2014 Medical Expense Assignment 2a

Medical Expense Plan Problems (based on BSU Health Plan) Name:_______________
You will need information about each of the BSU Health Plans to be able to complete this assignment. The information on the summary page is sufficient, and the summary pages for each plan are available under the documents included for Medical Expense Assignment #1. All expenses are assumed to be at in-network endorsed Encircle providers except where noted (Ball State uses a network-within-a-network, or two layers of PPO providers).
1. Assume that you have a family with four members. Each person incurs $300 in medical expenses for the year at in-network endorsed medical providers. Under each plan, how much will you pay? (include premiums) Under which plan would your family pay the least?

Low-Ded. Plan
High-Ded. Wellness
HSA Plan
Premiums
$7580
$2791.20
$1204.44
Deductible
$1600
$3100
$5000
Lesser of Coins/OOP Max.
$8000
$11000
$8250
Total
$17180
$16891.20
$14454.44

2. Start over, and assume that one family member incurs $30,000 in medical expenses in a single year at an in-network endorsed provider(no family members incur any other expenses in the year). Under each plan, how much will you pay (include premiums)? Under which plan will your family pay the least?

Low Ded. Plan
High Ded. Plan
HSA Plan
Premiums
$7580
$2791.2
$1204.44
Deductible
$1600
$3100
$5000
Lesser of Coins/ OOP Max.
.2*28400=5680
or
$8000
.2*26900=5380 or
$11000
.2*28440=5688 or
$8250
Total
$14860
$11271.20
$11892.44

3. Assume that you are an individual. You have one MRI (costing $2,500 from an “in-network endorsed physician”) and one doctor’s visit (costing $200). How much would you have to pay under each plan? Remember to include premiums.

Low Ded. Plan
High Ded. Plan
HSA Plan
Premiums
$2892.12
$1074.96
$464.16
Deductible
$700
$1300
$2000
Lesser of coins/OOP Max.
.2*2000=400
or
$2000
.2*1400=280 or $2750
.2*700=140
or
$4250
Total
$3992.12
$2654.96
$2604.16

4.