Three Plans
One is from Blue Cross and the other two are from Fallon. The two Fallon plans are the same plan design just different networks, Direct and Select (City of Worcester is calling it Advantage). Direct is smaller network mainly the old Fallon Clinics and if you are not already in the Direct network, it is hard to get a PCP. Select, on the other hand, matches up with Blue Cross except that they only have access to the Boston Hospitas through their Peace of Mind program.
My fiiend doctors do not accept Fallon Direct, so his choices are to stay with Blue Cross or go to Fallon Select. he does not want to change doctors
- Blue Cross total premium is 1652.49
- Blue Cross employee cost will cost 413.12 per month
- Fallon total premium is 1339.12
- Fallon Select employee cost 349.78 per month
- 63.34 per month difference
- 760.08 annual difference
There really is not much difference between the two plans, some slights ones with co-payments and extra like fitness benefits etc. The real difference is in the tiering of hospitals when it comes to day surgeries and hospitalizations. What is this?The plans are starting to put hospitals in dfiferent categories.
Blue Cross will charge, you either 150/200/500 for day surgeries and hospitalizations depending on which hospital you go to, after plan year deductible is paid (250). Click here for the list. Medical City or Saint Vincets (Enhanced Hospital) will cost 150, while UMASS (Belmont or Lake Ave) will cost 500 (Basic). Please note Harrington considered basic.
Fallon will charge 150/300 for day surgeries and 250/500 for Hospitalizations depending on which hospital you go to, after plan year deductible is paid (250).. Click here for their list. All the hospitals in Worcester would be in the first tier so day surgeries will cost 150 and hospitalizations will cost 250 at UMASS or Med City (Saint Vincent's).
What should he choose?
First his doctors utilizie UMASS so it would cost him more if he had Blue Cross (500) versus either (150 or 250) if he had Fallon. So he went with Fallon Select right?? No he did not. He likes the fact that Blue Cross has the Boston Hospitals in the network and does not have to go through Fallon's Peaace of Mind Program. It was worth the extra 63.34 pre month to him.
Flat Dollar
In the end the City of Worcester would rather see my friend go with Fallon since the premium for Blue Cross.
- Blue Cross monthly total premium is 313.37 more per month then Fallon or 3760.40 annual
- Employee total monthly premium is only 63.32 more per month then Fallon or 760.08 annual
- The City of Worcester is paying nearly 3,000 more towards the cost of an employee choosing Blue Cross over Fallon.
1 comment:
To steal a phrase, "is it just me" or is anyone else getting fed up with these editorial articles that take up 1/3 of the editorial page and seem to be almost always written by the usual whiners pushing their often clueless agendas...like............non profit titans, colleges students, college professors, politicians, gub'mint employees, quasi gob'mint employees, and nurses...none of whom have any real world experrience managing, running or owning a business......yet they have all the answers
hey how about this.............I work at St Gobain and I have to physically bust my ass to make my daily piece work quota and when all the dust settles (abrasive dust into my lungs) I still only make $18.00 and my ass is dragging everyday just driving home........and BTW I breathe that crap 9 hours a day.....not just when I get called out of the "House".........and also BTW .....the product of which I am an intergral part of the production process is critcal to well being, health, and safety of Americans
So on Bluto this morning some $54 per hour empoyees claim patient safety and care is their primary objective.........yet when questioned why then would they walk out on their patient care work obligations........they retort by calling the replacement nurses scabs and what these replacemnt nurses are doing as immoral.........HUH???
And dont anyone tell me that some day I may need thsoe who I criticize, becuz someday you re all going to need what it si that i manfacture....but I just toil at my job daily, and no even knows I nor my job even exists.
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