Eagle Mountain-Saginaw ISD
2015-2016 Health Insurance Plans
(Click on the links to see a detailed Wacasey Equation analysis of each coverage level)
Eagle Mountain-Saginaw ISD offers three Teacher Retirement System of Texas POS II plans and an HMO plan through Scott & White. The district subsidizes $225 per month, regardless of which plan is chosen.
As can be seen from the spreadsheet, the Active Care 1-HD 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 ActiveCare 1-HD plans to the other ActiveCare 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 among the ActiveCare plans, the “better” the insurance, the more you’ll spend; mostly on the premium. For example, consider the Employee + Spouse plans – if two couples in a car get hit by a train, then the folks insured through ActiveCare 2 will spend $7,068 more than the other couple who have the Active Care 1-HD plan!
When comparing the ActiveCare 1-HD to the Scott & White HMO plans, it’s a different story. For the Employee category the lower priced, high-deductible plans still offer the best value, both in sickness and in health. Interestingly though, for the Employee + Spouse, Employee + Child(ren) and Employee + Family categories the W is actually lower for the Scott & White HMO plans.
But a major drawback of any HMO is that they are restrictive, requiring you to stay within the plan’s network. As another ISD even posted, “BEWARE – This is an HMO plan utilizing the very small Scott & White network…Out-of-network benefits are NOT available.” Well said.
Plus, although the HMO plan may end up saving you money on the W in the (statistically unlikely) event of a catastrophe, how much more does it cost in the first place?
Let’s examine the difference in P‘s, compared to the potential savings on the W:
- An Employee + Spouse would pay $2,664 more in Premiums, to potentially save $236 on What might be spent.
- An Employee + Child(ren) would pay $2,196 more in Premiums, to potentially save $704 on What might be spent.
- An Employee + Family would pay $348 more in Premiums, to potentially save $2,552 on What might be spent.
So the ends don’t always justify the means, and if not careful, one could waste plenty of money buying the so-called “better” health insurance. Think of it this way: would you hand a Vegas casino $2,664 to sit for a poker hand worth $236?
To see a detailed Wacasey Equation analysis of each coverage level, click on the link above each box.