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 visit 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 some rashes that won’t go away. Each trip includes a few generic prescriptions that Sanjay fills at the pharmacy.

$150 visit x 8
$25 generic x 16

Cost

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

$700 preferred brand x 2
$500 preferred brand mail order x 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 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 also been paying for medical coverage from His paycheck and contributing to His HSA. 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 plan, he pays copays.

HSA Core
HSA Value
Copay PPO
Costs paid by
 
Sanjay
$4,860
$4,860
$1,940
Paycheck deductions
$8,036
$9,303
$12,094
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided HSA 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
$8,036
$9,303
$12,094
Employee HSA contributions
$1,000
$1,000
N/A
Company-provided HSA contributions
($1,000)
($1,000)
N/A
Sanjay
’s
 total cost
$12,896
$14,163
$14,034

For more information about the LSC Medical Plans, review the Benefits eGuide. Remember, this is an example and your actual costs may vary.