Page 2 - 2017 FutureSteps
P. 2
Future Steps for an Unsure Utilizer
Covers in-network preventive care at 100%; no deductible
$375 deposited by W&T Offshore into your HSA each quarter in case of
an emergency
Low per paycheck premiums
Same network of providers and discounts from BCBSTX
Individual deductible and out-of-pocket maximums apply to each family
member, even when family coverage is elected
Same emergency room coverage regardless of network status
After deductible, employee is only responsible for 20% of emergency
room or hospitalization costs
How You Might Use Your Plan
2017 2016
Coverage/Plan Future Steps PPO/family coverage
family coverage
1 Emergency Room Visit for Child
(average cost $1,200) $1,200 $1,200
2 PCP Visits for ER Visit Follow Up $40
for Same Child $400 (2 $20 copays)
($200 per visit or $400 total)
W&T Offshore HSA Contribution $1,500 N/A
Your Personal HSA Contribution $1,000 N/A
Total Costs $1,600 $1,240
Total Premium
$0
Total Costs Out of Your Pocket (pay full cost with $1,240
HSA)
Funds Left to Use in HSA Next
Year $900 N/A
“I have children in
Please note the costs for the various services used to create this scenario are for illustrative my family that I need
purposes only. Actual costs may differ based on the type of care or services provided.
good, solid, dependable
coverage for when an
emergency happens.”
Covers in-network preventive care at 100%; no deductible
$375 deposited by W&T Offshore into your HSA each quarter in case of
an emergency
Low per paycheck premiums
Same network of providers and discounts from BCBSTX
Individual deductible and out-of-pocket maximums apply to each family
member, even when family coverage is elected
Same emergency room coverage regardless of network status
After deductible, employee is only responsible for 20% of emergency
room or hospitalization costs
How You Might Use Your Plan
2017 2016
Coverage/Plan Future Steps PPO/family coverage
family coverage
1 Emergency Room Visit for Child
(average cost $1,200) $1,200 $1,200
2 PCP Visits for ER Visit Follow Up $40
for Same Child $400 (2 $20 copays)
($200 per visit or $400 total)
W&T Offshore HSA Contribution $1,500 N/A
Your Personal HSA Contribution $1,000 N/A
Total Costs $1,600 $1,240
Total Premium
$0
Total Costs Out of Your Pocket (pay full cost with $1,240
HSA)
Funds Left to Use in HSA Next
Year $900 N/A
“I have children in
Please note the costs for the various services used to create this scenario are for illustrative my family that I need
purposes only. Actual costs may differ based on the type of care or services provided.
good, solid, dependable
coverage for when an
emergency happens.”
