• Benefits Update - October 2011 - FAQ

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Here are some of the frequently asked questions I have been receiving on Benefits enrollment:

1. Do I have to change to the new HSA Insurance?  

No, you may still choose the 100%, 90% or 80% plan.

2. Do I have to sign up for benefits if I am making no changes?

No.  You do need to sign up for the FSA (Flexible Spending Account) each year, if you wish to continue that feature.

3. What is the difference between the 100% and 90% plan?

Both have the same deductible ($225 single; $450 for 2 or more people)

The 90% plan has a total out-of-pocket expense in-network of $1500 single and $3000 for 2 or more people.  That includes your deductible.  The out-of-pocket expense starts when you have an inpatient hospital stay, outpatient surgery or big ticket items such as a PET scan, MRI, CT Scan, etc.

4. What about the 80% plan?

The 80% plan has a deducible of $450-single and $900 for 2 or more people.  The maximum out-of-pocket expenses are $3,000 for single and $6,000 for two or more people on in-network services. The co-payments for drugs and doctor's office visits are the same as those on the 90% and 100% plan. Again, the only time your deductible and out-of-pocket expenses kick in is when you are in the hospital, outpatient surgery, MRIs, CT Scans, etc.

5. "I'd like to go to the 90% plan, but my kids are always at the doctor's. I need to save some money."

There is no difference between the 100% plan and 90% plan for your co-payment to the doctor or for prescription medication. You would still be spending the same amount of money. You would be saving money on your premiums. On the family plan the savings from the 100% plan to the 90% plan is $3,119.76 per year.  That is more than your out-of-pocket expenses for the 90% plan.  The saving on the employee only plan is $906.72 per year.

6. What happens if I get a hospital bill? I will have a bill for $10,000 if the hospital bill is $100,000. I can't afford that.

It does not work that way. You pay 10% on what the insurance carrier allows. Consider the story of a flight attendant (employee only plan) who this year switched to the 90% plan. She had an emergency admission to the hospital.  She still had to pay the $225 deductible which is the same on both plans.  She switched because she was going to save $720 per year. After all the bills came in, she only paid $70 out-of-pocket.  She still saved $650 for the year.

When I had my surgery 2 years ago, the hospital bill was $98,000 for 2 days in the hospital.

(Scary right!) Blue Cross said $30,000 is all the hospital was allowed to charge the insurance company. (The $68,000 goes away and nobody has to pay that amount).  Ten percent of $30,000 is $3,000.  My out-of-pocket maximum is $1500.  I paid the $1500 and Blue Cross picked up the other $1500 of the $3000. I had my own little account for the out-of-pocket expenses for "just in case."  The last time I was in the hospital for surgery prior to 2009 was 1982 for my appendix.

The point is, that on the 90% or 80% plan you never pay more out-of-pocket per year than what the maximum out-of-pocket expenses are. If you can discipline yourself to put your savings away for the first year or so you make the switch into a little savings account, you will always have the money - just in case something happens and you are in the hospital. Otherwise, hospitals do accept payment plans.

7. When is annual enrollment?

Annual enrollment opens on October 13, 2011 and closes at 11:59 PM EDT (8:59 PM PDT) on October 31, 2011.

In Solidarity

Paul H. Frishkorn
MEC Benefits Chairperson
PFrishkorn@afausairways.org

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Information contained within, provided by your MEC officers Mike Flores, Mark Gentile, and Glenda Talley. See local information, on your respective local page. All information posted by the Communications Chair.

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