache that turns
into appendicitis. He then has an inpatient procedure to remove his appendix. With Jill’s back pain and her
son’s surgery they are prescribed 5 generic medications. She selects the HSA 1400 plan based on low payroll
contributions and GLG’s HSA funding.
Aetna PPO 500 Aetna HSA 1400
Total Annual Contribution $5,424 $2,832
GLG Contribution to HSA N/A $1,500
Family Deductible to be Satisied $1,000 $2,800
Jill's Services Cost of Care Amount Applied to Cost of Care Amount Applied to
Deductible
Deductible
3 preventive physical exams 100%, deductible does 100%, deductible does
(In-Network) not apply: $0 not apply: $0
Assumes $80 per ofice visit charge $0 $0
Deductible then $50
3 specialists visits for Jill copay: $500 Deductible then 80%: $600
Assumes $200 ofice visit charge Satisies embedded 3 visits @ $200 = $600
deductible = $500
Deductible then 90%: Deductible then 80%:
$2,200 to satisfy
1 inpatient procedure for Jill’s son Satisies embedded $500 deductible = $2,200 $2,200
Assumes $2,600 charge deductible then 80% coinsurance on
coinsurance = $710 $400 = $80
1 urgent care visit for Jill’s son Deductible then $75 $0 Deductible then 80%: $0
80% coinsurance on
copay:
Assumes $700 charge 1 copay = $75 $700 = $140
5 generic non-preventive retail $10 copay: Deductible then $10:
drug purchase 5 copays = $50 $0 5 copays = $50 $0
(Assumes $40 cost/30-day Rx)
Amount Amount
Totals Cost of Care of Deductible Cost of Care of Deductible
Remaining Remaining
$1,335 $0 $3,070 $0
Jill's Total Annual Cost = Payroll + Cost of Care Payroll + Cost of Care – HSA Funding
$4,402
$6,759 ($0 HSA Funds Remaining)
13
Claims Example
Jill needs to consider which GLG plan option will be the right it for her and her family. Jill will enroll in family
coverage and her salary is $130K a year. While Jill reviews the medical plan options, she notices that on the
HSA 1400 plan the whole family deductible must be met before beneits begin being paid. Jill, her son and
husband will all receive one preventive annual exam which is covered at 100% on all GLG plans. Jill sees a
specialist three times a year for her back. Her son is rushed to the urgent care with a stomach ache that turns
into appendicitis. He then has an inpatient procedure to remove his appendix. With Jill’s back pain and her
son’s surgery they are prescribed 5 generic medications. She selects the HSA 1400 plan based on low payroll
contributions and GLG’s HSA funding.
Aetna PPO 500 Aetna HSA 1400
Total Annual Contribution $5,424 $2,832
GLG Contribution to HSA N/A $1,500
Family Deductible to be Satisied $1,000 $2,800
Jill's Services Cost of Care Amount Applied to Cost of Care Amount Applied to
Deductible
Deductible
3 preventive physical exams 100%, deductible does 100%, deductible does
(In-Network) not apply: $0 not apply: $0
Assumes $80 per ofice visit charge $0 $0
Deductible then $50
3 specialists visits for Jill copay: $500 Deductible then 80%: $600
Assumes $200 ofice visit charge Satisies embedded 3 visits @ $200 = $600
deductible = $500
Deductible then 90%: Deductible then 80%:
$2,200 to satisfy
1 inpatient procedure for Jill’s son Satisies embedded $500 deductible = $2,200 $2,200
Assumes $2,600 charge deductible then 80% coinsurance on
coinsurance = $710 $400 = $80
1 urgent care visit for Jill’s son Deductible then $75 $0 Deductible then 80%: $0
80% coinsurance on
copay:
Assumes $700 charge 1 copay = $75 $700 = $140
5 generic non-preventive retail $10 copay: Deductible then $10:
drug purchase 5 copays = $50 $0 5 copays = $50 $0
(Assumes $40 cost/30-day Rx)
Amount Amount
Totals Cost of Care of Deductible Cost of Care of Deductible
Remaining Remaining
$1,335 $0 $3,070 $0
Jill's Total Annual Cost = Payroll + Cost of Care Payroll + Cost of Care – HSA Funding
$4,402
$6,759 ($0 HSA Funds Remaining)
13
