Medical Plan Employee Scenario

$1,000-annual claims$3,000-annual claims$5,000-annual claims l $40,000-annual claims

Joe: Employee & family (spouse/same-sex domestic partner and children)

  • Medical costs = $700
  • Prescription costs = $300

Under $44,000 annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $3,834 $1,206 $241
+      
Deductible - Medical $700 $700 $700
Deductible - Rx $300 $300 $300
Coinsurance - Medical $0 $0 $0
Coinsurance - Rx $0 $0 $0
Claims paid using Purdue contribution N/A ($1,000) ($1,000)
Joe pays medical expenses + annual premium $4,834 $1,206 $241
Money left in HSA for next year  N/A  $300  $300


$44,000 and above annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $6,117 $2,178 $1,129
+      
Deductible - Medical $700 $700 $700
Deductible - Rx $300 $300 $300
Coinsurance - Medical $0 $0 $0
Coinsurance - Rx $0 $0 $0
Claims paid using Purdue contribution N/A ($1,000) ($1,000)
Joe pays medical expenses + annual premium $7,117 $2,178 $1,129
Money left in HSA for next year  N/A $300  $300 

Scenario assumes in-network providers are used in all cases and three preferred brand prescription drugs at a retail cost of $100 each.


Joe: Employee & family (spouse/same-sex domestic partner and children)

  • Medical costs = $2,400
  • Prescription costs = $600

Under $44,000 annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $3,834 $1,206 $241
+      
Deductible - Medical $1,200 $2,400 $2,400
Deductible - Rx $300 $600 $600
Coinsurance - Medical $240 $0 $0
Coinsurance - Rx $90 $0 $0
Claims paid using Purdue contribution N/A ($1,300) ($1,300)
Joe pays medical expenses + annual premium $5,664 $2,906 $1,941


$44,000 and above annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $6,117 $2,178 $1,129
+      
Deductible - Medical $1,200 $2,400 $2,400
Deductible - Rx $300 $600 $600
Coinsurance - Medical $240 $0 $0
Coinsurance - Rx $90 $0 $0
Claims paid using Purdue contribution N/A ($1,300) ($1,300)
Joe pays medical expenses + annual premium $7,947 $3,878 $2,829

Scenario assumes in-network providers are used in all cases and six preferred brand prescription drugs at a retail cost of $100 each.


Joe: Employee & family (spouse/same-sex domestic partner and children)

  • Medical costs = $4,600
  • Prescription costs = $400

Under $44,000 annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $3,834 $1,206 $241
+      
Deductible - Medical $1,200 $3,200 $4,600
Deductible - Rx $300 $300 $400
Coinsurance - Medical $680 $280 $0
Coinsurance - Rx $30 $35 $0
Claims paid using Purdue contribution N/A ($1,300) ($1,300)
Joe pays medical expenses + annual premium $6,044 $3,721 $3,941


$44,000 and above annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $6,117 $2,178 $1,129
+      
Deductible - Medical $1,200 $3,200 $4,600
Deductible - Rx $300 $300 $400
Coinsurance - Medical $680 $280 $0
Coinsurance - Rx $30 $35 $0
Claims paid using Purdue contribution N/A ($1,300) ($1,300)
Joe pays medical expenses + annual premium $8,327 $4,693 $4,829

Scenario assumes in-network providers are used in all cases and four preferred brand prescription drugs at a retail cost of $100 each.


Joe: Employee & family (spouse/same-sex domestic partner and children)

  • Medical costs = $38,000
  • Prescription costs = $2,000

Under $44,000 annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $3,834 $1,206 $241
+      
Deductible - Medical $1,200 $3,200 $4,700
Deductible - Rx $300 $300 $300
Coinsurance - Medical & Rx* $3,300 $3,350 $1,850
Claims paid using Purdue contribution N/A ($1,300) ($1,300)
Joe pays medical expenses + annual premium $8,634 $6,756 $5,791

“Reaches out-of-pocket-maximum. In 2016, the Purdue Health Plan Plus HSA 1 and Purdue Health Plan Plus HSA 2 medical plans include an individual out-of-pocket maximum of $6,850 (in-network) and $13,700 (out-of-network). Remaining family members will continue to pay expenses until the total family out-of-pocket maximum is met.

 


$44,000 and above annual salary

  Purdue Health Plan Purdue Health Plan Plus HSA 1 Purdue Health Plan Plus HSA 2
Annual deductible
= $1,500
Annual deductible
= $3,500
Annual deductible
= $5,000
Joe pays: Joe pays: Joe pays:
Annual premium $6,117 $2,178 $1,129
+      
Deductible - Medical $1,200 $3,200 $4,700
Deductible - Rx $300 $300 $300
Coinsurance - Medical & Rx* $3,300 $3,350 $1,850
Claims paid using Purdue contribution N/A ($1,300) ($1,300)
Joe pays medical expenses + annual premium $10,917 $7,728 $6,679

*Reaches out-of-pocket-maximum. In 2016, the Purdue Health Plan Plus HSA 1 and Purdue Health Plan Plus HSA 2 medical plans include an individual out-of-pocket maximum of $6,850 (in-network) and $13,700 (out-of-network). Remaining family members will continue to pay expenses until the total family out-of-pocket maximum is met.

 

Scenario assumes in-network providers are used in all cases and twenty preferred brand prescription drugs at retail costs of $100 each.

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