Opportunity Costs

There are lots of costs to consider when choosing a new health plan. It’s not just premiums, or even deductibles or co-pays or coinsurance. It’s also the cost we pay in time. Calls to the insurance company checking what’s covered, figuring out what happened to the prescription we renewed, submitting out-of-network reimbursement forms, and on and on. All of that takes time you could be using to live your life.

I had to go through open enrollment season for the second time in two years this month. Last year, I started with a new company. There were issues, as there always are -- they did not tell me that my benefits wouldn’t kick in until the month after I started, so I had to scramble for COBRA. Between that and parking in downtown DC, it cost me over $1,000 to start with that new company.

This year, that new company was acquired by one of the major contracting firms. This does not make me happy – I left one big firm for reasons that will undoubtedly resurface with this company, not the least of which is health coverage. It has not started off on a good note. Half of their plans are Kaiser, which are an automatic no, since I refuse to give up my provider partners now that I have found ones who will treat me as an equal.


That left Cigna, which has recently acquired Express Scripts, a pharmacy benefit manager (PBM) that I was convinced was trying to kill me through denial of coverage the last time I used them. Because the Kaiser plans were out, that left three Cigna options, which used language outside the norm (ex: “Personal Health Account Plans” instead of Preferred Provider Organizations (PPOs)), and each Summary Plan Description (SPD) was over 100 pages (industry average is about 40 pages). My retired health insurance lawyer father was kind enough to give it a stab, and invested four hours going through most, not all, of just one of the plans.

I looked at his notes and did my own analysis. I made my choice, but that was only half of the calculation I needed. I also needed to calculate what I should contribute to my Health Savings Account (HSA). The company offered a tool to make that calculation, but it only gave list price (pre-negotiated retail price) of any medication unless you were already enrolled, so my insulin came out to $1,600+ for three months. I tried to call, but after shuttling me around to four different people who couldn’t help, the fifth could only tell me the list price.

They even made signing up difficult. So far, the system they use has kicked me out three times because of technical difficulties on their end. There is no option to save as I go, so I have to start over every time.

My question for you is, at what point do you throw up your hands and just give up? How much money has to be at stake before your time becomes more valuable? Can health insurance be so burdensome, in both traditional and opportunity costs, that it might drive you to look for a new job?

I honestly don’t know. But I know I am not alone. ‘Tis the season, open season. I would love to hear your stories about the frustrations of open insurance enrollment. Has anyone been pushed over the line of tolerance? What was the final straw? I think I might be approaching mine.