For calendar year 2019, Vanderbilt will have two health plan offerings: the Select PPO (Preferred Provider Organization) and the Choice CDHP (Consumer-Driven Health Plan). While the two plans are quite different, they share several important common features. Both plans will continue to use the existing “Tier 1” VHAN (Vanderbilt Health Affiliated Network) and “Tier 2” Aetna network of health care providers, and both provide preventive care at 100 percent coverage. The monthly premium for both plans will continue to be based on a three-tier salary band approach established in 2018 – premiums are adjusted for salary level, and higher-paid employees have higher premiums.

So we can expect a slight decline in the value of premium subsidies in 2019, on the heels of two consecutive years when average premium subsidy amounts increased significantly. But the cost of your specific health insurance policy could go up or it could go down, depending on whether you receive a premium subsidy (most exchange enrollees do, but everyone who enrolls outside the exchange pays full price), and how much your plan's price is changing.
The primary advantage of a group plan is that it spreads risk across a pool of insured individuals. This benefits the group members by keeping premiums low, and insurers can better manage risk when they have a clearer idea of who they are covering. Insurers can exert even greater control over costs through health maintenance organizations (HMOs), in which providers contract with insurers to provide care to members. The HMO model tends to keep costs low, at the cost of restrictions on the flexibility of care afforded to individuals. Preferred provider organizations (PPOs) offer the patient greater choice of doctors and easier access to specialists, but tend to charge higher premiums than HMOs.
The Australian government announced in May 2008 that it proposes to increase the thresholds, to $100,000 for singles and $150,000 for families. These changes require legislative approval. A bill to change the law has been introduced but was not passed by the Senate.[12] An amended version was passed on 16 October 2008. There have been criticisms that the changes will cause many people to drop their private health insurance, causing a further burden on the public hospital system, and a rise in premiums for those who stay with the private system. Other commentators believe the effect will be minimal.[13]
Premiums subsidies are still available in the exchange for people with income up to 400 percent of the poverty level. (For 2018 coverage, a single person can earn up to $48,240 and be eligible for the premium tax credit, and a family of four can earn up to $98,400). Calculate your subsidy. In 2017, 84 percent of exchange enrollees received premium subsidies that covered an average of two-thirds of the total premiums.
×