Prosper ISD

2015-2016 Health Insurance Plans

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

Employee

Tier-2-Prosper-EO

Employee + Spouse

Tier-2-Prosper-ES

Employee + Child(ren)

Tier-2-Prosper-EC

Employee + Family

Tier-2-Prosper-EF

Prosper ISD offers the Teacher Retirement System of Texas POS II plans and an HMO plan through Scott & White. The district subsidizes on a graduated scale, and contributes:

  • $341 per month for ActiveCare 1-HD plans
  • $450 per month for ActiveCare Select plans
  • $460 per month for ActiveCare 2 plans, and
  • $450 per month for Scott & White plans

As can be seen from the spreadsheet, the best premiums for the Employee + Family category are with the ActiveCare Select, which is $108 less than the ActiveCare 1-HD, and the Scott & White plan, which costs a whopping $960 less in premiums than the ActiveCare 1-HD (and would also result in a potential savings of $3,860 should an insured suffer catastrophe).

For all the other categories though the usual pattern still holds – the ActiveCare 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 policies, the W for the all categories – Employee, Employee + Spouse, Employee + Child(ren) and Employee + Family – is the lowest for the Scott & White HMO plans.

However, keep in mind that a major drawback of any HMO is its’ restrictive nature; you must utilize in-network providers or face stiff penalties. Interestingly, the ability to see any information on how out-of-network coverage is handled is not readily available at the Scott & White Health Plan FAQ site.

Plus, although these plans may end up saving you money on the W in the (statistically unlikely) event of a catastrophe, how much more do they cost in the first place?

Let’s examine the difference in P‘s, compared to the potential savings on the W:

  • An Employee would pay $648 more in Premiums, to potentially save $802 on What might be spent.
  • An Employee + Spouse would pay $1,356 more in Premiums, to potentially save $1,544 on What might be spent.
  • An Employee + Child(ren) would pay $888 more in Premiums, to potentially save $2,012 on What might be spent.

So, the ends don’t always justify the means, and one can waste plenty of money buying the so-called “better” health insurance. Think of it this way: would you hand a Vegas casino $1,356 to sit for a poker hand worth $1,544?

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