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Spring Harbor 2022 Renewal Comparison

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Spring Harbor 2022 Renewal Comparison

2021 vs 202 2 Benefits Comparison

Medical | Dental | Vision

Spring Harbor 2022 Medical Insurance

2022 Aetna Insurance

2022 HRA Illustration's

Base Plan

Buy-Up Plan

HDHP w/HSA

Base Plan

Buy-Up Plan

$75 $75 $40

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

$40 $75 $75

$500 Copay (waived if admitted)

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

100%

80%

100%

80%

$14,000 $7,000

$13,100 $6,550

$2,500 $5,000

$1,000 $2,000

$15,800 (includes deductible) $7,900 (includes deductible)

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance $15,800 (includes deductible) $7,900 (includes deductible)

$13,500 (includes deductible) $6,750 (includes deductible)

$3,400 (includes deductible) $6,800 (includes deductible)

$1,900 (includes deductible) $3,800 (includes deductible)

$500 Copay + deductible, then 100% Coinsurance

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

$500 Copay + deductible, then 100% Coinsurance

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Deductible; then 100% Coinsurance

Combined with Medical

$75 $45 $15

$15 $50

$45 $75 $15

$15 $45 $75

$15 $50

$100

$250 / $500

$354.96 $226.91 $244.56 $77.68 $769.08 $491.64 $529.89 $168.30

$371.92 $237.76 $256.02 $82.18 $805.82 $515.14 $554.70 $178.06

$367.38 $234.92 $252.92 $60.23 $796.00 $509.00 $548.00 $130.50

Employee Only

Employee pays first $2,500 Employee only total = $3,400

Employee pays first $1,000 Employee only total = $1,900

HRA total = $4,500

HRA total = $6,000

Employee + Dependent(s) Employee pays first $5,000 Employee only total = $6,800

Employee + Dependent(s) Employee pays first $2,000 Employee only total = $3,800

HRA total = $9,000

HRA total = $12,000

Spring Harbor 2021 Medical Insurance

2021 Cigna Insurance

2021 DRA Illustration

Insurance Carrier:

Local Plus Plan

Open Access Plan

Either Plan

Plan Type:

In-Network Office Visit Copay - Primary Care Office Visit Copay - Specialist Care

$60 $75 $30

$30 $60 $75

Urgent Care Copay

$500 Copay (waived if admitted)

Emergency Room Care Preventative Visit Copay

$500 Copay (waived if admitted)

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Diagnostic Testing & Blood Work

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Advanced Imaging

80%

Coinsurance

80%

$14,000 $7,000

Employee Deductible Family Deductible

$2,200 $4,400

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance $16,300 (includes deductible) $8,150 (includes deductible)

Employee Out-of-Pocket Max Family Out-of-Pocket Max

$3,350 (includes deductible) $6,700 (includes deductible)

Inpatient Hospital

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Outpatient Hospital or Facility

Prescription Drugs Rx Deductible

25% $85 $15 $45 $150

$150

$85 $45 $15

Tier 1 Tier 2 Tier 3

$15 $45 $85

30 Day Supply

Specialty

25% DRA Breakdown Employee Only Employee pays first $1,000 Employee then pays 20% to the $7,000 deductible Employee only total = $2,200 DRA pays 80% after the first $1,000 up to $4,800 DRA total = $4,800 Employee + Dependent(s) Employee pays first $2,000 Employee then pays 20% to the $14,000 deductible Employee only total = $4,400 DRA pays 80% after the first $2,000 up to $9,600 DRA total = $9,600

Employee Monthly Deduction Employee Only

$373.57 $238.85 $257.21 $82.76 $809.40 $517.51 $557.29 $179.31

$430.63 $275.32 $296.49 $95.04 $933.03 $596.53 $642.40 $205.92

Employee + Child(ren) Employee + Spouse

Family

Employee Bi-Weekly Deduction Employee Only

Employee + Child(ren) Employee + Spouse

Family

Spring Harbor 2021 vs 2022 Medical Plan Comparison

2021 Cigna Insurance

2022 Aetna Insurance

Insurance Carrier: Plan Type: In-Network

Local Plus Plan

Open Access Plan

Base Plan

Buy-Up Plan

HDHP w/HSA

$60 $75 $30

$75 $75 $40

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

Office Visit Copay - Primary Care Office Visit Copay - Specialist Care Urgent Care Copay

$500 Copay (waived if admitted)

Emergency Room Care Preventative Visit Copay Diagnostic Testing & Blood Work Advanced Imaging Coinsurance Employee Deductible Family Deductible Employee Out-of-Pocket Max Family Out-of-Pocket Max Inpatient Hospital Outpatient Hospital or Facility Prescription Drugs Rx Deductible

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

80%

100%

80%

100%

$14,000 $7,000

$13,100 $6,550

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance $16,300 (includes deductible) $8,150 (includes deductible)

$15,800 (includes deductible) $7,900 (includes deductible)

