PPO plans
Copay plans like today’s. Listed from the lowest deductible to the highest. All in adds MetLife Mid dental, VSP Low vision and LBMC’s $31,995 fee; today’s side includes Paycor at about $1,200 a month.
| In network | TodayBlue Options 2500Today, Blue Cross NC | PPO 1LBMC, Blue Cross of TN | PPO 2LBMC, Blue Cross of TN | PPO 3LBMC, Blue Cross of TN | PPO 4LBMC, Blue Cross of TN | PPO 5LBMC, Blue Cross of TN | Most savingsPPO 6LBMC, Blue Cross of TN |
|---|---|---|---|---|---|---|---|
| DeductibleSingle / family | $2,500 / $5,000 | $500 / $1,000 | $1,000 / $2,000 | $3,000 / $6,000 | $4,000 / $8,000 | $5,000 / $10,000 | $6,350 / $12,700 |
| CoinsuranceAfter the deductible | 40% | 20% | 20% | 20% | 20% | 20% | 20% |
| Out-of-pocket maxSingle / family | $9,500 / $19,000 | $2,000 / $4,000 | $3,500 / $7,000 | $6,000 / $12,000 | $6,300 / $12,600 | $6,500 / $13,000 | $8,000 / $16,000 |
| Primary care / specialist | $30 / $150 | $20 / $40 | $30 / $50 | $50 / $75 | $25 / $50 | $25 / $50 | $25 / $50 |
| Emergency room | $1,750 | $150 | 20% after ded. | 20% after ded. | $500 | 20% after ded. | 20% after ded. |
| PrescriptionsGeneric / brand | $15 / $45 | $10 / $35 | $40 / $50 | $45 / $50 | $5 / $25 | $40 / $50 | $40 / $50 |
| Monthly premium | |||||||
| Employee only12 enrolled | $845.97 | $1,202.18 | $1,040.09 | $962.71 | $763.52 | $639.41 | $606.14 |
| Employee + spouse0 enrolled | $1,691.94 | $2,354.36 | $2,036.65 | $1,884.99 | $1,494.57 | $1,251.33 | $1,186.11 |
| Employee + children0 enrolled | $1,565.04 | $2,042.31 | $1,766.75 | $1,635.20 | $1,296.58 | $1,085.60 | $1,029.04 |
| Family1 enrolled | $2,622.51 | $3,398.52 | $2,939.79 | $2,720.80 | $2,157.09 | $1,805.88 | $1,711.71 |
| Medical, a year13 enrolled | $153,290 | $213,896 | $185,050 | $171,280 | $135,832 | $113,746 | $107,825 |
| All in, first yearMedical, dental, vision, and Paycor today or LBMC’s fee | $182,346 | $258,276 | $229,430 | $215,660 | $180,212 | $158,126 | $152,205 |
| Vs. renewing | Starting point | $75,930 more | $47,084 more | $33,314 more | saves $2,134 | saves $24,220 | saves $30,141 |
High-deductible plans (HDHP)
No copays: doctor visits and prescriptions go toward the deductible first; preventive care is free. These plans can be paired with an HSA.
