Straight Facts About the Advantage+ Health Plan
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- Penelope Tracey Haynes
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1 Benefits and Compensation Annual Enrollment Straight Facts About the Advantage+ Health Plan The Advantage+ health plan has unique features that can appeal to a wide range of employees. The key features are a comprehensive medical plan that protects you and your family, along with a separate Health Savings Account that provides an opportunity to pay current medical expenses or save for future medical expenses in a tax-efficient manner. You have a choice during annual enrollment You should choose the option that works best for you whether that s the Advantage+ health plan, the Traditional Medical Plan or, in some locations, an HMO-type plan. The Advantage+ health plan has two related parts: 1. A health care plan. 2. A health savings account. This summary looks at the facts about the health care plan. See Straight Facts About the Health Savings Account to learn more about the second part of the Advantage+ health plan. The Advantage+ health plan as a health care plan Let s look at the facts not just how costs compare under the Advantage+ health plan to the other options (you can use the modeling tools beginning Nov. 1 to do that), but also a few other factors that will help you choose a health care plan for Eligibility Most employees will be able to select the Advantage+ health plan as an option. However, employees in Hawaii and employees on assignment outside the U.S. are not eligible. What s the cost difference? Actual paycheck contributions for each plan will be available beginning Nov. 1. At that time, you also will have access to the Medical Expense Estimator, a modeling tool that you can use to compare your costs under each medical plan. It compares paycheck contributions and deductibles, which are the biggest cost differences among the options. It also includes your actual past claim cost, and you can add next year s expected medical expenses as well. This will help you estimate your out-of-pocket costs under each medical plan option. To find a network doctor Go to the Blue Cross and Blue Shield of Illinois website at and look for providers under the Traditional Medical Plan. Network providers everywhere If you are enrolled in the Traditional Medical Plan today, the Advantage+ health plan will use the same providers. If you re in any other plan, you ll need to check to see if your doctor is in the network. If you are traveling, you will find network doctors in most locations, but in emergencies you can use any provider. Copyright 2013 Boeing. All rights reserved AE-371 1
2 Comprehensive coverage The Advantage+ health plan has comprehensive coverage. As a networkbased plan, you pay less when using doctors or hospitals in the plan s network and more if you don t, but you have coverage either way, just like the Traditional Medical Plan. Some other key facts: Preventive care is covered at 100 percent with no deductible when using network providers. Most other services for example, office visits, most prescription drugs, laboratory, radiology, surgery and hospital care through network providers are covered at 90 percent subject to meeting the deductible first. The Advantage+ health plan and the Traditional Medical Plan have similar limits on the maximum you can pay out of pocket in a year. Prescription drugs With the Advantage+ health plan, some prescription drugs that are classified as preventive (e.g., certain contraceptives) are paid at 100 percent with no deductible. Certain other prescriptions classified as preventive (e.g., cholesterol-lowering drugs to prevent heart disease) are covered without having to meet the deductible (but are subject to coinsurance percentages; see below). A list of preventive prescription drugs can be found at For any other covered prescription drugs, you pay the full discounted cost (from retail pharmacies or mail-order) until the deductible is met by any combination of medical and prescription charges. You can pay eligible prescription drug expenses from your Health Savings Account or out of pocket if you want to conserve the money in your account. Once the deductible is met, prescription drugs are covered at 90 percent for generics, 80 percent for formulary brand-name drugs (Express Scripts list of preferred drugs) and 70 percent for nonformulary brandname drugs. This coinsurance percentage also applies to certain preventive care drugs. In most other Boeing-sponsored medical plans, prescription drugs are not subject to the deductible and require a flat dollar copayment. So, it s important to understand this difference with the Advantage+ health plan. Office visits and emergency room coverage In the Advantage+ health plan you pay the full discounted cost of these services except for preventive care until the deductible is met. You can pay these expenses from your Health Savings Account or out of pocket if you want to conserve the money in your account. After the deductible is met, the plan pays 90 percent of the expense. In most other Boeing-sponsored medical plans, you pay a copayment for doctor s office and emergency room visits, and there may be no deductible requirement. So, it s important to understand this difference. Single and family deductibles No deductible requirement for preventive care services from a network health provider. The Advantage+ health plan covers eligible preventive care services at 100 percent; no deductible. For single coverage, the deductible in 2014 is $1,250 per year, and eligible expenses will count toward the deductible. Boeing will contribute $600 to a health savings account for single coverage, if the employee is eligible for and elects a health savings account, so the net deductible to meet will be $650. For family coverage, the deductible is $2,500 per year, and eligible expenses from any number of enrolled dependents or employees will count toward the deductible. Boeing contributes $1,200 to the optional Health Savings Account for any level of family coverage, so the net deductible to meet is actually $1,300. Copyright 2013 Boeing. All rights reserved. Back to top 2
