Teamworks 

CDH Plan Scenarios

Scenario: Anna, family coverage

  • Anna is married with two children, and has UnitedHealthcare Consumer Directed Health (CDH) Gold coverage.
  • She is in good health.
  • Spouse has allergies requiring office visits and prescriptions.
  • Both children are healthy, and visit physician for annual physicals, well child visits, and immunizations.
  • Anna is in a car accident and is hospitalized.
Annual Activity CDH Gold Family Coverage

Services

  • Preventive care (100% in network)
  • 4 office visits
  • 12 allergy prescriptions
  • hospitalization for car accident
 Cost
$800
$400
$900
$25,000
2009 Costs Subtotal (excludes preventive care, $800 paid 100%) $26,300

Wells Fargo pays (HRA credit)

 ($2,000)
Remaining Balance $24,300

Anna pays (annual deductible)

 ($1,000)
Remaining Balance $23,300

Wells Fargo pays (coinsurance 80%)

 ($18,640)

Anna pays (coinsurance 20%, capped at out-of-pocket maximum of $4,000

 $4,000
Remaining Balance $660

Wells Fargo pays (ongoing 100%)

 ($660)
Anna’s Total Costs Before Payroll Contributions $5,000
HRA Rollover $0


Scenario: Lee, single coverage

  • Lee is single with no children, and has UnitedHealthcare Consumer Directed Health (CDH) Gold coverage.
  • He is in better-than-average health.
  • Visits doctor for preventive care.
  • Has high cholesterol.
Annual Activity CDH Gold
Single Coverage

Services

  • Preventive care (100% in network)
  • 1 office visit
  • 12 cholesterol prescriptions (generic)
 Cost
$200
$100
$600
2009 Costs Subtotal (excludes preventive care, $200 paid 100%) $700

Wells Fargo pays (HRA credit)

 ($700)
Remaining Balance $0
Remaining Balance in HRA $300
Lee’s Total Costs Before Payroll Contributions $0
HRA Rollover $300


Costs listed are for illustrative purposes only. Your actual costs may vary.

 

Published 10/06/2008

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