Should my Wife be covered under two health care plans?
Hello,
My Wife & I want to start a family this year. I am assuming we will hit our max spend for the year. Given the circumstances below, should my Wife be covered under two health care plans?
Currently, our BCBS (IL) HDHP Healthcare is through my Company, "H". My Wife's Company, "W", offers an HDHP too. It's through HealthPartners (MN) which uses Cigna's network. We work/live in NY. "W"s HDHP plan has premiums of $83/biweekly and an OOP max of $3,300 = $4,738 total max spend. Given the <$5k total max spend of "W"'s individual HDHP, it seems like the obvious choice for our family-starting plans.
Here's the tricky part; on paper, "H"s premiums are $188 (likely more for 2025)/biweekly. However, in the three calendar years we've used "H"s HDHP self+spouse plan, I've never had a premium deduction. I've asked HR expressly about this and they haven't given a straight answer. They have told me that they contribute to my healthcare costs, but that they cannot disclose how much. I've asked colleagues too, but I've yet to find anyone else at "H" who uses the HDHP (most colleagues have young kids/more claims or spouses with better plans). In short, HR is not ignorant to my situation, but will not reconcile the on paper-costs with what I actually pay, $0. How am I supposed to argue with the fact that I spend $0 on health care during years of minimum use? Actually, they pay me considering the employer contribution to my HSA, but it's close to negligible for purposes of this post.
If we stay on "H"s HDHP plan and hit the OOP max of $14,100, that would be a total max spend of $18,497 on paper, or $14,100 given the mysteriously premium-free coverage I've had for three years.
Putting this all together, I am wondering if it is a good idea to have my Wife sign up for "W"s HDHP individual plan and have that carrier process all the health care claims. It would be as if she wasn't even on my "H" plan. I'm not trying to "double dip" claims, fix it so we both max out individual HSA deductions, or otherwise be fraudulent. I just want to make use of the low OOP max of "W"s HDHP without compromising the $0 minimum use cost of "H"'s HDHP. If this works as I'm wondering, we'd save more than $9,000 maxing out "W" instead of "H".
Other information
"H" does offer three other PPO's which are essentially a series of higher premiums for lower deductibles, but I have no idea if I'd actually pay the on paper premiums or if my $0 HDHP premium would carry over in whole or part to the other, higher-premium PPO plans.
"W" would charge $359 (HDHP) or $406 (non-HDHP) in premiums and double the OOPMs if I was included on those plans, making them $10,000-$14,000 more expensive than if my Wife uses them individually.
Thanks for any advice in advance!
submitted by /u/xfdecudo
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