3 Two examples show how the family deductible works 1. Kevin has family coverage and his son has $3,000 in covered medical expenses. The first $2,500 is subject to the deductible, and the next $500 is paid at 90 percent. For any other family member, the deductible is now met, and covered expenses are paid at 90 percent (or for prescription drugs, at 90 percent, 80 percent or 70 percent, depending on the drug classification). 2. Christina has family coverage. Her daughter has $1,500 and her husband $1,000 in covered medical expenses. The total family deductible of $2,500 is now met for all family members. The Health Savings Account If you enroll in the Advantage+ health plan, you can set up a Health Savings Account, provided you meet the eligibility requirements. Boeing contributes to the account, and you can add your own pretax funds: Boeing contributes $600 for single coverage and $1,200 for all other family coverage levels. You can contribute up to $2,700 for single coverage and $5,350 for family coverage (the maximum 2014 contribution limits for the combined amount of your and Boeing contributions under federal law are $3,300 for employee-only coverage and $6,550 for family coverage). There is also a $1,000 catch-up contribution available for persons age 55 or older in The Health Savings Account is an FDIC-insured account that earns interest, and investment options are available for Health Savings Account balances that exceed $1,000. (This is a change as of Oct. 1. Previously, your account balance needed to be more than $2,000 to invest it.) Contributions are not subject to federal tax withholding or state income taxes in most states. Use the money in your account to pay expenses to meet the deductible, pay for vision or dental expenses or save the money to use for future medical expenses. Unused amounts roll over each year, and you own the account. For more information about the Health Savings Account, see the summary below. Every effort has been made to provide an accurate summary of your benefits in this document. The material provided here is for informational purposes only; it does not constitute a contract or contractual obligation. Certain eligibility provisions apply to each of the programs, policies, and benefits; not all of these provisions are described here. In the event of a conflict between this document and any of the benefit plans, the terms of the plans will control. Copies of official plan documents are available by written request through the Contact TotalAccess online form on the Boeing TotalAccess website. Subject to the applicable bargaining agreement, The Boeing Company reserves the right to change, modify, amend, or terminate any or all of the provisions of the plans at any time and for any reason for employees, former employees, retirees, and their dependents and/or beneficiaries. Copyright 2013 Boeing. All rights reserved AE-371 Back to top 3
4 Benefits and Compensation Annual Enrollment Straight Facts About the Health Savings Account Employees enrolling in the Advantage+ health plan have the option of setting up a Health Savings Account (HSA), which allows you to pay for many medical expenses with tax-advantaged dollars. This summary looks at the facts about the HSA. For more information about the Advantage+ health plan, see the summary above. The Advantage+ health plan and the Health Savings Account If you enroll in the Advantage+ health plan, you can set up an HSA if you meet the eligibility requirements (below). But this savings account is not available if you enroll in any other medical plan offered by Boeing. Once you understand how the HSA works, you ll see that it offers significant advantages. Contributions Boeing contributes to the account for eligible employees, whether or not you contribute, but you must enroll in the HSA to be eligible for Boeing s contribution. You can add your own pretax funds to your account and change your contribution amount at any time. The following table shows contribution amounts for 2014: Contributions to a Health Savings Account Coverage level Boeing contributes You can contribute 2014 maximum contributions* If you are age 55 or older, you can contribute more** Employee only $600 $2,700 $3,300 Employee and any dependents $1,200 $5,350 $6,550 $1,000 * Limited by federal law. ** Referred to as catch-up contributions. If your spouse is age 55 or older, your spouse can open an HSA, if eligible, and contribute another $1,000. Your Triple Tax Advantage in a Health Savings Account Both the money you and Boeing contribute to an HSA have no federal taxes, and in most cases, no state taxes, providing three tax advantages on: 1. Contributions to the account. 2. Interest and earnings on the account. You earn interest on the money in your account and you can invest amounts more than $1,000. (This is a change as of Oct. 1. Previously, your account balance needed to be more than $2,000 to invest it.) 3. Withdrawals for qualified health expenses. Copyright 2013 Boeing. All rights reserved AE-372 1
5 Ownership You own the account, and any unused balance rolls over from year to year. No use it or lose it rule applies and you can take it with you if you change medical plans or leave Boeing employment. You even can use your HSA after you retire, which can be especially important when relying on a monthly fixed income. Eligibility According to federal rules, to be eligible to make or receive contributions to an HSA, you must be enrolled in a qualified high-deductible health plan one with a minimum annual deductible of $1,250 for self-only coverage or $2,500 for family coverage. The Advantage+ health plan meets this requirement. However, you are not eligible if you have certain types of other medical coverage for example, a spouse s health care plan (unless it is also a high-deductible health plan), a spouse s flexible spending account (FSA), Medicare or Tricare. Finally, if you can be claimed as a dependent on someone else s tax return, you are not eligible to make or receive HSA contributions. (If you are married, you are not considered a tax dependent of your spouse for this purpose.) These rules about other coverages apply to you. If you (the employee) do not have any of these other coverages, but your spouse does, you can still enroll for family coverage under the Advantage+ health plan, elect an HSA and get the Boeing HSA contribution for the family level of coverage. And you can use your HSA for your spouse s medical expenses. If you (the employee) have any of these other