During Open Enrollment, you can make changes to your benefit elections and add or remove eligible dependents, with most changes going into effect on January 1 of the following year. With this year’s Open Enrollment period fast approaching, you may be reevaluating your current medical plan. Keep reading to learn about GW’s medical plans and identify what questions to ask when deciding which plan to choose.
GW offers two medical plan options: GW Preferred Provider Organization (PPO) and GW Health Savings Plan (HSP). Both plans share the UnitedHealthcare (UHC) Choice Plus network, featuring more than 911,000 doctors and health professionals, 5,647 hospitals and over 2,220 convenience care centers.
Both the GW PPO and the GW HSP allow you to visit your doctor of choice, with no requirements for selecting a Primary Care Physician to coordinate your care and no need to obtain referrals for specialty care. Both plans cover in- and out-of-network services (you pay less out-of-pocket for services received in-network), and include 100 percent coverage for in-network preventive care. Take a closer look at services provided under the GW PPO and GW HSP with this medical comparison chart (PDF).
There are a couple of things to keep in mind when examining the two medical plans. Each plan has its limits, meaning that not everything will be covered. Carefully review the Summaries of Benefits and Coverage (SBCs) and Summary Plan Descriptions (SPDs) for both plans at benefits.gwu.edu/medical-benefits to understand what’s covered (and what’s not) under both plans. Moreover, while premiums may be lower for the GW HSP, your annual deductible and out-of-pocket maximum will be higher:
Deductibles (In-Network)
- GW HSP: $2,000 (individual) and $4,000 (family)
- GW PPO: $750 (individual) and $1,500 (family)
Out-of-Pocket Maximums (In-Network)
- GW HSP: $4,000 (individual) and $7,900 (family)
- GW PPO: $3,000 (individual) and $6,000 (family)
You’ll want think about what you prefer. For example, would you prefer to pay less per paycheck but pay more out-of-pocket initially (your deductible for medical and prescription under the HSP), or pay more per paycheck and less out-of-pocket initially (under the PPO)? Remember, under both plans, you’ll pay less if you use providers that belong to the plan’s network. Tip: Check out this health costs worksheet (PDF) to compare your coverage options and estimate your potential costs.
In addition, depending on which plan you choose, you may be eligible to open a Health Care Flexible Spending Account (FSA) or a Health Savings Account (HSA).
FSAs and HSAs
The Health Care FSA and HSA allow you to set aside money from your paychecks on a pre-tax basis to pay for eligible out-of-pocket expenses. You are only eligible to participate in the HSA if you are covered under a high deductible health plan, such as the GW HSP. In contrast, you do not need to be covered under a GW health plan in order to elect the Health Care FSA.
Other major differences between the Health Care FSA and the HSA include the following:
- GW makes a matching contribution to your HSA (but not to your Health Care FSA). If you have individual HSP coverage, GW will match your HSA contribution on a dollar-for-dollar basis up to $600; if you have family HSP coverage, GW will match your HSA contribution on a dollar-for-dollar basis up to $1,200.
- FSAs are “use to or lose it,” meaning that you forfeit any unused balance at the end of the plan year, and you must re-enroll in the FSA each year. In contrast, HSA contributions will roll over from year to year and accumulate.
- HSA contribution amounts can be changed at any point throughout the year, while FSA contribution amounts can only be changed during Open Enrollment or if you experience a Qualified Life Event (QLE).
When choosing your medical plan for 2019, take into consideration whether the Health Care FSA or the HSA would be a good fit for you and your family. Learn more about the difference between the FSA and HSA.
Upcoming Seminars: How to Pick a Medical Plan
Hosted by UHC, the How to Pick a Medical Plan seminars will provide an overview of the university’s medical plans, including a comparison of the GW PPO and GW HSP. Understand your medical options and choose the best plan for you and your family this Open Enrollment season. Seminars will be held both in-person at Foggy Bottom and virtually, and will include a Q&A portion. Light refreshments will be served at the in-person sessions.
- Foggy Bottom Campus (Marvin Center 307)
August 22, 2018 | Noon – 1 p.m.
September 25, 2018 | Noon – 1 p.m. - Virtual (via WebEx)
August 23, 2018 | Noon – 1 p.m.
September 26, 2018 | Noon – 1 p.m.
WebEx details for virtual sessions are available at benefits.gwu.edu/events.
