Page 14 - GLG 2021 Annual Benefits
P. 14
Claim Comparison: Choosing the Right Plan (continued)
Claims Example
Jill, her partner, and their child are considering which GLG plan will be the best the best it for family coverage
and will pay contributions based on a $130K annual salary. While reviewing the plans, they notice that with
the HSA 1400 medical plan, the whole family deductible must be met before beneits will begin to be paid.
Everyone in Jill’s family will receive an annual preventive exam, which is covered at 100% on all GLG plans. Jill
sees a specialist three times a year for back pain. Additionally, their child was rushed to the urgent care with a
stomachache that turned into appendicitis, which lead to an inpatient appendix removal surgery. With Jill’s back
pain and their child’s surgery, the family receives 5 generic prescription medications. Jill selects the HSA 1400
plan based on the low payroll contributions and GLG’s annual 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 child 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 child 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)
14
Claims Example
Jill, her partner, and their child are considering which GLG plan will be the best the best it for family coverage
and will pay contributions based on a $130K annual salary. While reviewing the plans, they notice that with
the HSA 1400 medical plan, the whole family deductible must be met before beneits will begin to be paid.
Everyone in Jill’s family will receive an annual preventive exam, which is covered at 100% on all GLG plans. Jill
sees a specialist three times a year for back pain. Additionally, their child was rushed to the urgent care with a
stomachache that turned into appendicitis, which lead to an inpatient appendix removal surgery. With Jill’s back
pain and their child’s surgery, the family receives 5 generic prescription medications. Jill selects the HSA 1400
plan based on the low payroll contributions and GLG’s annual 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 child 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 child 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)
14
