Comments on: 5 Things to Consider During Open Enrollment

By: Bonefish Grill recipe: Salmon topped with Spinach, Bacon & Gorgonzola Bleu Cheese

Tue, 01 Dec 2009 04:49:20 +0000

[...] 5 Things to Consider During Open Enrollment. [...]

By: Milton

Milton — Fri, 20 Nov 2009 15:53:22 +0000

Our open enrollment window was decreased to two weeks. I consider that a very short time period for such an important decision as health care. There is not one size fit all, everyone needs are different. Please take the time to consult with your doctor and dentist first. If you have a choice between a HMO or PPO make sure your Doctor or Dentist will remain in a plan that meets your needs. Beware that comparison charts are not an accurate measurement of coverage. Companies will favor an HMO because of lower incurred cost to them over a PPO. Example: a HMO will pay $ 2300 for Orthodontic Procedures (Braces), while a PPO will $ 0.00 nothing – Important: HMO will pay say $45.00 for a Surgical Removal of Tooth while a PPO will pay up to 60% —–60% OF WHAT. What Dentist do you know will Surigcally remove a tooth for $45.00. (NONE). Consider Major Restorative Procedures thru a HMO Plan: Inlay $276-Core Buildup Including Pins-$110.0,- Crown porcelain/ceramic substrate – $385.00. What Dentist do you know would perform these procedures for the prices provided above, (NONE) During open enrollment there is a rushed to get you signed up with a Doctor or Dentist. They get paid for each patient signed up thru a HMO provider whether you see a Doctor or not. Meanwhile a PPO plan pays 60% of allowable amount, member pays 40%. I would like to know the amount the doctor is being paid. If the PPO plan is paying the Doctor 60%, then tell me up front what is his fee is for the procedure. Why is this a big secret. Consider emergency transportation, ALS or BLS , (Advance Life Support or Basic Life Support ) what does your provider pay. I found this out the hard way. I needed to have a MRI and needed to be transported to the clinic for the MRI which was 1.5 miles each direction to and from the hospital. I needed no medical attention during each trip, but I was billed for $750.00, my HMO covered up to $500.00. That was two years ago. I contacted my insurer and was told they pay up to $500.00 and the charge was (not) excessive. Talk with your Doctor and Dentist and try to make an informed decision regarding your current medical needs now and a least for the upcoming year. Invest not only in your financial future but also invest in your own physical health and well being. Good Luck.

By: Patrick

Patrick — Thu, 19 Nov 2009 12:57:47 +0000

Our open season just ended and I was shocked to see how much our coverage increased – 33%! This is on top of a 30% increase over last year. It amazes me how much health insurance coverage has increased over the last few years.
Patrick´s last blog ..Individual Health Insurance vs. Group Health Insurance

By: Nifty

Nifty — Thu, 19 Nov 2009 04:25:35 +0000

@Wojciech, my company offers health incentives. In 2007 and 2008, they reimbursed us up to $300 for expenses we made for health-related purchases in the first quarter of the year. And they were pretty flexible in what they allowed: gym membership, sports equipment, running shoes, smoking cessation programs, weight-loss club memberships, etc. Even things like massage packages.

In 2010, they’re doing it a little differently. We recently had our annual all-hands conference and the company arranged for the employees to have free health screenings if they wanted them: weight, BMI, blood pressure, total cholesterol, HDL cholesterol, glucose, coronary risk ratio. I forget what else. This was not mandatory and there was no charge, and over 70% of our workforce (of 1200 employees) voluntarily participated. The next step was going online and taking a risk assessment. The assessment asked you questions about your bloodwork results, but also about your lifestyle habits: food, sleep, stressors, exercise, tobacco use, alcohol use, etc. (You received a score from 0-100. 0-24 is very bad; 25-49 is needs improvement; 50-74 is good; 74-100 is excellent.) Any employee who completed these two tasks will receive an additional $12.50 per pay period (x 24) in his/her paycheck for all of 2010.

The company also encourages us to take breaks during the workday to walk around the block…supports yoga classes on the premises…brings in a massage therapist once per month…supports employee-led bootcamps and exercise clubs…hosts lunch-and-learn sessions about nutrition, diabetes, etc. They’ve brought Olympic gymnast Shawn Johnson to speak to us, and I think there was another notable athlete who came another time.

Our insurance plans at our company are self-funded, and during our enrollments sessions this year, they told us that our costliest issues are cancer, arthritis, heart disease, pregnancy…and one other I forget. So obviously the company is looking at ways to prevent illness and the costs associated with those illness. And yeah…I suspect that in time — as early as a couple years from now, I imagine — the company will begin a system of rewards and penalities. If you’re a healthy weight and your health assessment is good, then you pay less; if you’re an unhealthy weight with several risk factors, then you pay MORE. In one sense, it’s a little scary in a Big Brother sort of way. But on the other hand, the company is bending over backwards to provide us you with the tools and motivation and opportunity we need to take control and improve our health.

By: Wojciech

Wojciech — Wed, 18 Nov 2009 11:54:18 +0000

Very timely post, as we’re currently considering most of the above in order to lower our insurance costs. The rate of inflation on some of these plans is worse than some credit card rates!

One thing I had never really heard of are employer health incentives! I’d love to find out more from you or other readers, if they have experience with it. Is it something administered by the insurance company or voluntarily by the employer?