Thursday, January 16, 2014

Cat Plan and HSA Update [UPDATED]

[Please scroll down for update - Thanks!]

So it turned out that my prediction regarding the availability of Catastrophic plans to the over-30 crowd has been confirmed: of the 5 major carriers in this market (southwest Ohio), only 1 offers this option. Surprisingly (to me, anyway), that carrier is Golden Rule, er, United Health One. None of the others surveyed offer it.

On the one hand, 20% is still decent, but I think it's unlikely that any of the other carriers are going to be scrambling to get a piece of that action.

And while we're on the subject of high deductible plans, Bob pointed out, in comments to yesterday's same-sex couples' insurance woes post) that "Some HDHP (HSA qualified) plans use an aggregated deductible for family plans. As a family you must satisfy $12,000 in expenses before the carrier pays [aggregate model]. But if you split them into two separate plans the carrier will pay once you (as an individual) hit $6,000 [embedded model]."

This is a critical point of distinction, and I did a little digging this morning to see which plans offered which model. So far, it appears that all of our carriers are going the aggregate deductible route [incorrect: please see update below].

This is important because, as Bob noted, the aggregate model requires that the entire family's deductible (usually two or three times the individual) must be met before covered expenses are paid. To take the example of the folks in North Carolina, an aggregate deductible means that either one or both of them must have enough expenses to meet the $12,700 (Bronze plan) family deductible; with separate policies, one might easily satisfy the $6,350 individual deductible and be done with it.

One last note: only one of the carriers' brochures (Anthem) explicitly states this; I had to contact each of the others to find out. I think that's a bit disingenuous on the carriers' part.

: As it turns out, I was initially misinformed about one carrier's "take" on the embedded/aggregate issue and HSA's. Late yesterday afternoon, my Assurant rep called to let me know that his company's HSA-compliant plans do, in fact, use embedded deductibles. As noted above, this can be a very important factor when comparing plans, especially for couples.

Good to know, and Thanks to Assurant's William W. for the heads' up.
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