Health Care Option Decision Helper Project Abstract

Document Type


Lead Author Type

CIS Masters Student


Dr. Yonglei Tao, taoy@gvsu.edu

Embargo Period



It is increasingly difficult for consumers in the USA to make informed decisions on Health Care Insurance for themselves and for families, due to the many choices offered by employers. Options for medical coverage at one West MI employer are:

- Core Health Plan: Blue Cross/Blue Shield Network

- Core Health Plan: Out-of-Network Providers

- Core Health Plan Plus: Blue Cross/Blue Shield Network

- Core Health Plan Plus: Out-of-Network Providers

- Advantages Health Plan: Blue Cross/Blue Shield Network

- Advantages Health Plan: Out-of-Network Providers

- Integrated Health Plan: Blue Cross/Blue Shield Network

- Integrated Health Plan: Out-of-Network Providers

- Paramount Steps2Health

The differences between the above health plan options are summarized in a ten page brochure and a costing sheet. It is extremely difficult for employees to determine which plan is best for their family circumstances and to understand which plan has the lowest projected out of pocket costs. To project effectively, the spreadsheet would include differences between the following:

- Cost of insurance for employee, employee plus child, employee plus spouse or employee plus family

- In network verses out of network costs

- Different deductible levels

- Impact of employer savings account contribution to the employee out of pocket costs

- Cost of Primary Care visits verses Specialist Visits

The Health Care Decision Helper application stores the coverage rules for the five coverage choices. The employee enters their projected medical costs for next year. The application estimates of out of pocket costs for the year for each plan.

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