Which plan is right for me?
We encourage you to use the tools on the Mercer Marketplace 365+ enrollment system to complete a plan comparison for your own particular situation if you haven’t done so already. For illustrative purposes only, the rest of this section outlines a few sample scenarios.
Single Cigna example
| Medical Plan Utilization - Light User | 900 PPO | 1850 HSA | 2850 HSA |
|---|---|---|---|
| Jake is a healthy person in his mid-20s. Jake does not use tobacco. Last year, he went to the doctor for his annual check-up and took one preferred brand prescription each month. While he is an avid skier, he doesn’t anticipate any major medical expenses this year. | Preventive 100% $407 (Member pays applicable copays) | Preventive 100% $582 (Member pays full cost for services up to the $1,850 deductible) | Preventive 100% $582 (Member pays full cost for plan expenses up to the $2,850 deductible) |
| Total employee spend at the time of care | $407 | $582 | $582 |
| HSA employer contribution | N/A | $500 | $500 |
| Employee Out-of-Pocket Costs | |||
| Cigna - employee only premium tier | $2,249 ($187.39 x 12) | $1,312 ($109.35 x 12) | $660 ($55.04 x 12) |
| Total employee cost | $2,656 | $1,394 | $742 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Moderate User | 900 PPO | 1850 HSA | 2850 HSA |
| Jake is a relatively healthy person in his mid-20s. Jake does not use tobacco. Jake takes one monthly brand preferred medication. Jake has recently been having back problems, he saw a specialist, had one x-ray and an MRI and had 6 visits to the chiropractor. | Preventive 100% $967 (Member pays applicable copays, deductible and coinsurance) | Preventive 100% $1,934 (Member pays deductible and 20% coinsurance) | Preventive 100% $2,270 (Member pays deductible and 30% coinsurance) |
| Total employee spend at the time of care | $967 | $1,934 | $2,270 |
| HSA employer contribution | N/A | $500 | $500 |
| Employee Out-of-Pocket Costs | |||
| Cigna - employee only premium tier | $2249 ($187.39 x 12) | $1,312 ($109.35 x 12) | $660 ($55.04 x 12) |
| Total employee cost | $3,216 | $2,746 | $2,430 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Heavy User | 900 PPO | 1850 HSA | 2850 HSA |
| Jake is a relatively healthy person in his mid-20s. Jake does not use tobacco. Jake had a ski accident that resulted in a head injury and broken leg for which he needed surgery which included hospitalization and 12 sessions of physical therapy to recover. | Preventive 100% $3,000 (Member pays plan out of pocket maximum) | Preventive 100% $3,500 (Member pays plan out of pocket maximum) | Preventive 100% $5,500 (Member pays plan out of pocket maximum) |
| Total employee spend at the time of care | $3,000 | $3,500 | $5,500 |
| HSA employer contribution | N/A | $500 | $500 |
| Employee Out-of-Pocket Costs | |||
| Cigna - employee only premium tier | $2,249 ($187.39 x 12) | $1,312 ($109.35 x 12) | $660 ($55.04 x 12) |
| Total employee cost | $5,249 | $4,312 | $5,660 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
Family Cigna example
| Medical Plan Utilization - Light User | 900 PPO | 1850 HSA | 2850 HSA |
|---|---|---|---|
| Joe and his wife Katherine are a generally healthy couple in their late 40s. They see the doctor annually for their preventive visits. Their daughter Anne has asthma for which she sees a specialist 4 times a year and uses an inhaler that she refills every month. This year she had to go to the emergency room when she had asthma attack. | Preventive 100% $1,942 (Member pays applicable copays, deductible, and coinsurance) | Preventive 100% $2,196 (Member pays full cost for services up to the $3,700 deductible) | Preventive 100% $3,069 (Member pays full cost for plan expenses up to the $5,700 deductible) |
| Total employee spend at time of care | $1,942 | $2,196 | $3,069 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Cigna - family premium tier | $7,589 ($632.42 x 12) | $4,808 ($400.68 x 12) | $2,853 ($237.77 x 12) |
| Total employee cost | $9,531 | $6,004 | $4,922 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Moderate User | 900 PPO | 1850 HSA | 2850 HSA |
