When you're factoring plans, you might want to do a little 'total cost of ownership'. Lay out a little spreadsheet with the coverages, co-pays, drug costs, out of pocket maximums and so forth, then figure what your average use is going to be and plug that into each plan.
Then you might want to look at the consumer reports ratings for PPO and HMO companies and weight that in to the cost accordingly. When we went through the process recently, we found that a particular PPO plan was more expensive but let us pick our own doctors, while the HMO plan was the cheapest, but we had to take the doctor of the day as they change often. However we've used the HMO provider before and had good luck.
When I looked up the PPO provider, they were among the worst in consumer reports ratings across the board. The HMO provider was at the top of their ratings. That flipped the 'on the fence' decision.
While the clear out of pocket costs for the PPO's Gold/Silver/Bronze offerings were only about a thousand apart, the TCO showed figures of 7000, 5000 and 4000 (approx) vs a cost of under 4k for the HMO. We'd need the $7000 PPO offering to equal the coverage of the HMO.
Of course, if you're healthy, dont use prescription drugs, dont balance on ladders with a nail gun in one hand and a paint gun in the other, etc...the cheaper PPO plan might TCO out to be pretty competitive.
As far as this continued escalation of costs and shaving of benefits, theres got to be an end in sight for it. Employers will simply stop bearing the cost burden at some point and nobody but the rich will be able to afford personal premiums.
At that point we degrade to a walmart like structure or a nationalized plan. I cant see a whole lot of room for other options. Either way the HC costs almost have to stabilize at some point.