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance $15,800 (includes deductible) $7,900 (includes deductible)

$13,500 (includes deductible) $6,750 (includes deductible)

$500 Copay + deductible, then 100% Coinsurance

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

25% $85 $45 $15 $150

$150

Combined with Medical

$85 $45 $15

$75 $45 $15

$50 $15

$75 $45 $15

Tier 1 Tier 2 Tier 3 Specialty

30 Day Supply

$100

$250 / $500

Employee Monthly Deduction Employee Only

$373.57 $238.85 $257.21 $82.76 $809.40 $517.51 $557.29 $179.31

$430.63 $275.32 $296.49 $95.04 $933.03 $596.53 $642.40 $205.92

$354.96 $226.91 $244.56 $77.68 $769.08 $491.64 $529.89 $168.30

$371.92 $237.76 $256.02 $82.18 $805.82 $515.14 $554.70 $178.06

$367.38 $234.92 $252.92 $60.23 $796.00 $509.00 $130.50 $548.00

Employee + Child(ren) Employee + Spouse

Family

Employee Bi-Weekly Deduction Employee Only

Employee + Child(ren) Employee + Spouse

Family

2021 DRA vs 2022 HRA Comparison Spring Harbor

2021 DRA Illustration Either Plan

2022 HRA Illustration's

Base Plan

Buy-Up Plan

$30 $60 $75

$40 $75 $75

$500 Copay (waived if admitted)

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Deductible; then 100% Coinsurance Deductible; then 100% Coinsurance

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

80%

100%

80%

$2,200 $4,400

$2,500 $5,000

$1,000 $2,000

$3,350 (includes deductible) $6,700 (includes deductible)

$3,400 (includes deductible) $6,800 (includes deductible)

$1,900 (includes deductible) $3,800 (includes deductible)

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

$500 Copay + deductible, then 100% Coinsurance

Deductible; then 80% Coinsurance Deductible; then 80% Coinsurance

Deductible; then 100% Coinsurance

$150 $15 $45 $85 25%

$15 $45 $75

$15 $50

$100

$250 / $500

HRA Breakdown

DRA Breakdown Employee Only

Employee Only

Employee pays first $1,000

Employee pays first $2,500 Employee only total = $3,400

Employee pays first $1,000 Employee only total = $1,900

Employee then pays 20% to the $7,000 deductible

Employee only total = $2,200

HRA total = $4,500

HRA total = $6,000

Employee + Dependent(s) Employee pays first $5,000 Employee only total = $6,800

Employee + Dependent(s) Employee pays first $2,000 Employee only total = $3,800

DRA pays 80% after the first $1,000 up to $4,800

DRA total = $4,800

Employee + Dependent(s) Employee pays first $2,000

HRA total = $9,000

HRA total = $12,000

Employee then pays 20% to the $14,000 deductible Employee only total = $4,400 DRA pays 80% after the first $2,000 up to $9,600 DRA total = $9,600

Spring Harbor Dental Comparison

2021 Anthem

2022 UNUM

Insurance Carrier:

$50 Individual / $150 Family

Annual Deductible Calendar Year Maximum Preventive Services

$1,500

100%

80% 50%

Basic Services Major Services Orthodontia (dependent children only) Out-of-Network Reimbursement

$1,500

90th UCR

Monthly Rates Employee Only Employee + Spouse Employee + Child(ren) Family Employee Bi-Weekly Deduction Employee Only Employee + Spouse Employee + Child(ren) Family

$85.12 $60.11 $49.78 $24.77 $22.98 $11.43 $39.29 $27.74

$24.67 $84.78 $59.87 $49.58 $22.88 $11.39 $39.13 $27.63

Spring Harbor Vision Comparison

2021 Anthem

2022 UNUM

Insurance Carrier: Network:

Blue View

EyeMed

In-Network

Out-of-Network

In-Network

Out-of-Network

Eye Exam

$10

up to $42 up to $40 up to $60 up to $80

$10

up to $40 up to $30 up to $50 up to $70 up to $70

Lenses - Single Lenses - Bifocal

$25 Copay $25 Copay $25 Copay

$25 Copay $25 Copay $25 Copay $25 Copay

Lenses - Trifocal Lenses - Lenticular

N/A

$130 Allowance, then 20% off remaining balance

up to $45

up to $91

Frames

Elective Contact Lenses (in lieu of complete set of glasses) Frequency for Exam / Lenses / Frames

up to $60, Medically necessary up to $210

up to $130, Medically necessary up to $210

$130 Allowance

12 / 12 / 24

Monthly Rates Employee Only Employee + Spouse Employee + Child(ren) Family Employee Bi-Weekly Deduction Employee Only Employee + Spouse Employee + Child(ren) Family

$5.87 $11.75 $13.29 $20.72

$13.35 $12.75 $6.91 $19.99

$2.71 $5.42 $6.13 $9.56

$9.23 $6.16 $5.88 $3.19