I work for a large global company. Last year I elected to go with the PPO with an HRA. That means you exhaust the HRA and then you have to pay the high deductible ($1500 per person or $3K per family), because my PPO+ went up $4K. BIG MISTAKE. It cost me a ton. Keep in mind I have 3 kids! I finally got to open enrollment and was ready to go back the PPO+, but I was SHOCKED to see the premiums jump up $1,800 to $5,880!!! That is a huge increase. With the deductibles going up and the co-pay down to 85% instead of 90%! Now the PPO with the HRA jumped up to $4K with only $1,200 HRA! It's not because of head count. We had huge layoffs in 2008, 2009 and my co increased head count in 2010 and early 2011. The only explanation I can come up with is Obaminationcare drove up the costs. I am seriously considering a HMO, a plan I had had since 2002 when I was single! This is change, but definitely not hope!