Meet Sanjay

Sanjay's family is usually in good health. They don't use tobacco products, and they get their annual physicals. They use in-network doctors and pharmacies. Except for a few expensive medications, they have a pretty smooth year.  

Let's take a look…

Cost

All of the family members get their physicals and the kids get their immunizations.

$150 x 4
100% paid by the Company!

A few of them go to the doctor for the flu. The kids also go to the doctor a few times for sinus infections and a few rashes that won't go away. Each trip includes a few generic prescriptions.

$150 visit x 8
$25 generic x 15

Cost

Sanjay develops a condition that requires a preferred brand medication. Sanjay fills it twice at the pharmacy and the switches to mail order.

$700 preferred brand retail x 2
$500 preferred brand mail orderx 3

His wife starts feeling ill, so she goes to the to the doctor. After testing, the doctor prescribes her a generic medication. She fills it twice at the pharmacy then switches to mail order for the rest of the year.

$150 visit x 1
$100 labs x 1
$25 generic retail x 2
$20 generic mail order x 3

Sanjay's total expenses

Sanjay has incurred a total of $5,460 in expenses. Now, let’s see which plan would have been better for Him.

$5,460

in total expenses

Wait!

Sanjay has been paying for medical coverage from His paycheck too and contributing to Him HSA in those plans. We'll add that in.

Remember, Sanjay incurred $5,460 in total expenses.

In the HSA plans, Sanjay pays for his care out-of-pocket, while in the Copay PPO, he pays copays.

HSA Core
HSA Value
Copay PPO
Costs paid by
 
Sanjay
$4,860
$4,860
$1,940
Paycheck deductions
$5,888
$7,360
$11,040
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided contributions
($1,000)
($1,000)
N/A

And the winner is...

The HSA Core is the winner for Sanjay!
HSA Core
HSA Value
Copay PPO
Costs paid by
 
Sanjay
$4,860
$4,860
$1,940
Paycheck deductions
$5,888
$7,360
$11,040
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided contributions
($1,000)
($1,000)
N/A
Sanjay
's
 total cost
$10,748
$12,220
$12,980

For more information about the medical plans, review the Benefits Guide. Remember, this is an example, your actual costs may vary.