Page 14 - 2015 DAN-Dentsu New Hire Guide
P. 14
Beneits Enrollment
Moderate Utilizer
Jill, age 42, covers herself and her spouse on the plan and seeks healthcare services moderately. Her 2015 medical expenses
might look like this.
Premium PPO Enhanced PPO Standard PPO HSA PPO
Total Cost (In-Network) 1 Out-of-Pocket Expenses by Plan
Well woman & male oice visits: $572 Free Free Free Free
Four Primary Care Visits ($120/visit) $30 copay ($120 total) $30 copay ($120 total) $30 copay ($120 total) $480 (deducible)
One Brand Rx/Month: $30/Month $30 monthly copay $30 monthly copay $30 monthly copay $3,520 to saisfy
($360) ($360) ($360) deducible; then 20%
of remaining $80
2
Outpaient service for spouse : $2,500 $250 to saisfy $500 to saisfy $1,000 to saisfy 20% of remaining
deducible; then 0% of deducible; then 10% deducible; then 20% $2,500
$2,250 of remaining $2,000 of remaining $1,500
Total Employee Responsibility
Total Out-of-Pocket Expenses $730 $1,180 $1,780 $4,516
Annual Payroll Deducion $6,577 $4,554 $2,680 $1,712
(EE + Sp)
Company HSA Contribuion N/A N/A N/A ($1,000)
Jill’s Total Cost $7,307 $5,734 $4,460 $5,228
The best opion for Jill is the Standard Plan.
Notes:
1 Please note the costs for the various services used to create the preceding scenarios are for illustraive purposes only. Actual costs may difer the type of care or services
provided.
2 Outpaient Services—cost assumed as total of all outpaient expenses; therefore, applying directly to deducible and coinsurance for all modeled plans.
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Moderate Utilizer
Jill, age 42, covers herself and her spouse on the plan and seeks healthcare services moderately. Her 2015 medical expenses
might look like this.
Premium PPO Enhanced PPO Standard PPO HSA PPO
Total Cost (In-Network) 1 Out-of-Pocket Expenses by Plan
Well woman & male oice visits: $572 Free Free Free Free
Four Primary Care Visits ($120/visit) $30 copay ($120 total) $30 copay ($120 total) $30 copay ($120 total) $480 (deducible)
One Brand Rx/Month: $30/Month $30 monthly copay $30 monthly copay $30 monthly copay $3,520 to saisfy
($360) ($360) ($360) deducible; then 20%
of remaining $80
2
Outpaient service for spouse : $2,500 $250 to saisfy $500 to saisfy $1,000 to saisfy 20% of remaining
deducible; then 0% of deducible; then 10% deducible; then 20% $2,500
$2,250 of remaining $2,000 of remaining $1,500
Total Employee Responsibility
Total Out-of-Pocket Expenses $730 $1,180 $1,780 $4,516
Annual Payroll Deducion $6,577 $4,554 $2,680 $1,712
(EE + Sp)
Company HSA Contribuion N/A N/A N/A ($1,000)
Jill’s Total Cost $7,307 $5,734 $4,460 $5,228
The best opion for Jill is the Standard Plan.
Notes:
1 Please note the costs for the various services used to create the preceding scenarios are for illustraive purposes only. Actual costs may difer the type of care or services
provided.
2 Outpaient Services—cost assumed as total of all outpaient expenses; therefore, applying directly to deducible and coinsurance for all modeled plans.
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