How to Decide?

Once you've decided who's eligible, it's time to decide which plans are best for you. Here are three easy steps to help.



First, look at your past claims to get a good picture of your usage. You might check a couple years if one happened to be unusual. Log in to to easily review your medical and pharmacy claims histories.



Next, take a look at the total expense for the different plans and consider:

Premiums* – Total each plan's biweekly premiums to find out what your annual costs would be.

Copays and Coinsurance* – Using your past-years medical and pharmacy usage, consider how much you might pay in copays or coinsurance with each plan over the course of a year.

Deductibles and Annual Maximum* – Consider a worst-case scenario year and what you can comfortably pay when considering your deductible and annual out-of-pocket maximum.  

*For definitions of these terms see the Good to Know section at the bottom of this page



Finally, take these things into account before making your decision:

  • If you have access to other group health coverage through your spouse, take time to understand which plan is the best fit for you and your family by comparing out-of-pocket costs, premiums and coverage options.

  • Think about regularly putting money, to be used on medical expenses, into a Health Savings or Flex Spending account. These are pre-tax payroll deductions so you'll use tax-free dollars on your care.

  • Use the free My WealthCare Online cost comparison tool provided by Benefit Planning Consultants (BPC). It takes less than five minutes to estimate out-of-pocket costs for a plan. Please register if you do not already have an account set up.

  • Based on your annual usage, balance the decision to pay more up-front in premiums or pay more later in out-of-pocket expenses. What are you most comfortable with?

 Good to Know

Premium: Amount deducted from each paycheck for coverage.
Deductible: A set amount you pay first for medical services and prescriptions before the health plan starts to pay.
Copay: A set amount you pay each time you see a doctor, fill a prescription or go to the Emergency Department.
Coinsurance: A set percentage of the total cost of certain medical services covered by the plan that you pay when you use them. 
Out-of-Pocket Maximum: The maximum amount you'll pay towards all medical and prescription drug expenses each year. Once the maximum is reached, the health plan pays all additional costs for health care services and prescriptions received during the remainder of the plan year.