| Joe and his wife Katherine are a generally active, healthy couple in their late 40s. They see the doctor annually for their preventive visits. Katherine sprained her ankle hiking. She went to urgent care, had an x-ray, saw a specialist twice and had to go to 6 sessions of physical therapy. Their daughter Anne has asthma for which she sees a specialist 4 times a year and uses an inhaler that she refills monthly. This year she had to go to the emergency room when she had an asthma attack. | Preventive 100% $2,153 (member pays applicable copays, deductible and coinsurance) | Preventive 100% $3,987 (member pays deductible and 20% coinsurance) | Preventive 100% $4,515 (member pays deductible and 30% coinsurance) |
| Total employee spend at time of care | $2,153 | $3,987 | $4,515 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Cigna - family permium tier | $7,589 ($632.42 x 12) | $4,808 ($400.68 x 12) | $2,853 ($237.77 x 12) |
| Total employee cost | $9,742 | $7,795 | $6,368 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Heavy User | 900 PPO | 1850 HSA | 2850 HSA |
| Joe and his wife Katherine are a generally active, healthy couple in their late 40s. They see the doctor annually for their preventive visits. Katherine recently had a baby with complications that required her and the baby to be hospitalized for a week. Their daughter Anne has asthma for which she sees a specialist 4 times a year and uses an inhaler that she refills monthly. This year she had to go to the emergency room when she had an asthma attack that ultimately ended with a 4 day stay in the hospital. | Preventive 100% $6,000 (Member pays plan out of pocket maximum) | Preventive 100% $6,500 (Member pays plan out of pocket maximum) | Preventive 100% $11,000 (Member pays plan out of pocket maximum) |
| Total employee spend at time of care | $6,000 | $6,500 | $11,000 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Cigna - family premium tier | $7,589 ($632.42 x 12) | $4,808 ($400.68 x 12) | $2,853 ($237.77 x 12) |
| Total employee cost | $13,589 | $10,308 | $12,853 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
Single Kaiser example
| Medical Plan Utilization - Light User | 900 | 1850 HSA | 2850 HSA |
|---|---|---|---|
| Jake is a healthy person in his mid-20s. Jake does not use tobacco. Last year, he went to the doctor for his annual check-up and took one preferred brand prescription each month. While he is an avid skier, he doesn’t anticipate any major medical expenses this year. | Preventive 100% $407 (Member pays applicable copays) | Preventive 100% $582 (Member pays full cost for services up to the $1,850 deductible) | Preventive 100% $582 (Member pays full cost for plan expenses up to the $2,850 deductible) |
| Total employee spend at time of care | $407 | $582 | $582 |
| HSA employer contribution | N/A | $500 | $500 |
| Employee Out-of-Pocket Costs | |||
| Kaiser - employee only premium tier | $1,967 ($163.90 x 12) | $1,011 ($84.26 x 12) | $520 ($43.33 x 12) |
| Total employee cost | $2,374 | $1,093 | $602 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Moderate User | 900 | 1850 HSA | 2850 HSA |
| Jake is a relatively healthy person in his mid-20s. Jake does not use tobacco. Jake takes one monthly brand preferred medication. Jake has recently been having back problems, he saw a specialist, had one x-ray and and an MRI and had 6 visits to the chiropractor | Preventive 100% $967 (Member pays full cost for services up to the $1850 deductible) | Preventive 100% $1,934 (Member pays deductible and 20% coinsurance) | Preventive 100% $2,270 (Member pays deductible and 30% coinsurance) |
| Total employee spend at time of care | $967 | $1,934 | $2,270 |
| HSA employer contribution | N/A | $500 | $500 |
| Employee Out-of-Pocket Costs | |||
| Kaiser - employee only premium tier | $1,967 ($163.90 x 12) | $1,011 ($84.26 x 12) | $520 ($43.33 x 12) |
| Total employee cost | $2,934 | $2,445 | $2,290 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Heavy User | 900 | 1850 HSA | 2850 HSA |
