What a difference a month makes

Posted on April 22, 2013
Tags: society

Normally employers switch to a new health plan on January 1. However, this year, my employer decided to switch plans on February 1. Due to the fact that plans operate on a calendar year, this ended up costing me an extra $1465.48, even though they promised me it wouldn’t.

My understanding is that our plans were thus:

My prescriptions are expensive enough (technically something north of $6000 per month, I believe) that we can essentially model the prescription cost as “infinity.” Therefore, the fact that the percentage changes at some inflection point (“the deductible”) is irrelevant, as is the exact percentage that has to be paid between the “deductible” and “stop loss.” All that really matters is the total amount that has to be paid out of pocket per year. (Which the company’s “insurance broker,” Diana, calls “stop loss.”) In other words, the total amount per year that has to be paid is $4500 for the old plan, and $5000 for the new plan.

So firstly, I’d like to call BS on the assertion that the new plan is “better” than the old plan. The old plan cost $4500 per year, and the new plan costs $5000 per year. Although that’s a fairly small difference, it’s still obvious that the new plan is slightly “worse” than the old plan.

Secondly, I’d like to call BS on the assertion that switching recklessly between January and February, instead of at the end of the year, wasn’t going to cost me any extra. Despite Diana’s statement to the contrary when I asked her at the company meeting where the transition was presented, it now appears that only the “deductible” (i. e. $3000) is transferable from the old plan to the new plan. In January, for Blue Shield, I paid a total of $4465.48. (i. e. $3500 of “deductible” and $965.48 of “stop loss”) But only $3000 of that is applicable to Anthem, meaning essentially that switching between January and February cost me an extra $1465.48 versus if the company had switched insurance at the new year.

The point isn’t really about the $1465.48. It’s a matter of principle. I feel like I’ve been misled, and have had a great deal of difficulty getting a straight answer out of anybody about the insurance. Also, I feel that switching insurance one month into the year was extremely reckless and careless.