American News compares health insurance plans for 2010

Come Christmas, the health-care battle raging in Washington could be finished.

Exactly what U.S. citizens will be left with when the dust settles -- an expanded Medicare program, no new government plan or something in between -- is yet unknown.

But right now, we do know that millions of Americans are without health insurance. The U.S. Census Bureau reported this fall that the number of people without health insurance coverage rose from 45.7 million in 2007 to 46.3 million in 2008.

People who are covered face continuously rising health-care costs -- proof of which can be found right here in Aberdeen.

Eight years ago, the American News charted insurance information from various local government agencies. Today, many of those costs have increased -- just as they have likely increased for your health plan.

Take a look at the 2010 plans for the city of Aberdeen, Brown County, Aberdeen Public School District and the state of South Dakota.

Complete health insurance information for federal employees was unavailable, but several options exist for all federal employees, including members of Congress. As an example, one plan found at opm.gov/insure that is open to postal workers in Aberdeen has a monthly premium of $58.44 for an individual, $136.87 for a family and no deductible.

While no easy answers seem to exist in the health-care debate, we hope this chart helps you compare your coverage to others. How does your plan measure up?

CITY: 2010 rates

Individual premium per month: 0 (2001: 0)

Two-party premium per month: $280 (2001: $170)

Family (three plus) premium per month: $425 (2001: $260)

Individual deductible: $750 (2001: $400)

Dental coverage included? No

Vision coverage included? No

Percent pay after deductible: Plan pays 70 percent and employee pays 30 percent in network, or 60 percent/40 percent out of network.

Out-of-pocket limit: In network: $3,000 single, $6,000 two-party/family; out of network: $4,000 single, $8,000 two-party/family.

When 100 percent kicks in: after deductible and out of pocket have been reached.

Prescriptions covered? Yes

Cost of prescriptions: 20 percent generic, 30 percent brand name (employee cost).

When eligible? First of the month following 30 days of employment.

Name of insurance company: Self-insured; DAKOTACARE is third-party administrator.

Preferred providers? DAKOTACARE network

COUNTY: Plan through June 30, 2010

Individual premium per month: 0 (2001: 0)

Two-party premium per month: $377.52 (2001: $176.66)

Family (three plus) premium per month: $567.36 (2001: $321.62)

Individual deductible: $1,500 (2001: $200)

Dental coverage included? Through a separate company.

Vision coverage included? Through a separate company.

Percent pay after deductible: Person pays 20 percent in network, 30 percent out of network.

Out-of-pocket limit: $3,000 single; $6,000 two-party; $9,000 family.

When 100 percent kicks in: After out-of-pocket max is reached.

Prescriptions covered? Yes

Cost of prescriptions: $100 deductible for single; $200 for family. Co-pays: $10 for generic; $25 for specially selected brand name drugs; $40 for all other brand name drugs; $85 for self-administered specialty drugs.

When eligible? First of the month following one full month of employment.

Name of insurance company Wellmark Blue Cross Blue Shield of South Dakota.

Preferred providers? Providers must be in the Blue Cross Blue Shield network; a majority of providers are.

PUBLIC SCHOOL: Plan through June 30, 2010

Individual premium per month: $434 (2001: $250)

Two-party premium per month: $868 (2001: $500)

Family (three plus) premium per month: $1,004 (2001: $600)

Individual deductible: $1,000 (2001: $500)

Dental coverage included? District pays single portion of dental insurance ($35.50 per month), not included in above premium.

Vision coverage included? District offers vision plan, but employee pays entire premium.

Percent pay after deductible: 70 percent/30 percent co-insurance after deductible.

Out-of-pocket limit: $2,500 individual, $5,000 family.

When 100 percent kicks in: After first $5,000 of costs for individual and first $10,000 for family.

Prescriptions covered? Yes, subject to deductible and co-insurance.

Cost of prescriptions: Normal cost subject to deductible and co-insurance.

When eligible? All full-time employees (work at least 20 hours a week) on first day of work.

Name of insurance company: Self-insured; use DAKOTACARE as our third party administrator.

Preferred providers? All participating providers in the DAKOTACARE network. Providers out of network are reimbursed at 60 percent instead of 70 percent.

STATE: Plan through June 30, 2010

Individual premium per month: 0

Two-party premium per month: Premiums are based on the age of the spouse as well as number of dependents. For example, in the $300 deductible/co-pay plan, the most common plan for state members, the cost for an employee and spouse younger than 30 is $103.12. The cost is $82.70 for employee plus one child.

Family (three plus) premium per month: Premiums are based on the age of the spouse as well as number of dependents. For example, in the $300 deductible/co-pay plan, the cost for an employee, child and spouse younger than 30 is $174.72. For the employee, two plus children and spouse younger than 30, the cost is $245.60. Employee and two children costs $151.10. Employee and three plus children costs $193.

Individual deductible: $300 deductible/co-pay plan is the most common plan for state members.

Dental coverage included? Offered through Delta Dental for an additional monthly premium.

Vision coverage included? Offered for an additional monthly premium.

Percent pay after deductible: The employee is responsible for 25 percent of covered charges up to the maximum out of pocket.

Out-of-pocket limit: For the $300 deductible/co-pay plan: in network, $2,500 per person; out of network, $5,000 per person

When 100 percent kicks in: If a member or the covered dependent reaches the medical out-of-pocket limit, the plan pays 100 percent of eligible charges up to the plan maximum allowable charges or usual, customary, and reasonable charges for most eligible expenses for the rest of the plan year.

Prescriptions covered? Yes

Cost of prescriptions: A $50 deductible per person per plan year exists on prescription drug coverage for those enrolled in the $300 deductible/co-pay plan. For tier one (primarily generics), a 30-day supply has a $9 co-pay. For tier two (preferred brand-name drugs), a 30-day supply has a $25 co-pay. For Tier Three (non-preferred brand-name drugs), a 30-day supply has a $40 co-pay.

When is an employee eligible? Employees are eligible to enroll in the Group Health Plan after one month and one day of employment if: scheduled to work at least 20 hours per week; scheduled to work at least six months during the plan year; and have a permanent job classification.

Name of insurance company: The South Dakota State Employee Health Plan is self-insured.

Preferred providers? The South Dakota State Employee Health Plan through a contractual agreement utilizes the DAKOTACARE network of providers. Members have the option to choose their own provider.