open enrollment 2025

[azucena]

Just sat through open enrollment mtg...

- healthcare prems for me and my family going up 8% to $815/month. Company covers 77% of the total cost. Deductible is $900 indiv/$1800 per family which hasn't changed in a couple of years. Note that this is the top of the line plan with copays of $35 for specialist, $50 for urgent care, $200 ER.
    - mental health continues to be covered at 100% so I never pay for therapy
SO THANKFUL as my DH costs a small fortune in ostomy supplies.

- they noticed that 15% of total medical spend was musculoskeletal so are adding Hinge Health app for prevention and virtual physical therapy. Might check it out for exercises for my back.

- expanded coverage for critical illness for children. I'm not super sold on CI but might peek at it.

- new stock purchase plan open to everyone. Buy 4 stocks, get one free from the company.

- new lifestyle spending account (LSA) with $500 on a spending card to be used for employee's physical, financial or emotional wellbeing.
     - can buy anything athletic related, weight loss, gym membership, etc
     - can be used for student loan, fin advisor, estate planning, etc
     - massages, cooking classes, park passes, etc
     - basically they're not going to police it too much as long as you think you can justify it in physical, fin, emotional.
PRETTY COOL!

- expanded EAP options and better provider

- LTC - life insurance hybrid product group rate negotiated; portable policy
    - might glance at costs to get an idea; will look into this when I'm 55+

No changes to
- 401k 3% match on 5%
- employer paid life insurance at 2.5 x (salary + benefits)
- long term incentive stock options for VP+
- pension plan

This is why even though I complain about my job and my boss and how my company has changed over the years, I know I won't be able to replicate these benefits anywhere else. Overall feeling very grateful and thinking I'll treat myself to more massages next year using LSA card.

FWIW they said industry average healthcare prem increase is 9%.

How are your benefits looking?

[raeoflyte]

We got new insurance Friday 11/1. They haven't filled it yet but site says it will fill a 90 day supply of insulin pumps for $105, and the same for a 90 day supply of sensors. If that's true...I'm going to cry happy tears.

I can't make myself believe it, but if that's true, then that's the cost before hitting a deductible and I'm paying $460 a month for family coverage.

$20 copay for therapy so I saved $105 on my session last night.

[minnesotapaintlady]

I'm on a cheap HDHP, and it's going from $121 to $133/month for me +kids. It has a $5000 individual deductible and comes with a $1000 HSA contribution from our employer.  

The low deductible plan which is up 9% to $488/month for employee+ kids has a $750 deductible ($2250 family).  $20 copay for physician, $40 for specialist and $200 for ER. 

We have the Hinge Health as well which seems like a huge waste of money to me.  They're sent me this thing to put vibrating pads on my knees and it was almost 2K insurance paid!

Otherwise, it's a lot of the typical benefits of a large employer.  Discounts on a lot of things like gym memberships and phone plans, free consultations with attorneys and financial advisors, tele health and EAP, STD, LTD, LTC, life...

[daisylu]

We like Hinge Health. They sent us a tablet and sensors to wear that interact with app.  Has definitely helped with back issues.

Other than that our insurances suck but at least we pay very little for them. But with no one at home with chronic health issues it makes sense for us to go lower tier and load HSAs.

[azucena]

Guess I could add my other options...I'll run the math this weekend but with ostomy supplies at $600/month the low deductible always wins.

Mid tier medical plan for family is $460/month with deductibles of $2000/$4000. Co contributes $600/$1200 to HSA.

Lowest plan is $350/month; $2500/$5000 deductible; HSA contribution $300/$600.


Interesting that others have Hinge Health.

[wvugurl26]

DH has Hinge Health but he never uses it. They send fliers, that's how I know.

Our open enrollment doesn't start until Monday but I snagged my 2025 rates last week. It's actually going down $0.91/check for me. It's an open access HMO and the premium is obscene to me. It was $65/check in 2010 when I started.

I compare each year but the math isn't straightforward. I basically pay $0 for my prescriptions. For the cheaper plans, I'd owe something and that would be with after tax dollars. As DINK with 6 figure salaries, there aren't many tax breaks.

DH rarely goes to the doctor so I can't justify Cadillac coverage for him. I have bad years where I've hit OOP max. This year is a pretty heavy utilization year for me.

