At my last job, we never had employer-supplied care; it was too small a firm to get into anything unless he bought into a cooperative, which I think was a word

At my last job, we never had employer-supplied care; it was too small a firm to get into anything unless he bought into a cooperative, which I think was a word with about three too many syllables for the CEO to grasp. I ended up buying marketplace plans, and the first two or three years, you had a choice between HMO and PPO plans; after that, it's obvious the local insurers (who also dwindled to one or two) decided all the market wanted was "it's the minimum that counts as coverage" Silver-tier HMO plans, all with the exact same (highest legal) copay/out-of-pocket limits, and either removed anything else or priced it stratospherically. I guess the health-care marketplace ended up much like the airlines after Expedia; they had to jettison anything appealing to look good on a price-comparison engine. Once we had a guy visit the office trying to sell a HSA/HDHP plan; after three minutes discussing it after his visit, we all decoded that the basic premise of the plan was that it disincentivizes you from getting the care you actually need. It's sold on the concept of "you're an above average driver" (you won't ever be sick enough to actually need to tap the HSA) and promises of being able to stick the IRS with a tax-exempt savings scheme. My current position offers a PPO or HSA/HDHP scheme and pays like 90% of the costs for your choice. I wouldn't touch the HSA option with a 10-metre pole.