Melissa ISD

2015-2016 Health Insurance Plans

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

Employee

08-03-15 Metroplex ISD Analysis - Tier 2 - $529 EO

Employee + Spouse

08-03-15 Metroplex ISD Analysis - Tier 2 - $529 ES

Employee + Child(ren)

08-03-15 Metroplex ISD Analysis - Tier 2 - $529 EC

Employee + Family

08-03-15 Metroplex ISD Analysis - Tier 2 - $529 EF

Melissa ISD offers three Teacher Retirement System of Texas POS II plans and an HMO plan through Scott & White. The district subsidizes a whopping $529 per month (the highest in this survey), regardless of which plan is chosen. Because of this enormous subsidy, this district did not fit the usual pattern amongst almost all of the others insured through TRS.

With The Wacasey Equation, adding the Premium (or P) and the out of pocket maximum (O) gives WHAT (W) might be spent on health insurance AND health care during the plan year:

P + O = W

As can be seen from the spreadsheet, the Employee and Employee + Spouse categories would get the best deal (by far!) by choosing the Scott & White HMO plan.

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.

 

 

for the Employee + Child(ren) and Employee + Family categories the Active Care 1-HD plans still 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)? 

 

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 every insured category the HMO wins out on the W – especially for the Employee and Employee + Spouse categories. 

 

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 + 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 $2,196 to sit for a poker hand worth $704?

To see a detailed Wacasey Equation analysis of each coverage level, click on the link above each box.