Seriously...you don’t think I’ve run the numbers...every year? I shouldn’t have to explain it, but I will so you guys will stop making your claims.
It’s not that hard actually, prescription drugs.
B plan
Per paycheck premiums $353.85 x 24= $8,492.40 + $750 deductible= $9,242.40 max health care costs annually (100% pre tax money with FSA covering the deductible).
Diamond plan
Per paycheck premiums $154.94 x 24= $3,718.56 + $7,000 max out of pocket= $10,718.56 max health care costs annually.
In reality, it would effectively be $12,168.56 since only $6,368.56 (premiums + 2018 FSA limit of $2,650) of total would be with pre-tax money, the remaining $4,350 after tax money would require $5,800 in earnings at the 25% tax bracket.
Here’s the part you guys miss. The $3,000/year company funded account can not be used on prescription drugs. The Diamond plan non-formulary brand prescription drugs (tier 4 drugs) have a 50% copay (min $50/no max) until you reach your max out of pocket. Even brand drugs are 25% copay (min $25/max $300).
When you have a loved one who has a prescription drug need anywhere from $5,000-$15,000 monthly, you could easily reach the max out of pocket ($7,000) in February, all self funded, and haven’t seen a doctor or been to a hospital yet. Meanwhile, the company’s money sits unused because the out of pocket max was reached, and the plan pays the rest. So what, it rolls over, you say? Sure, same thing happens next year, and the next year, and the next.
You guys think in terms of healthy vs. catastrophic. High costs don’t just come from catastrophic events, they also come from expensive drugs associated with chronic illnesses. I’m not alone, I know of pilots and/or their loved ones with MS, cancer, genetic diseases, etc. who are in the same boat on prescription drug costs that make the Diamond plan cost prohibitive. What’s sad, it’s allowable for Spirit’s money to cover drugs, they choose not to allow it. R&I is skeptical that will ever change, but should it, I’ll be on the Diamond plan right along with you. Although, if you know you’ll hit the max out of pocket I’d argue the cost differences would be negligible.
If you are curious what was wrong in the union’s cost analysis? They showed the annual cost for the B plan including the $3,000 max out of pocket. Where that’s misleading, the plan pays 100% after the $250/$750 deductible is met, except for mental healthcare. So unless you have mental healthcare needs, it’s really just the premiums plus the deductible annually, as I showed above, which is $2,250 less than what the union analysis reflected.
This is all a moot point, the B plan is closed to new entrants. So you guys get what you believed to be true, the Diamond plan is best for everybody. Well, except those of us that were on it.
