We've had one for 5 years and for 5 years I have contributed enough to cover the deductible and built up a nice balance so now I have reduced my contributions.

The premiums for our plans are set so that if you ended up paying the entire out of pocket max for a year, your total outlay between premiums and copays would equal the cost of premiums on the $20 co-pay plan....thus you will always do better with the HD program anything less than the annual out of pocket max is yours (either in your HSA or your paycheck as saved premiums).

Last year had some pretty hefty bills and used the deductible for the first time, and while it seemed bad when I had to pay full charges for xrays, casts, exams, Physical Therapy, etc....when you look at the big picture I estimate that between saved premiums and now my reduced contributions I have saved about $20k over 5 years.

Hardest part is when you pay $1,200 for a prescription that cost $200 3 months earlier....but you have to keep the big picture in mind (which is why the majority of our employees still use the old $20 copay program)