Open enrollment for the Standard Automotive Agreement Insurance is about to begin and letters will be mailed out to members informing them of their options shortly. Members covered under the Standard Automotive Agreement who wish to remain with their current insurance coverage (Premier Plus Plan) through 2017 will continue to be subject to a $10 per week premium co-pay. The Open Enrollment Period will end December 14th and your selection will take effect on January 1, 2017. If you do nothing you will remain in the current Premier Plus Plan and will continue to pay the same $10 weekly premium insurance co-pay. Members can also choose to go into the Premier Plan, which will not be subject to the weekly premium co-pay but does offer LESS coverage than the current plan. It is extremely important that all members understand what their options are regarding their insurance coverage.
The premium co-pay to remain in the Premier Plus Plan amounts to $520 for the entire year (52 weeks) or approximately $1.42 per day (520 / 365). For the price of a cup of coffee per day, you can keep your current coverage. The difference in the amount of premium co-pay vs. no premium co-pay, should you elect to drop down to the Premier Plan, will be virtually instantly consumed with a claim in comparison to the per person deductibles. There are other differences which you should consider between the two plans.
What are the differences in the plans? The Premier Plan has:
Double the per person deductible as the Premier Plus Plan!
$250 per person w/Premier Plus Plan vs. $500 per person w/Premier Plan.
Triple the per family deductible as the Premier Plus Plan!
$500 per family w/Premier Plus Plan vs. $1,500 per family w/Premier Plan.
Double the annual max out of pocket for medical!
$2,500 single / $5,000 family w/Premier Plus Plan vs. $5,000 single / $10,000 family w/Premier Plan.
10% less coverage for hospital.
90/10 Premier Plus Plan vs. 80/20 Premier plan.
AND up to 32% HIGHER prescription drug costs!
Premier Plus Plan coverage’s:
-Generic max= $6
-Name Brand max= $25
-Single Source max= $40
-Generic max = $20 (+30%)
-Name Brand max= $100 (+25%)
-Single Source max= $125 (+32%)
Not to mention the differences in Dental and Vision!
Premier Plan has NO coverage for major services for dental!
-Premier Plus Plan covers 50% of major services vs.
-Premier Plan covers 0% of major services.
Premier plan has NO orthodontia coverage for dental!
-Premier Plus Plan covers 50% of Orthodontia vs.
-Premier Plan covers 0% of Orthodontia.
Premier Plan offers LESS coverage for Vision!
-Premier Plus Plan $20 co-pay lenses, $20 co-pay for frames ($120 max for frames) vs.
-Premier Plan offers up to a $75 “discount” for lenses and frames.
To be fair, those who choose to take the lesser coverage to avoid the small co-pay will be enrolled in an HRA at $7 per week through the end of the contract, it then becomes your decision where you wanted to spend your $7 per week….Your higher deductible?… Your higher prescription costs?… Your higher maximum out of pocket expenses?
As you can see, with the lesser coverage outlined in the Premier Plan, the $7 per in your HRA account wouldn’t go very far relative to what could potentially be your costs for opting for lesser coverage percentages, deductibles and max out-of-pocket amounts.
It should also be noted that the employer is saving nearly the same amount during the same time period due to the lower premiums paid on your behalf. The difference between what you would get in your HRA and what your employer saves is nominal through the duration of the contract and the employee has to shoulder the added costs associated with taking the lesser coverage.
The bottom line – …. it is not worth it to take less coverage for the minimal $10 per week premium co-pay. It is in your best interest to continue to stay in the Premier Plus Plan.