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Help With Choosing Health Insurance Plans

Duke employees say cost, location and coverage influence their health plan choices

Every year in October, Duke employees enroll in, drop or change a health care insurance plan for themselves and their dependents from an array of options. The task involves balancing cost, coverage, location and other personal preferences.

Duke currently offers four medical plan options: Duke Select HMO, Duke Basic HMO, Blue Care HMO and Duke Options PPO. 

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"Our plans offer a wealth of choices designed to meet the needs of an incredibly diverse community at Duke," said Kyle Cavanaugh, vice president for administration at Duke. 

To help faculty and staff prepare for open enrollment in October, Working@Duke interviewed employees about the factors that influenced their decisions about medical plan coverage.

Duke Select: Ease of use

Phyllis Holt

Phyllis Holt

Phyllis Holt, health system analyst with Duke Health Technology Services, chose the Duke Select health plan because of its simplicity.

Duke Select is the most popular of Duke's four plans, covering more than 17,000 faculty and staff.

"It's the easiest plan for what I need," she said. "I know exactly how much I'll have to pay for each doctor's visit."

Holt realizes that if any of her two teenage children attend college outside the Triangle area, she may need to switch plans during open enrollment. Duke Select only covers out-of-network providers for emergency care. 

"I dread the thought of having to switch plans," she said, "because with Duke Select there is no guesswork. It's just so simple."

Duke Basic: Cost-effective plan

Taylor Hemphill

Taylor Hemphill

Taylor Hemphill investigates health plan costs for his family every year, but each time, the Duke Basic plan is the top choice as the most cost effective plan for his family of five. 

Duke Basic has slightly higher out-of-pocket expenses for co-pays and deductibles but lower monthly premiums than other Duke plans. 

"We are a pretty healthy bunch," said Hemphill, a performance analyst for DUMAC, Duke's investment manager. "We mostly just use primary care and save over $100 a month in premiums compared to other plans."  

What makes Duke Basic another draw for Hemphill is Duke's contribution to his health care reimbursement account. To help offset higher co-pays and deductibles, Duke makes an annual contribution to the health care reimbursement account of each employee covered by Duke Basic.

"It's a wonderful extra perk," Hemphill said.  

Duke Options: Worldwide network

 photo copyright by Cristin M. R. Paul

   Christy Michels  (Photo by Cristin M. R. Paul)

In 2002, while travelling in Hong Kong with the Fuqua Global MBA program, Christy Michels was rushed to a hospital for emergency surgery. Her bills for the four-day hospital stay totaled more than $4,000, but Duke Options covered the cost.

Duke Options is the only Duke plan that offers a national network of physicians and hospitals and a network of international hospitals for individuals who travel frequently or live outside of North Carolina. This includes coverage for children of faculty and staff who attend school out of state. While the plan has higher deductibles and out-of-pocket costs, it is the only plan that offers out-of-network coverage for non-emergency care. 

"I have my work visa for China and expect to be travelling there in the coming year," said Michels, a senior manager in the Office of Global Strategy and Programs. "The international coverage is definitely worth it for me."

Blue Care: Flexible options

Sonya Johnson

Sonya D. Johnson

Sonya D. Johnson, assistant information technology manager for Duke University Press, chose Blue Care because she had a pre-existing condition when she joined Duke three years ago and wanted to continue seeing her dermatologist. 

Blue Care, which has the highest monthly premium of the four plans, does not require an annual deductible and features a network of physicians throughout most of North Carolina, including several Johnson had been seeing in Raleigh. 

"I wanted to stay with the doctors who been treating me," Johnson said.  "The premiums were reasonable, and I liked the flexibility."