Help Choosing the Right Plan

Open Enrollment Meetings

Informational Meeting

Slides from our Open Enrollment meetings can be downloaded here:  NGE 2022 Open Enrollment (PDF)  

A video of the HSA presentation is available below.

Medical

Choose the best plan for you

Choosing a medical plan is a personal decision, and there is not always a “right” choice. The right medical plan for one person or family may be totally different for another. The following scenarios have been created to help you think about selecting the right plan for you. Please contact Alison Spring if you would like help determining which plan is right for you.

Barbara

Current Situation:

Barbara and her husband have 2 young children. They have a lot of outside expenses and don't like to make large expenditures.

Medical Needs:

In addition to preventative visits, this year, both kids will see a few specialists to monitor health conditions.

Barbara has been seeing a therapist weekly and is considering sending one kid to a therapist as well.

The whole family takes several monthly prescriptions.

Solutions:

Barbara's family sees doctors and therapists regularly. They like being able to pay a co-pay at the visit with no big bills. Their monthly prescriptions can be expensive, but they like the lower cost of the co-pays.

They are lucky and have found several providers in the BlueChoice network (with lower co-pays).

While the premium is slightly higher than other plans, they select the PPO plan.

Roberta

Current Situation:

Roberta, a partner at the Firm, has a spouse and 3 children. As a partner, Roberta pays the full medical premium for any plan selected.

Medical Needs:

Roberta has a child with a medical condition that requires several prescriptions, doctor visits and lab work.

Her husband is probably going to have knee replacement surgery this year.

Solutions:

It is likely that Roberta will meet the out-of-pocket maximum for any health plan this year.

Reviewing the premiums plus the maximum out-of-pocket expense, the HD 1500 plan is the best choice this year.

Dave

Current Situation:

Dave is single and fairly healthy. He's comfortable saving money for future medical expenses.

Medical Needs:

Dave knows he will see his doctor for his annual physical and blood work.

He often gets a sinus infection each year requiring a doctor visit and prescription.

Other than that he's been pretty healthy.

Solutions:

Dave chose the HD 3000 plan.

He has plenty of savings in his HSA which would cover his costs if he should have a significant injury that causes him to meet his deductible and out-of-pocket maximum.

He likes saving money on premiums by choosing the lowest-cost plan.

 

Dental

Choose the best plan for you

The following scenarios have been created to help you think about selecting the right plan for you. Please contact Alison Spring if you would like help determining which plan is right for you.

Susan

Current Situation:

Susan has seen her current dentist for many years. She really likes the office and doesn't want to change providers.

Dental Needs:

She usually only needs preventative cleanings. She's had a few fillings over the years.

Solution:

Susan doesn't want to change providers, and her current provider does not participate in the DHMO plan.

The PPO is the best choice for Susan.

Stuart

Current Situation:

Stuart recently moved into the city and doesn't have a dentist. He likes saving money when possible.

Dental Needs:

His teeth are quite healthy. He only has two fillings.

Solution:

Stuart doesn't have a current dentist and is happy to select from the DHMO providers available. The premiums are significantly less than the PPO which makes him happy.

The DHMO is a good choice for Stuart.

Brady and Family

Current Situation:

Brady, his spouse and 2 children need dental insurance.

Dental Needs:

Brady's children both need braces in the next few years. Brady has been told he needs 3 crowns and has gum disease to manage in the upcoming year. He's not sure how he can afford all of this.

Solution:

Brady may want to consider the DHMO plan.

Orthodontia has a clear cost (and no maximum benefit like the PPO). The DHMO plan has co-payments with no limit on the amount one person or family can spend.

Since Brady has high expected costs, the DHMO may be the most cost-effective way to cover his family.

Roberta and Family

Current Situation:

Roberta's child is ready for braces. They plan to go to the orthodontist recommended by their family dentist.

Dental Needs:

In addition to braces, Roberta's younger child found out that he needs a few fillings and her husband just cracked a tooth and needs a crown.

Solution:

While the expenses for the family are adding up quickly, each person's total cost will still likely be less than the $2,000 per person annual benefit maximum.

Roberta already has an orthodontist in mind, so the PPO may be the best choice.