Health Insurance Open Season

For 10 to 15 years (I've lost track) we've just stuck with Aetna Insurance. Open Season came and went and all the companies seemed similar enough. But Aetna is adding a Fourth Tier to its Pharmacy program -- a recommendation of the President's own Office of Personnel Management by the way -- so my wife's specialty Multiple Sclerosis drugs just went from $450 to $3,500 a year. So, we could switch to Kaiser which hasn't added the Fourth Tier yet. Then we lose the pediatricians we've had since 1996. And then there's dental insurance -- they'll give you a chance to choose your own dentist but why is it that the dentists I like have a fee schedule about twice as expensive as the insurance company allocates