Grand Prairie ISD

2015-2016 Health Insurance Plans

(Click on the links to see a detailed Wacasey Equation analysis of each coverage level)

Employee

Wacasey Equation Analyses - Dallas ISDs 2015-2016.xlsx

Employee + Spouse

Wacasey Equation Analyses - Dallas ISDs 2015-2016.xlsx

Employee + Child(ren)

Wacasey Equation Analyses - Dallas ISDs 2015-2016.xlsx

Employee + Family

Wacasey Equation Analyses - Dallas ISDs 2015-2016.xlsx

Wow. All I can say is, wow. 

Grand Prairie ISD offers three PPO plans and a high deductible HDHP plan administered by Blue Cross/Blue Shield, and the district subsidizes $350 per month, regardless of which plan is chosen. The policies share the same general characteristics as virtually all the others I’ve analyzed in this post; the higher-priced policies are just that. Higher-priced. Like the 64 other districts, the only thing these plans offer is a chance to part with significantly more of your hard-earned dollars if you choose the “better” coverage.

But that, as they say my friends, is where the similarities end.

By far, this is the most interesting of all the 65 districts analyzed. And I’m not referring to that $32,788 figure at the bottom right hand of the last spreadsheet either, although that happens to be one of the biggest “W’s” I’ve come across.

Before I get into the reasons why I’m aghast, I’ll run the numbers as usual:

As can be seen from the spreadsheet, the Low plans have the lowest premiums (or P), and make the most economic sense from the standpoint of staying well. But what if the insured should suffer a serious illness or injury, and reach their out of pocket maximum (O)?

With The Wacasey Equation, adding these two variables gives WHAT (W) might be spent on health insurance AND health care during the plan year:

P + O = W 

In comparing the W for the Low plans to all the other policies, we can see that the idea of a lower deductible resulting in greater savings just doesn’t add up. Because in every single case, the “better” the insurance, the more you’ll spend; mostly on the premium.

In fact, looking at the difference in W‘s between the Low, Mid, and High plans, you find that the only difference comes from extra premiums paid; because the O values for these plans are all the same:

  • An Employee would pay $2,148 more in Premiums for the Mid, and $4,476 extra for the High plan, with no added benefit
  • An Employee + Spouse would pay $4,680 more in Premiums for the Mid, and $7,920 extra for the High plan, with no added benefit.
  • An Employee + Child(ren)would pay $3,912 more in Premiums for the Mid, and $6,624 extra for the High plan, with no added benefit.
  • An Employee + Family would pay $6,360 more in Premiums for the Mid, and $11,784(!!!) extra for the High plan, with no added benefit.

I say no added benefit because these plans all share the same O value of $5,600 for individuals, or $11,200 for families. But, keep your eye on the birdie! The deductibles creep down with each successive “upgrade:” from $10,500 to $7,500 to $4,500. It’s a mirage, folks – like pinstripes on a car, those deductibles will cost you more but in reality they don’t mean a thing. In case of catastrophe, you will not achieve any savings by having the higher level plans!

The real story involves the out of pocket maximums, or O. Specifically, the Out of Network, out of pocket maximums (call it OOn). See, the O values I used to make the calculations above represent the In Network out of pocket maximum (or OIn). For example, if you get assigned an out of network anesthesiologist to put you under for your otherwise “covered” procedure, never mind potential blood loss; you’ll also be in for some serious sticker shock.

Click on the link to see the benefits listed for each plan:

 

   Low Plan   HDHP Plan     Mid Plan   High Plan
OIn $5,600 Individual $5,000 Individual $5,600 Individual $5,600 Individual
$11,200 Family $10,000 Family $11,200 Family $11,200 Family
OOn $17,000 Individual $10,000 Individual $19,000 Individual $13,000 Individual
$51,000 Family $20,000 Family $57,000 Family $39,000 Family

 

My problem with these numbers is that, compared to every other district in this analysis, this is the only one that actually penalizes those who buy the higher-priced plans.