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Choosing a 2014 Health Plan

Both the Unity Basic Health Plan and the Unity Enhanced Health Plan provide comprehensive coverage. To choose the one that’s best for you, consider your own particular situation:

  • Use the Health Care Comparison information to calculate the annual amount you’d pay in premiums for each Plan.
  • Consider what health care services you and your family are likely to need in the upcoming year. (What did you spend last year? What might be different in the coming year?)
  • Estimate what these services will cost you out-of-pocket under each Plan. Remember to factor in deductibles and out-of-pocket maximums where they apply. (Note that co-pays and co-insurance count toward out-of-pocket maximums.)
  • Add up premiums and costs to see which Health Care Plan is right for you and your family.

Below are some scenarios that provide examples of how different situations can affect which health plan will save you the most.All examples assume 2014 costs for full-time employees utilizing Blue Cross Blue Shield Network of Providers.

Keep in mind that these scenarios do not represent the added savings you’ll get—under both plans—when you take advantage of our Unity Services Discount by using Unity providers and services:

Scenario A.

Jim needs health insurance for his wife, daughter and himself. Everyone in the family is healthy, but Jim’s wife is four months pregnant.

 

Unity Basic Health Plan

Unity Enhanced Health Plan

Total annual premiums for Family Coverage

$141.84 x 26 pay periods = $3,687.84

234.79 x 26 pay periods = $6,104.54

Annual physicals and well child visits

(No co-pay) $0

(No co-pay) $0

8 remaining pre-natal check-ups for Jim’s wife

(No charge) $0

(No charge) $0

Generic prescription pre-natal vitamins

$10 co-pay x 5 = $50

$10 co-pay x 5 = $50

Delivery and maternity hospital care for Jim’s wife
Cost: $8,000

Deductible =  $600
$8,000-$600 deductible =$7,400
$7,400 x 20% co-insurance =$1,480

Physician = $350 co-pay
Hospital care = $350 co-pay
Total = $700

Hospital nursery care for baby
Cost: $1,500

Deductible = $600
$1,500 - $600 deductible = $900
$900 x 20% co-insurance = $180

(No co-pay) $0

Sub-total $6,597.84 $6,854.54
Out-of-pocket Maximum savings*
Basic - $2,400 Individual
Enhanced - $1,500 Individual
In this example, the out-of-pocket maximum for Jim's wife or his daughter was not met.  
$0
In this example, the out-of-pocket maximum for Jim's wife or his daughter was not met.
$0

Jim’s total estimated health care costs for year:

$6,597.84

$6,854.54


Scenario B.
Marie needs health insurance for her husband and herself. They are both generally pretty healthy, although Marie sometimes gets sinus infections. Her husband recently began going to a psychotherapist weekly.

 

Unity Basic Health Plan

Unity Enhanced Health Plan

Total annual premiums for Employee and Spouse Coverage

$123.75x 26 pay periods = $3217.50

$206.43 x 26 pay periods = $5,367.18

Annual physicals for Marie and her husband

(No co-pay) $0

(No co-pay) $0

Average of 2 visits to primary care doctor/year, other than physicals

$40 co-pay x 2 = $80

$30 co-pay x 2 = $60

Name-brand (tier 2) antibiotics twice/year

$45 co-pay x 2 = $90

$30 co-pay x 2 = $60

Weekly psychotherapy for Marie’s husband

Deductible  = $600
$120 x 52 weeks = $6,240
$6,240-$600 deductible = $5,640
$5,640 x 20% coinsurance = $1,128

$50 co-pay x 52 weeks = $2,600

Sub-total $5,115.50 $8,087.18
Out-of-pocket Maximum Savings*
Basic $2,400 Individual
Enhanced $1,500
Out-of-pocket Maximum Not Met    $0  ($1,220)

Marie’s total estimated health care costs for year:

$5,115.50

$6,867.18

Scenario C.
Jordan needs insurance for himself only. Due to a chronic condition, he regularly takes two medications, one classified as Tier 2 and one classified as Tier 3. In addition, his physician recently recommended minor surgery. Jordan has also been thinking of joining a gym.

 

Unity Basic Health
Plan

Unity Enhanced Health Plan

Total annual  premiums for Employee Coverage

$58.79 x 26 pay periods =  $1,528.54

$93.08 x 26 pay periods = $2420.08

Annual physical

 (No co-pay) $0

(No co-pay) $0

Tier 2 medication
Tier 3 medication

$45 co-pay x 12 = $540
$90 co-pay x 12 = $1080
Total = $1,620

$30 co-pay x 12 = $360
$50 co-pay x 12 = $600
Total = $960

In-patient surgery in December

Deductible = $600 
$4,700 - $600 deductible =$4,100
$4,100 x 20% co-insurance =$820

Physician = $350 co-pay
Hospital care = $350 co-pay
Total = $700

Pre-and post-surgery office visits (specialist)

$60 co-pay x 2 = $120

$40 co-pay x 2 = $80

Sub-total $4,688.54 $4,160.08

Lifestyle Allowance

($250)

($500)

Out-of-pocket Maximum Savings*
Basic $2,400 Individual
Enhanced $1,500 Indvidual
 ($760)  ($240)

Jordan’s total estimated health care costs for year, minus his savings on a gym membership

$3,678.54

$3,420.08


*Out-of-pocket Maximum Savings - This number represents dollars NOT spent because the out-of-pocket maximum was met. Co-pays, deductibles and co-insurance all count toward the out-of-pocket maximum, but insurance premiums do not.