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Peer Comparison: Costs of Health Plan Features

The following 2009 data is from a report conducted by Hewitt Consulting. Sixty colleges and universities are in the data set.

Deductible: Almost half of the plans have one, and of those the average is $623 ($400 median). Our proposed Point-of-Service (POS) deductible is $250. The family deductible is similarly positioned with the survey average of $1453 (median $800). The Dartmouth proposal is $750.

Primary Care Physician (PCP) Copay: The average is $17. Dartmouth’s proposed POS copay for a PCP is $20. Please note that that this is 2009 data, while Dartmouth’s proposal is 2011.  Other schools may have changes in progress that will be effective in 2011 and 2012.

Specialist Copay: The average is $33. Dartmouth’s proposed POS copay for a specialist is $30.

Emergency Room (ER) Copay: Based on 2009 data, the average is $82. Dartmouth’s proposed POS copay for an ER is $100.

Out-of-Pocket Maximum: 68% of the surveyed plans have one, and for those that do the average is $1,217 (median: $2,000), not including the deductible. Dartmouth’s proposed POS out-of-pocket maximum is $1,000 not including the deductible.

Prescription Drugs—Retail: The average copays are $8.70/$23.45/$42.88 for generic/formulary brand/nonformulary brand; Dartmouth’s proposed POS copays are $5/$25/$40.

Prescription Drugs—Mail: The average copays are $17.23/$47.18/$86.07 for generic/formulary brand/nonformulary brand; Dartmouth’s proposed POS copays are $10/$50/$80.

—Source: Hewitt Consulting SpecSelect Report of College and University Health Plan Features

Last Updated: 5/4/10