Group Health Insurance
Health insurance isn’t always simple. In fact, for many employees, it’s downright confusing. The good news is that you can learn to be a wiser benefits consumer by first understanding the basics. Please see a brief introductory video to group health insurance below:
Additionally, please see ways to save money by spending less on health care in the video below:
Coinsurance: The percentage of a covered health care expense that you pay, usually after you’ve met your deductible. For example, if the plan pays 80% of an expense, the other 20% is your coinsurance.
Copay: A flat-dollar amount you pay for health-related services. Normally, you’re expected to pay your copay at the time you receive the service (for example, appointment with your doctor).
Deductible: The amount of covered health care expenses you pay out of your own pocket before the plan begins to pay part of your expenses.
Out-of-Pocket Maximum: The maximum amount you will pay for medical costs per year. After you reach your out-of-pocket maximum, your medical plan pays 100% of your covered medical costs for the rest of that plan year (copays and service-specific deductibles may still be required).
To better understand the difference between a deductible and out-of-pocket maximum, watch this short video below:
Eligible Expenses: The services and supplies eligible for reimbursement under your medical plan.
Health Savings Account (HSA): An HSA is a savings account used in conjunction with a High Deductible Health Plan (HDHP) to cover out-of-pocket qualified medical expenses on a tax-advantaged basis. DSB Technologies offers a contribution to offset eligible out-of-pocket medical, dental, and vision care services. You must be enrolled in the DSB Technologies HDHP medical plan to receive the company contribution.
For more information on HSAs, please watch the following video:
In-Network Provider: Medical providers (doctors, specialists, hospitals, and clinics) who are members of a network. In most circumstances, you will pay less for your care when you use in-network providers.
Out-of-Network Provider: Medical providers who are not members of a network. In most circumstances, you’ll pay more for your care if you use and out-of-network provider than you would if you received the same services from an in-network provider.
Flexible Spending Account (FSA): A Flexible Spending Account allows you to contribute pre-tax money for healthcare and/or dependent care. Healthcare expenses include eligible out-of-pocket medical, dental, and vision services established by the IRS. Participating in a Flexible Spending Account will save you money on taxes. Unused contributions will be forfeited at the end of the plan year.
Understanding Your Health Plan Option
DSB Technologies offers the choice of two PPO plans and one HDHP plan. However, how do you know which plan is right for you? See below for a bit more information on the differences between a PPO and an HDHP/HSA plan.
A PPO Plan, or Preferred Provider Organization is a plan that contracts with medical providers to create a network of participating providers. These providers have agreed to provide care to the plan members at a certain rate. You can use providers outside of the network, but it will cost more.
The nice thing about a PPO is, there are usually copays for basic services, such as a visit to your doctor for an illness or a visit to a specialist for dermatology (for example). A copay is a fixed amount you will pay for the services received at the visit. Paying copays limits your responsibility to pay down the deductible.
Another point to mention, is the deductible is quite lower on a PPO Plan. For example, at DSB Technologies, there are two PPO Plan options, one is a $1,000 deductible and the other is a $2,000 deductible (in-network); both are much lower than the HDHP. However, as the costs seem less overall, the monthly premiums you will have deducted from your paycheck are quite a bit higher than the HDHP. You will also not have access to the HSA (discussed on future pages), but you can participate in Flexible Spending for Medical and/or Dependent Care.
You may want to enroll in the PPO Plan if:
- You do frequent the doctor
- You have many prescriptions
- Want a lower deductible, but don’t mind paying a bit more in monthly premiums.
A HDHP is a High Deductible Health Plan. Which means, you will have to meet a higher deductible before the plan begins to pay, but that is in exchange for lower monthly premiums taken from your paycheck.
For example, at DSB Technologies, the HDHP for single coverage (in-network) is $3,000. That means that you will have to pay $3,000 before your plan pays, BUT there is a bit more to it!
If you enroll in the HDHP at DSB Technologies, you will receive a contribution to your Health Savings Account (HSA) in the amount of $500 FREE from DSB Technologies to help you offset that high deductible. (HSA’s will be discussed more in depth on future pages).
You may want to enroll in the HDHP if:
You do not frequent the doctor
Want to save money on your premiums
Have money set aside to cover your deductible should something big happen, such as an accident, etc.
Still not sure if the HDHP/HSA plan is right for you? Watch this short video for additional considerations and information: