I also found the AV calculator that the insurers are using.
Centers for Medicare & Medicaid Services
1st link
Centers for Medicare & Medicaid Services
1st link
No number running - what I'm thinking is that this would be a given now because of the minimum essential standards.
I'm not sure this matters to me as a customer. The Bronze plans are HSA qualified period. I don't see an option for Bronze HSA versus Bronze non-HSA plan I can purchase.
Yes, how they arrive at the actuarial value of a plan.Am I missing something?
Yes, how they arrive at the actuarial value of a plan.
The deductible, co-pays, coinsurance all go into a formula that makes up the AV of a plan - correct?
A high deductible would subtract from the AV of a plan, correct?
You're right - just the Bronze PPOs.Audrey, when I look at the plans, the Bronze PPO plans are showing up as HSA-eligible but the bronze HMO plans are not. And maybe it's different in my county, but the only HSA-compatible plans I'm seeing are the two Bronze-level PPO plans offered by BCBS through the Exchange. I don't know if this is a bug or if there is something about the HMO plans that don't meet all the technical criteria for HSA eligibility.
OK, let's try this again: once you've met the deductible, sure, anything that results in a lower premium AND lets you contribute to an HSA looks better.
But the problem is that few of know this will be the case going into any given year. And it ignores the concept that one deductible may be $2000 and the other may be $6000.
Am I missing something?
Maybe this no or low copay stuff is what limits a plan from being HSA eligible?
I haven't looked into detail on the Bronze HMOs. I know absolutely nothing about the HMO network in our area. The plans are cheaper, and even though they have high deductibles like the PPOs, they seem to offer more in-network office visits, etc. before you start having to pay towards your deductible. Maybe this no or low copay stuff is what limits a plan from being HSA eligible?
Yes. HSA plans pay nothing until you meet your out of pocket deductible, I believe.
One of the important requirements for a plan to be HSA compatible is it CANNOT pay ANY benefit until the minimum deductible is met.
That does not apply to this pre-ACA plan.The *ONLY* exception is ACA mandated preventative care.
That's exactly how my pre-ACA plan works. I pay 100% up to $10K/yr, then the insurer pays 100%.
That does not apply to this pre-ACA plan.
I think I am going to stick with my plan for 1 more year while this ACA settles out. It appears that my insurer will not drop this plan.
Sorry, a plan that HAS cheaper copays might not be HSA compatible.I suspect that might be right. A plan that has no copayments might not be HSA compatible.
Still, one of the BCBS Bronze PPOs offered in Texas has a $6000 deductible and a $6000 OOP max (i.e. no copays effectively, you either pay all or nothing)... and it's HSA compatible. So again, I'm confused.....
That's my understanding too, unless that max oop limit is for both you and wife.There is a max limit for oop for it to be HSA compatible. If your $10K/yr figure is for an individual plan, then I am not sure it would qualify for HSA as the limit is $6,250. The family limit is $12,500.
Thanks for this animorph. I have never learned Excel.Here's the spreadsheet I created
It has been HSA qualified pre-ACA for many years that we have had it. And yes, the $10K is for 2 of us.There is a max limit for oop for it to be HSA compatible. If your $10K/yr figure is for an individual plan, then I am not sure it would qualify for HSA as the limit is $6,250. The family limit is $12,500.
There is a max limit for oop for it to be HSA compatible. If your $10K/yr figure is for an individual plan, then I am not sure it would qualify for HSA as the limit is $6,250. The family limit is $12,500.
Awesome! Just the kinds of answers I was looking for, but I didn't know how to set that up. I only took a quick look at it so far...I hope I can figure it out. So many folks talk of spreadsheets on this board, but not too many are shared. Hats-off to you!Here's the spreadsheet I created to compare a few health plans.
That's a useful spreadsheet. Thanks for another addition to the FAQ. The one I was using had much less granularity in pricing, and the additional clip levels make a difference, much easier to filter, and choose. It's also visually well structured. Add a spouse, project out over 3-5 years (for us, Medicare eligibility), and we can see which policies make sense and also how much we should reasonable set aside to fund in additional to premiums.Here's the spreadsheet I created to compare a few health plans. It simply compares the costs of several plans for a given level of medical charges for the year, assuming you pay premiums, a deductible, and then coinsurance amounts, with a maximum out of pocket amount that includes both the deductible and coinsurance. Not a lot of detail. You enter the plan data and it creates a table that shows you costs for various levels of medical charges. It's pre-loaded with real plans I was looking at directly from BCBS.
You can see one plan is best with low medical charges, one is best with high charges, one or two are best within a particular range of charges, and one was actually not too far off from the best at all charge levels.
Here's the spreadsheet I created to compare a few health plans.
Price Deduct Coinsur OOPMax SBC
1628.19 0 50.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Silver_0.pdf
1497.87 2800 30.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Silver_2800.pdf
1488.15 3500 30.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Silver_3500.pdf
1481.57 0 50.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Value_Silver_0.pdf
1462.05 5000 30.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Silver_5000.pdf
1387.83 3500 30.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Value_Silver_3500.pdf
1372.09 3000 30.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Silver_3000.pdf
1167.47 3000 30.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Value_Silver_3000.pdf
1264.64 5000 20.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Bronze_5000.pdf
1264.24 2600 50.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Bronze_2600.pdf
1170.08 5500 0.00% 5500 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Bronze_5500.pdf
1150.81 5000 20.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Value_Bronze_5000.pdf
1150.45 2700 50.00% 6350 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Value_Bronze_2700.pdf
1064.8 5500 0.00% 5500 https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Value_Bronze_5500.pdf