| In network | TodayBlue Options 2500Today, Blue Cross NC | HDHP 1LBMC, Blue Cross of TN | HDHP 2LBMC, Blue Cross of TN | HDHP 3LBMC, Blue Cross of TN | HDHP 4LBMC, Blue Cross of TN | HDHP 5LBMC, Blue Cross of TN |
|---|---|---|---|---|---|---|
| DeductibleSingle / family | $2,500 / $5,000 | $2,500 / $5,000 | $3,300 / $6,600 | $4,000 / $8,000 | $5,500 / $11,000 | $7,400 / $14,800 |
| CoinsuranceAfter the deductible | 40% | 20% | 20% | 30% | 20% | 0% |
| Out-of-pocket maxSingle / family | $9,500 / $19,000 | $5,000 / $10,000 | $5,000 / $9,600 | $6,500 / $13,000 | $8,000 / $16,000 | $7,400 / $14,800 |
| Primary care / specialist | $30 / $150 | Deductible first | Deductible first | Deductible first | Deductible first | Deductible first |
| Emergency room | $1,750 | Deductible first | Deductible first | Deductible first | Deductible first | Deductible first |
| PrescriptionsGeneric / brand | $15 / $45 | Deductible first, then 40% / 50% | Deductible first, then 40% / 50% | Deductible first, then 30% | Deductible first, then 40% / 50% | Deductible first, then $0 |
| Monthly premium | ||||||
| Employee only12 enrolled | $845.97 | $904.96 | $761.73 | $609.64 | $541.38 | $468.59 |
| Employee + spouse0 enrolled | $1,691.94 | $1,771.80 | $1,491.07 | $1,192.98 | $1,059.18 | $916.51 |
| Employee + children0 enrolled | $1,565.04 | $1,537.03 | $1,293.54 | $1,035.00 | $918.94 | $795.20 |
| Family1 enrolled | $2,622.51 | $2,557.37 | $2,152.04 | $1,721.63 | $1,528.44 | $1,322.44 |
| Medical, a year13 enrolled | $153,290 | $161,003 | $135,514 | $108,448 | $96,300 | $83,346 |
| All in, first yearMedical, dental, vision, and Paycor today or LBMC’s fee | $182,346 | $205,383 | $179,894 | $152,828 | $140,680 | $127,726 |
| Vs. renewing | Starting point | $23,037 more | saves $2,452 | saves $29,518 | saves $41,666 | saves $54,620 |
Dental
MetLife and Delta Dental offer the same three plan designs at slightly different rates. Standard Tools pays 75% of employee-only, as today.
| TodayHumanaToday | MetLife LowThrough LBMC | In the totalsMetLife MidThrough LBMC | MetLife HighThrough LBMC | Delta LowThrough LBMC | Delta MidThrough LBMC | Delta HighThrough LBMC | |
|---|---|---|---|---|---|---|---|
| Deductible | $50 | $50 | $50 | $50 | $50 | $50 | $50 |
| Cleanings and checkups | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Fillings and extractions | 80% | 80% | 80% | 90% | 80% | 80% | 90% |
| Crowns, bridges, dentures | 50% | 50% | 50% | 60% | 50% | 50% | 60% |
| Yearly max | $1,000 | $1,000 | $2,000 | $3,000 | $1,000 | $2,000 | $3,000 |
| Child orthodontia, lifetime | $1,000 | $1,500 | $1,500 | $1,500 | $1,500 | $1,500 | $1,500 |
| Monthly premium | |||||||
| Employee only16 enrolled | $36.80 | $23.28 | $28.62 | $47.03 | $22.91 | $28.16 | $44.11 |
| Employee + spouse0 enrolled | — | $49.44 | $60.79 | $99.92 | $48.66 | $59.83 | $93.71 |
| Employee + children2 enrolled | $100.09 | $49.75 | $61.19 | $100.59 | $48.98 | $60.22 | $94.34 |
| Family2 enrolled | $138.14 | $110.53 | $135.89 | $223.33 | $108.75 | $133.72 | $209.45 |
| A year20 enrolled | $12,783 | $8,316 | $10,225 | $16,804 | $8,184 | $10,061 | $15,760 |
Vision
Employee paid, as today. VSP and Superior networks at the same rates.
| TodayHumana Vision 130Today, EyeMed | In the totalsVSP LowThrough LBMC | VSP HighThrough LBMC | |
|---|---|---|---|
| Eye exam | $10 | $10 | $10 |
| Glasses lenses | $15 | $10 | $10 |
| Frames | $130 every 12 months | $150 every 24 months | $225 every 12 months |
| Contacts, instead of glasses | $130 | Up to $150 | Up to $225 |
| Monthly premium | |||
| Employee only13 enrolled | $6.06 | $6.96 | $9.30 |
| Employee + spouse0 enrolled | — | $13.90 | $18.35 |
| Employee + children2 enrolled | $11.51 | $13.26 | $17.72 |
| Family3 enrolled | $18.09 | $21.00 | $28.10 |
| A year18 enrolled | $1,873 | $2,160 | $2,888 |