It's interesting my brother has the same insurance and pays way less. He's got a blue collar union job though so the union is picking up the difference. We are open about finances so I know his union dues plus premium aren't as much as my premium.

[raeoflyte]

Nov 7, 2024 17:38:10 GMT -5 azucena said:

Guess I could add my other options...I'll run the math this weekend but with ostomy supplies at $600/month the low deductible always wins.

Mid tier medical plan for family is $460/month with deductibles of $2000/$4000. Co contributes $600/$1200 to HSA.

Lowest plan is $350/month; $2500/$5000 deductible; HSA contribution $300/$600.


Interesting that others have Hinge Health.

The hsa has always been better for us with high rx costs, but I'm hoping they'll get a couple of these filled before I have to do open enrollment for next year.

[Cookies Galore]

We're getting our first premium increase in a few years - going from $363/month to $394/month for employee + spouse coverage. This is for no deductible, no coinsurance, $1,000 individual max OOP, $15 copays, 100% covered labs and imaging.

I'm paying a lot for my husband (employee only would be $115/month). He's lucky I love him, lol.

[Ava]

Can anyone explain what 0% copay after deductible means?
Thank you

I know it sounds self explanatory, but the max. Out of pocket is higher than the deductible.
So my question is, it's 0% the company will pay, or 0% the employee will pay?
And if it's 0% for the employee, why is the max out of pocket higher than the deductible?

There are 2 other plans that have 50% and 70% copay respectively.

The 0% is an ACO plan.

[seriousthistime]

Are some services not 0% copay?

[chiver78]

Nov 7, 2024 16:42:23 GMT -5 azucena said:

How are your benefits looking?

not nearly as good as I'm looking at COBRA as of next Friday. 

that said, I've still been getting all the emails from HR that open enrollment closes tomorrow. I've got half a mind to complete it, just to fuck with the system. lol... 

[grumpyhermit]

Nov 14, 2024 13:36:49 GMT -5 Ava said:

Can anyone explain what 0% copay after deductible means?
Thank you

I know it sounds self explanatory, but the max. Out of pocket is higher than the deductible.
So my question is, it's 0% the company will pay, or 0% the employee will pay?
And if it's 0% for the employee, why is the max out of pocket higher than the deductible?

There are 2 other plans that have 50% and 70% copay respectively.

The 0% is an ACO plan.

Does your plan also have coinsurances?

www.nerdwallet.com/article/health/coinsurance-vs-copay

[NastyWoman]

Nov 14, 2024 16:02:16 GMT -5 chiver78 said:

Nov 7, 2024 16:42:23 GMT -5 azucena said:

How are your benefits looking?

not nearly as good as I'm looking at COBRA as of next Friday. 

that said, I've still been getting all the emails from HR that open enrollment closes tomorrow. I've got half a mind to complete it, just to fuck with the system. lol... 

You go girl. I did the same in October '21 when I knew that I would retire in December. I just hadn't announced it yet so I just enrolled anyway. 

[chiver78]

Nov 14, 2024 16:19:31 GMT -5 NastyWoman said:

Nov 14, 2024 16:02:16 GMT -5 chiver78 said:

not nearly as good as I'm looking at COBRA as of next Friday. 

that said, I've still been getting all the emails from HR that open enrollment closes tomorrow. I've got half a mind to complete it, just to fuck with the system. lol... 

You go girl. I did the same in October '21 when I knew that I would retire in December. I just hadn't announced it yet so I just enrolled anyway. 

legit, depends on my mood in the morning. we were given instructions to update ADP (payroll) with a personal email address prior to termination. I checked back then, and that wasn't an option. my boss (also getting cut) asked me if I'd ever figured it out, b/c I asked him when I first checked. I followed up, and it's still not an option. oh, and ADP directs us to HR. so, I reach out to HR and get told some bullshit about Workday. well, the only contact info Workday ever had was from my resume, which is the same damn email I'm trying to add to ADP. why wasn't it tracking to shit I could see, so that I knew that I'd updated as requested? why do I have to waste both our time with this garbage? 

*after writing all of this out and my last post in the what are you doing? thread, I'm signing up tomorrow for the annual enrollment. fuck all of them haha. I won't wish away the weekend, I'm heading to CT to spend the weekend with friends, but next week needs to fly by. I'm well past over ALL of it. 