coverages and are not eligible for an HSA, you can still choose to enroll in the Advantage+ health plan with its lower paycheck contributions. If you become ineligible to make or receive contributions to an HSA for one of the reasons noted above (e.g., you become covered by Medicare), you can still use the funds that you have accumulated in your HSA. Paying expenses from a Health Savings Account You can use the funds to pay for current medical expenses, including expenses that count toward the Advantage+ health plan deductible. You can also pay qualified dental and vision expenses. In addition, you have the option to pay some expenses out of pocket and save the money in your account for future qualified expenses, including certain retiree medical expenses. If you enroll in the HSA, you ll receive a Visa debit card that you can use to pay most expenses. You can also use the secure HealthEquity website to pay your expenses directly from your account, including payment to a provider or to reimburse yourself. What expenses can be paid: Qualified medical expenses that you can pay from your account are generally those that would otherwise qualify as a tax deduction as outlined in IRS Publication 969 Health Savings Accounts and Other Tax-Favored Accounts and Publication 502 Medical and Dental Expenses. That would include expenses that would apply to the Advantage+ health plan deductible and out-of-pocket expenses for vision and dental care. Whose expenses can be covered: The money in an HSA can be used to pay for qualified medical expenses of any family member who qualifies as a dependent on your tax return, even if the family member is not covered on your health plan. Conversely, you can t use the HSA for someone who doesn t qualify as a tax dependent, even if they are covered on your health plan for example, you can t use the HSA for a child who wouldn t qualify as a tax dependent, or for a domestic partner who isn t your legal spouse or who doesn t meet the requirements of IRS Code Section 152. Copyright 2013 Boeing. All rights reserved. Back to top 2
6 Growing your account Boeing s contributions and any contributions that you add are initially deposited to an FDIC-insured account that earns interest. Once the value of your account exceeds $1,000, you ll have the opportunity to invest amounts over the limit in a selection of mutual funds. Where s the money? HealthEquity administers the HSA. HealthEquity is the nation s oldest and largest dedicated health savings plan trustee. You will receive more information on how to open your account and account management details in the enrollment materials. Health Savings Account versus Flexible Spending Account Both accounts help you save on taxes on the money you set aside to pay qualified medical expenses. You can choose a Health Care FSA, no matter which health plan you select.* But, because of federal rules, you can only open an HSA if you enroll in the Advantage+ health plan. *If you enroll in the Advantage+ health plan, and you choose both an HSA and an FSA, special rules apply to the FSA. Basically, you cannot pay expenses from the FSA to cover expenses that would apply to the Advantage+ health plan deductible. But, you can use the FSA to pay eligible dental and vision expenses, and you can use it for medical expenses after you have satisfied the deductible. Here are key differences between the two types of accounts: Feature Health Care FSA (available with all medical plans) HSA (available only with the Advantage+ health plan) Boeing contributes No Yes, Boeing contributes $600 for single coverage and $1,200 for family coverage if you meet eligibility requirements (described on page 2) and enroll in an HSA You contribute Yes Yes, if you choose to and meet eligibility requirements (described on page 2) Mid-year contribution changes When money in your account is available How you access money in your account No, except in limited circumstances, such as a change in family status Jan. 1, even if funds are not yet deposited Use the Aetna debit card for some expenses, file claims for others Yes Only after funds are deposited Use the HealthEquity debit card or HealthEquity online payment tool Use money in your account by year end or lose it Yes No, you can carry over your account balance year to year Take your account with you if you leave Boeing No Yes 2014 contribution limit $2,500 Listed on page 1 Copyright 2013 Boeing. All rights reserved. Back to top 3
7 Important Information The HSA isn t subject to ERISA, the federal law that governs employer-sponsored benefit plans (such as the medical portion of the Advantage+ health plan). Because Boeing doesn t sponsor or endorse the HSA, there are some differences between it and medical plans sponsored by Boeing: You can continue contributing to your HSA after you leave Boeing if you re enrolled in a high-deductible health plan and meet all other contribution requirements. You can also move it to another qualified HSA custodian. HealthEquity administers the HSA and is the HSA custodian; neither Boeing nor the Employee Benefit Plans Committee will have any involvement in HSA administration or claim issues. The HSA is your personal account with HealthEquity. As a result, Boeing can t sponsor or endorse it. You can continue to maintain your HSA with HealthEquity or transfer it after you leave Boeing. Every effort has been made to provide an accurate summary of your benefits in this document. The material provided here is for informational purposes only; it does not constitute a contract or contractual obligation. Certain eligibility provisions apply to each of the programs, policies, and benefits; not all of these provisions are described here. In the event of a conflict between this document and any of the benefit plans, the terms of the plans will control. Copies of official plan documents are available by written request through the Contact TotalAccess online form on the Boeing TotalAccess website. Subject to the applicable bargaining agreement, The Boeing Company reserves the right to change, modify, amend, or terminate any or all of the provisions of the plans at any time and for any reason for employees, former employees, retirees, and their dependents and/or beneficiaries. Copyright 2013 Boeing. All rights reserved AE-372 Back to top 4
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