Which Health Insurance Plan is Right for You?
During the Annual Benefits Enrollment (ABE) period (September 28 - October 23, 2020), you will have an opportunity to select your health insurance plan for coverage effective January 1, 2021. It is important to select the plan design and health insurance carrier that best fits the needs of you and your family. To help you prepare for ABE, this article highlights what is the same and what is different between High-Deductible Health Plans (HDHP) and Non-HDHP health plans.
What is the same for the HDHP and the Non-HDHP Health Plans?
- In-network preventive services are covered at 100%.
- Both cover telehealth services at 100% without cost-sharing.
- Coverage for federally required preventive drugs at 100%.
- Both have a deductible (the amount you pay before the plan pays).
- In-network coinsurance is 10% (the amount you pay after the deductible for specific services; the plan pays the remaining 90%).
- In-network providers will provide lower out-of-pocket expenses than out-of-network providers.
- Both allow participation in the Well Wisconsin program to earn $150 wellness incentive.
- Both provide an opportunity to enroll in Uniform Dental Benefits.
- Both offer out-of-network coverage through the Access HDHP and Access Non-HDHP Health Plans. Due to out-of-network coverage, Access plans are more expensive.
- Premiums for all plans are required regardless of whether you use your health insurance.
What is different between the HDHP and the Non-HDHP Health Plans?
- HDHPs have lower premiums (the amount deducted from your paycheck).
- HDHPs include a Health Savings Account (HSA) to help you prepare for out-of-pocket expenses. An HSA provides three separate tax benefits:
- Contributions are tax-deductible.
- HSA assets may grow tax-free (through interest or investing).
- Withdrawals for qualified medical, dental and/or vision expenses are not taxed.
- HDHPs include an employer contribution to the HSA (up to $750 for single coverage, $1,500 for family) which remains in your HSA until you use it.
- Non-HDHP Health Plans have a deductible for medical services and a separate deductible for pharmacy benefits; HDHPs have a deductible that includes medical services and pharmacy benefits.
- Non-HDHP Health Plans have an out-of-pocket limit for medical services and a separate out-of-pocket limit for pharmacy benefits; HDHPs have a combined out-of-pocket limit that includes medical services and pharmacy benefits.
- Non-HDHP Health Plans have lower deductibles.
How prepared are you and your family for expected/unexpected out-of-pocket health, dental and/or vision expenses?
Review the expenses you have incurred so far in 2020 for health, dental and vision services to help you prepare for 2021. Some of the ways you can save for expected and/or unexpected health, dental and vision out-of-pocket expenses include:
- With a HDHP you may use the HSA (medical, dental and/or vision expenses) or Limited Purpose Flexible Spending Account (FSA) (dental, vision and post-medical deductible expenses) to set aside pre-tax earnings to help pay for qualifying out-of-pocket expenses.
- With a Non-HDHP Health Plan you may set aside pre-tax earnings in a Health Care FSA (pre-tax) or after-tax earnings in a personal account for out-of-pocket expenses.
- ALEX is a personalized benefits counseling tool that can help you make decisions about which benefits offered to you through UW System would be the best for you and your family. The more information you provide (typical number of office and emergency room visits, number of prescriptions per year, etc.) the more personalized the tool will be for your specific situation.
- Comparison of Health and Pharmacy Benefits for HDHP and the Non-HDHP Health Plans
- UW System Human Resources Employee Benefits website
Source: UW System Human Resources