r/HealthInsurance • u/DecentDeer2818 • Jul 04 '25

Plan Choice Suggestions Is this coverage pricing the norm?

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Hi all,

I just got a job offer in NYC where the cost of living is crazy high, as you probably know. This is my first corporate job and I need advice/feedback on is this pricing structure for insurance is the norm.

I know you can’t believe everything you read on the internet but I’ve read that the general norm is for the employer to cover 80-85% of the monthly premium.

I would be earning less than 75k and only covering myself but the price still seems quite high? I’ve never paid more than $118 bi-weekly.

Thank you.

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u/PortofinoBoatRace Jul 05 '25

Those premiums look insanely high to me. I pay $160 for employee + family coverage but I have far less covered and my individual deductible (6850) and max OOP are much higher. I also don’t have copays for various services they just all count towards the deductible so it’s functionally much less coverage.

2

u/DecentDeer2818 Jul 05 '25

Honestly, I’d be okay with that and less coverage as I never hit the deductible. The HDHP/HSA option they have is not an option for me as it does not cover any mental health services until after the 6k deductible.

6

u/[deleted] Jul 05 '25

But what is the premium on the HDHP? Because you’d be spending $4728 on premiums with the PPO before any co-pays. 

Does the employer contribute any to the HSA?

How much do you spend on mental health each year? Is it more than 5)3 total of premiums for the PPO?

My HDHP has zero premium to employee and they give $1000 into the HSA each year. I have $6000 deductible. Even with monthly or twice monthly therapy, I still come out ahead versus my PPO option. 

ETA: people who haven’t been on HDHP before often feel uncomfortable with the setup at the start. It feels like you’re spending more, but it’s just spending it differently. And with how most places have jacked up PPO premiums and OOP max, it rarely makes sense to select the PPO anymore, regardless of medical situation. 

3

u/QuantumDwarf Jul 05 '25

Yes this right here!! Right now OP is going to be spending about $400 a month and then also whatever the copay is for therapy.

With an HSA you will pay everything up to $6k but need to work out if therapy costs + HSA premium is more or less than $400/month.

2

u/pellakins33 Jul 05 '25

Also, remember that money spent through an HSA isn’t taxed, so in my case $100 of PPO spend is $130 to spend with an HSA

1

u/PortofinoBoatRace Jul 05 '25

Mine is the same way. I literally cover every medical cost irrespective of what type until my $6850 deductible is met.