Sorry to keep beating this horse, when we could be discussing alpa/dpa or underboob
Ok, if my math is correct in a worse case situation in network only(gold $1908 premium + $2300 deductible + $4500 coinsurance max -$1050 rewards = $7658 out of pocket)(silver $708 + $4300 + $4500 - $550 = $8958) Difference of $1300 savings going with the gold. With only the individual maximums the difference is much smaller $5008(gold) vs $5308(silver). The calculator shows the silver saves me $700 for the year based on our past use, which was a pretty standard year for us.
Originally Posted by
LeineLodge
Look at max coinsurance as well. I ran the numbers a week ago when my wife's company was in open enrollment. I don't remember the exact numbers but the max coinsurance was significantly higher for the silver than gold (if I remember correctly.)
Like scambo said, run the numbers for worst case to determine your max out of pocket should the worst occur. Worst case should be the sum of: annual premium (fixed), family deductible and max coinsurance. That will give you the maximum you could be stuck with out of pocket should something really bad happen next year.
Best case would be if you paid premiums only and no one gets sick or has any medical expenses throughout the year - you could make the case that as long as those expenses don't exceed your delta dollars then it's still $0 out of pocket for expenses. Some guys like to factor in the value of their rollover balance.
Once you have those numbers for each plan it's a risk/reward based on your expected expenses, potential for an unknown (expensive) event, and the best case/worst case numbers. It's all a trade off and what you're comfortable with.
Good luck. I absolutely hate sifting through all this stuff. Glad to have it behind me for another year.
Fwiw, we have a babysitter that watches the kids 3 days a week and we have been able to pay her with dependent FSA dollars for the past several years. Since she's not a business, she just has to sign the claim form and put her tax ID on there. The downside of this is the IRS sees us as an employer so we have to withhold FICA, unemployment, etc for her. To keep it all above the table and pay the CPA to figure it all out decreases the value of the tax benefit, BUT it's still worth it to us, and she gets some benefit in the form of SS contributions (not that it will be around for her to collect) and unemployment should she ever need it when we part ways.