My wife doesn't work outside the home so I've always chosen medical coverage.
At Fermi I was in an two different HMOs. The one run by Blue Cross SUCKED!!! I think it cost me 55 a paycheck with 15 dollar co pays. The trouble was if you got a referal to a specialist it was only good for one visit. So if you had to see the same specialist 5 times you'd need to see your Primary Care physician 5 times too. It really added up.
The second HMO I was in was AWESOME. I believe it was called HAP. I think it ran me maybe 45 a pay check, with a 15 dollar co pay. They paid the bills quickly, a referal was worth 5 visits to the specialist, and if the specialist needed to see you past that the Primary Care physician would call HAP and that was that.
Overall Blue Cross in Michigan really bit, and DTE Benefits was not of any assistance whatsoever. Blue Cross rarely enforced their negotiated rate and if you called the people from DTE who were supposed to straighten it out they'd say it sounds like an individual problem. DTE also did some sneaky stuff when you signed up each year. For instance if you were a smoker you had to pay more, I don't have a problem with that. HOWEVER when you signed up when they asked Are You A Smoker the DEFAULT answer was yes and was buried below the question. It was the same for Do You Have Other Primary Coverage?
I don't remember what the Opt out price was but I'm thinking it couldn't have been over 1000 dollars for the year.
TVA isn't bad at all. We don't have as many choices as I did at DTE and they're a tad bit more expensive. Not enough to make a difference though. The Base Plan is an 80% Blue Cross plan, it costs me 80 per pay check. My deductible is 300 Ind/ 600 Family after that they pay 80% up to a stop loss of 2500/5000 for 2006. ( I will say I do believe raising the stop loss every year is BS). After that they cover it 100%. I do wish they had an HMO.
I pay a bit more, but Blue Cross Tennessee is spectacular about enforcing their rules, paying their portion, and making sure you understand your obligations when you go to Emergency Rooms and for stuff like surgery. If you ask TVA for help, they get things straightened out. (which I only had to do once, but by the time TVA got involved Blue Cross had realized their mistake, the point is, when I explained the situation to TVA they said ok Mike we got the ball).
My guess is if it was just me and my wife I'd go the CDHP route because she and I rarely get sick and usually when we do we just gut it out.
I know there are those who will say 80% with 80 a pay check is really paying an extra 2600 or so a year BUT when you have kids and major stuff comes up it pays for itself. My daughter had her tonsils out, then a week later suffered a complication. WE'd already paid off her deductible. I had fully figured on paying up to the stop loss. When I got the full bill for her surgery, PLUS an overnight emergency room stay due to the complication it came to around 550, out of a total of more than 15,000. You really can't beat that.
I'm not sure if TVA offers an opt out. Another thing I think where TVA really was superior to my old company. My first week here we had an HR person explain EVERY benefit plan and help you fill out the paperwork. Same with retirement 401K and moving benefits. Within 2 weeks of me moving to Tennessee I was all straightened out on everything. Realistically I was all set the first day I showed up. By the way, for those of you who have been through Company Orientations I believe TVA probably has the industry standard for the Utility Industry. It really is quite good and lasts about a week. When I hired in at Detroit Edison I showed up at corporate, signed some papers and NO ONE COULD GIVE ME DIRECTIONS TO MY PLANT. The whole orientation lasted maybe 90 minutes. I figured the best way to find the plant was get on I 75 South and look for Cooling Towers and drive towards them.
I know this was a long babble to a simple question! Sorry!!
Mike
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