[Pink Cashmere]

My insurer also offers HingeHealth, I am guessing that those of us that use that term probably have the same insurer, one way or another. You’d think I would’ve taken advantage of it by now, given the nature of my job, but I haven’t so far. 

A lot of my coworkers have been fussing about the price increases with their health insurance for 2025. Premiums for one of the family plans with the most popular insurer will cost over $800/month in 2025, which is why so many people at my job are talking about it, because that is the plan they have with that company. Mine went up less than $10, I will pay less than $180/month in 2025 for the insurance I’ve had for years, so I’m going to keep what I have, since I’ve never had any problems with it. I only insure myself now, since my children have aged out. Even if I still covered them, it would cost me less than $400/month.

This open season, I will enroll in the FSA benefit again. I’d been using that benefit every year for at least 15 years, until I got really pissed off with the company that handled the program, at the end of 2022. My employer will be using a different company in 2025, so I will go back to using the benefit.

That’s pretty much it for open season for me. 

That LSA benefit sounds like a great option!

[schildi]

I have selected the HDHP again during annual enrollment for next year.
The annual deductible has increased to $4,500 for our family of 4, but there is no monthly premium ($0.00, company pays 100%). OOP max is $6k, so our monthly cost will be somewhere between $0 (best case) to $500 (worst case).
Looking at the posts above, I am happy with our plan.
I've been maxing the HSA for the last 13 years, and paid for premiums with after tax money. Has grown to more than $200k. I am sure it will be helpful during retirement.

[jeffreymo]

Started a job last month and signed up for HDHP. I was surprised to learn that they don’t prorate the company HSA contribution and it’s a lump sum contribution, so it was funded for 2024, and then on January 1 when the new plan starts it funds again for 2025.

[resolution]

We have a high deductible plan on the Pennsylvania exchange. It went up this year from $1000 per month to $1200 per month, but our subsidy is increasing so our actual payment will be going down from $450 per month to $300 per month.

The subsidies that we are receiving will expire at the end of 2025 (unless they are stopped earlier by the new administration), so I expect we will be paying $1000+ per month for my former employer plan in 2026. As a retiree, they offer me a $300 per month subsidy, so it should end up being cheaper than an unsubsidized exchange plan, and should cover a lot more.

[raeoflyte]

Some of you have amazing plans...I am super jealous.

I'm taking a risk and not going with the hdhp plan next year. I picked the cheapest plan my new employer has (covered for 19 days so far) and they've covered ds insulin pods and cgms for $35 a month (each) and dh's nurtec for $0. Those will go up to $45 each next year. If we have ER, imaging, or testing it'll cost a decent amount, but our guaranteed costs are so low on this plan I had to try it.

[lurkyloo]

We do the HDHP plan and love it.  Premiums are about $350/month and deductible is $3300 for the family.  Basically I fill my migraine med once or twice and everything after that is free, or at least no copay for in network.  I like knowing our total cost is going to be fixed at about $7800 for the year, and I’m still under the SS cutoff on salary so that’s $8300 this year I can shield from 37% fed + 9ish% state/local plus 7.65% FICA.

Additional consideration:  DH has an old HRA with maybe 10K left in it, like a company-funded HSA except it will go away if and when he leaves his company.  Unfortunately it’s locked from 1/1-4/15 so this year I will see about paying the Jan-Feb costs OOP and getting reimbursed.

[schildi]

Nov 20, 2024 12:28:50 GMT -5 lurkyloo said:

We do the HDHP plan and love it.  Premiums are about $350/month and deductible is $3300 for the family.  Basically I fill my migraine med once or twice and everything after that is free, or at least no copay for in network.  I like knowing our total cost is going to be fixed at about $7800 for the year, and I’m still under the SS cutoff on salary so that’s $8300 this year I can shield from 37% fed + 9ish% state/local plus 7.65% FICA.

Additional consideration:  DH has an old HRA with maybe 10K left in it, like a company-funded HSA except it will go away if and when he leaves his company.  Unfortunately it’s locked from 1/1-4/15 so this year I will see about paying the Jan-Feb costs OOP and getting reimbursed.

Would you mind giving more details on the tax / FICA savings above? How does work?