| Jake is a relatively healthy person in his mid-20s. Jake does not use tobacco. Jake had a ski accident that resulted in a head injury and broken leg for which he needed surgery which included hospitalization and 12 sessions of physical therapy to recover. | Preventive 100% $3,000 (Member pays plan out of pocket maximum) | Preventive 100% $3,500 (Member pays plan out of pocket maximum) | Preventive 100% $5,500 (Member pays plan out of pocket maximum) |
| Total employee spend at time of care | $3,000 | $3,500 | $5,500 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Kaiser - employee only premium tier | $1,967 ($163.90 x 12) | $1,011 ($84.26 x 12) | $520 ($43.33 x 12) |
| Total employee cost | $4,967 | $3,511 | $5,020 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
Family Kaiser example
| Medical Plan Utilization - Light User | 900 | 1850 HSA | 2850 HSA |
|---|---|---|---|
| Joe and his wife Katherine are a generally healthy couple in their late 40s. They see the doctor annually for their preventive visits. Their daughter Anne has asthma for which she sees a specialist 4 times a year and uses an inhaler that she refills every month. This year she had to go to the emergency room when she had asthma attack. | Preventive 100% $1,942 (Member pays applicable copays, deductible and coinsurance) | Preventive 100% $2,196 (Member pays full cost for services up to the $3,700 deductible) | Preventive 100% $3,069 (Member pays full cost for plan expenses up to the $5,700 deductible) |
| Total employee spend at time of care | $1,942 | $2,196 | $3,069 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Kaiser - family premium tier | $6,638 ($553.16 x 12) | $3,679 ($306.57 x 12) | $2,230 ($185.87 x 12) |
| Total employee cost | $8,580 | $4,875 | $4,299 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Moderate User | 900 | 1850 HSA | 2850 HSA |
| Joe and his wife Katherine are a generally active, healthy couple in their late 40s. They see the doctor annually for their preventive visits. Katherine sprained her ankle hiking. She went to urgent care, had an x-ray, saw a specialist twice and had to go to 6 sessions of physical therapy. Their daughter Anne has asthma for which she sees a specialist 4 times a year and uses an inhaler that she refills monthly. This year she had to go to the emergency room when she had an asthma attack. | Preventive 100% $2,153 (Member pays applicable copays, deductible, and coinsurance) | Preventive 100% $3,987 (Member pays deductible and 20% coinsurance) | Preventive 100% $4,515 (Member pays deductible and 30% coinsurance) |
| Total employee spend at time of care | $2,153 | $3,987 | $4,515 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Kaiser - family premium tier | $6,638 ($553.16 x 12) | $3,679 ($306.57 x 12) | $2,230 ($185.87 x 12) |
| Total employee cost | $8,791 | $6,666 | $5,745 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||
| Medical Plan Utilization - Heavy User | 900 | 1850 HSA | 2850 HSA |
| Joe and his wife Katherine are a generally active, healthy couple in their late 40s. They see the doctor annually for their preventive visits. Katherine recently had a baby with complications that required her and the baby to be hospitalized for a week. Their daughter Anne has asthma for which she sees a specialist 4 times a year and uses an inhaler that she refills monthly. This year she had to go to the emergency room when she had an asthma attack that ultimately ended with a 4 day stay in the hospital. | Preventive 100% $6,000 (Member pays plan out of pocket maximum) | Preventive 100% $6,500 (Member pays plan out of pocket maximum) | Preventive 100% $11,000 (Member pays plan out of pocket maximum) |
| Total employee spend at time of care | $6,000 | $6,500 | $11,000 |
| HSA employer contribution | N/A | $1,000 | $1,000 |
| Employee Out-of-Pocket Costs | |||
| Kaiser - family premium tier | $6,638 ($553.16 x 12) | $3,679 ($306.57 x 12) | $2,230 ($185.87 x 12) |
| Total employee cost | $12,638 | $9,179 | $12,230 |
| HSA fund carry over for next plan year | N/A | $0 | $0 |
| **The numbers used above are for illustrative purposes only. Actual prices are based on services rendered and discounted rates at the time of service. Actual savings will vary. | |||