Repairman and His Job-Based Coverage

An appliance repair technician—yes, they still exist—had health insurance through the U.S. division of a multinational company. The repairman shared his family’s experience with the employer’s health benefits program.

What were his family’s needs? His children “were always doing something” that required a trip to the doctor’s office or local Target now that the school year had begun. While he wanted the best possible care for his children, he was also budget conscious.

How did he shop for coverage? His employer encouraged employees to evaluate their options and make informed choices. For example, he understood wonky features like a Health Savings Account (HSA). The employer provided an information hub that made it easier—if not easy—to do so.

Where did he get information? The employer’s public site contained information about (three) health plans, employee support, and other programs. Information was available in print and video. The employer provided insurers’ contracted rates in a machine-readable format, as required by federal law.

Which plan did he choose? He enrolled in the plan with the lowest total medical costs (annual contribution + deductible + maximum) for a family. Although the contribution was the highest of the options, the deductible and maximum were the lowest. It did not offer a self-funded HSA.

How much did he spend? His total medical costs were projected to be as much as $10,000 per year for his family. Given a repair technician’s salary range, health care expenses could account for up to 13 to 19 percent of his annual salary. This excluded any dental and vision coverage.  

When did he make decisions? Like many employees of large employers in the U.S., open enrollment happens in October. He said it was important to pay attention because the employer made changes to the health plans and their prices every year.

What else? He liked the idea of universal coverage but not like in Canada or England. He worried about delays in care. As long as doctors, hospitals, and insurers were still private, he was open to a system that didn’t include employer-sponsored insurance. “When I switched jobs, my insurance changed. It made no sense.”

This appliance repair technician would make his employer proud. He was a well-informed consumer who chose his employer-sponsored health plan based on his family’s personal and financial needs. In other words, he was Mastering Health Insurance.

Photo: Super Blue Moon over Lake Michigan