[lurkyloo]

Nov 20, 2024 13:28:23 GMT -5 schildi said:

Nov 20, 2024 12:28:50 GMT -5 lurkyloo said:

We do the HDHP plan and love it.  Premiums are about $350/month and deductible is $3300 for the family.  Basically I fill my migraine med once or twice and everything after that is free, or at least no copay for in network.  I like knowing our total cost is going to be fixed at about $7800 for the year, and I’m still under the SS cutoff on salary so that’s $8300 this year I can shield from 37% fed + 9ish% state/local plus 7.65% FICA.

Additional consideration:  DH has an old HRA with maybe 10K left in it, like a company-funded HSA except it will go away if and when he leaves his company.  Unfortunately it’s locked from 1/1-4/15 so this year I will see about paying the Jan-Feb costs OOP and getting reimbursed.

Would you mind giving more details on the tax / FICA savings above? How does work?

The tax rates are our marginal rates.  Money withheld from a paycheck and deposited by the employer to an HSA is invisible to SS and Medicare taxes-but if you are earning more than the HSA withholding over the SS max then only the Medicare amount affects you   
Of note, if you make your own deposits to an HSA rather than having money withheld by the employer there is no FICA advantage.  It also slightly reduces your SS total earnings which may or may not be important in terms of SS benefit amount at retirement.

[minnesotapaintlady]

Nov 20, 2024 12:28:50 GMT -5 lurkyloo said:

We do the HDHP plan and love it.  Premiums are about $350/month and deductible is $3300 for the family.  Basically I fill my migraine med once or twice and everything after that is free, or at least no copay for in network.

Holy expensive migraine meds! 

[lurkyloo]

Nov 20, 2024 13:51:40 GMT -5 minnesotapaintlady said:

Nov 20, 2024 12:28:50 GMT -5 lurkyloo said:

We do the HDHP plan and love it.  Premiums are about $350/month and deductible is $3300 for the family.  Basically I fill my migraine med once or twice and everything after that is free, or at least no copay for in network.

Holy expensive migraine meds! 

It’s the difference between being curled up whimpering for days or being functional after an hour’s kick-in time    I suspect I would probably qualify as disabled without effective meds.

DS’s ADHD med is also like $400 a month* so we’re going to hit the deductible anyway and it’s easier to reimburse 2-3 things than 8-9.  My coworker has the upscale plan, where the monthly premiums add up to the same total as HDHP premiums + deductible and he still has copays.  I don’t understand his logic but whatever.

*yes there is a generic.  it’s never ever in stock and its existence causes all kinds of trouble with getting the name brand, which is not in shortage, filled.

[minnesotapaintlady]

Nov 20, 2024 14:42:24 GMT -5 lurkyloo said:

Nov 20, 2024 13:51:40 GMT -5 minnesotapaintlady said:

Holy expensive migraine meds! 

It’s the difference between being curled up whimpering for days or being functional after an hour’s kick-in time    I suspect I would probably qualify as disabled without effective meds.

DS’s ADHD med is also like $400 a month* so we’re going to hit the deductible anyway and it’s easier to reimburse 2-3 things than 8-9.  My coworker has the upscale plan, where the monthly premiums add up to the same total as HDHP premiums + deductible and he still has copays.  I don’t understand his logic but whatever.

*yes there is a generic.  it’s never ever in stock and its existence causes all kinds of trouble with getting the name brand, which is not in shortage, filled.

I'm feeling very grateful that $8 Sumatriptan works for me.

[wvugurl26]

I thought the would be cash price on my inhaler was bad.

I pay the premiums because they come out tax free. And I throw the max in a FSA. I always figured if I pay less in premiums but then actually owe for prescriptions with after tax money, the math isn't working out.

[lurkyloo]

It’s newer drug and I’m now prescribed it as a preventative so double the dosage-not sure what the cost will be in January.  It’ll come down when it goes off patent.  In the meantime, somehow the pharmacy charges me slightly less than the health insurance credits me for spending, so I hit my deductible e.g. I think last year might have been $2500 actual spend to hit a $3000 deductible.  My coworker also on HDHP has noted this as well.

As a side benefit, my insurance usually is pretty easygoing about approving things.  It doesn’t object for example to the $400 name brand kid med when the $100 generic is OOS which is always. 

Like I said, I’m going in knowing that my fixed cost for the year is X or slightly less and it’s actually easier on me to hit the deductible with just a few transactions.