Health Savings Option with a Health Savings Account (HSA)

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1 Health Savings Option with a Health Savings Account (HSA) The Health Savings Option is a high deductible health insurance plan administered by United Medical Resources (UMR), a United Healthcare Company, which works in conjunction with a tax advantaged health savings account. In addition to paying low premiums each pay period, you may voluntarily contribute pre tax dollars from your paycheck to a health savings account. You may use those funds to pay for a variety of qualified medical expenses for you and your dependents as allowed by federal tax law. The Health Savings Option paired with a Health Savings Account Voluntary Contribution gives you the flexibility to pay for qualified medical expenses now or save for future qualified expenses to use later or after you retire. 1. Can anyone enroll in the Health Savings Option and contribute to a Health Savings Account (HSA)? No. This plan design is governed by federal regulations. You cannot contribute to the health savings account if: You are entitled to Medicare, TRICARE or TRICARE for Life You have received VA benefits within the past 3 months You are over age 65 You are claimed as a dependent on someone else s tax return You are covered by a Medical Flexible Spending Account, or You are covered by any other health plan that is not a federally qualified, high deductible plan. Additionally, you must allow Windstream to establish a Health Savings Account on your behalf. You ll be prompted to affirm the set up of a health saving account during your online Annual Enrollment session prior to making your medical election. 2. What family members can I cover on the Health Savings Option with HSA? All eligible family members (see eligibility section) may be enrolled in the HSO. However, federal law only allows your federal tax dependents to have claims paid from your Health Savings Account. 3. Why are there no co pays with the Health Savings Option Plan? In most cases, you will have no medical or prescription drug co pays with the Health Savings Option. Instead, all eligible medical and prescription drug expenses are paid by you until you meet your deductible. Then, after your deductible is met, you share the cost of your expenses with Windstream up to the out of pocket maximum. The sharing percentage is defined by the medical plan. However, preventative medications as defined by the IRS and maintained by Express Scripts follow the same co pay structure as the PPO plans (currently $10 for generic, $40 for formulary). For all other medication, prescriptions are charged at the full price until the

2 deductible is met, then you pay a percentage in coinsurance until out of pocket max is met. The percentage is based on the class of prescription and the pharmacy network you use. See the Express Scripts Rx Coverage section on windstreambenefits.com for more detail. 4. Can I have a Medical Flexible Spending Account and a Health Savings Account? No. Federal law does not permit you to participate in the Medical Reimbursement Flexible Spending Account (FSA) if you enroll in the Health Savings Option. However, you ll still be able to participate in Dependent Care Reimbursement, Mass Transit and Parking Reimbursement Accounts. 5. Do I need to open a Health Savings Account on my own? No. When you enroll in this plan, you will authorize that a health savings account will be created for you at Optum Bank and you will be issued a debit card (in late December) to use for your qualified medical expenses. The debit card will be funded as your voluntary pre tax paycheck contributions are made. If you don t contribute to your account, funds will not be available for use. If you want to contribute to your account, make your election on the Health Savings Option Voluntary Contribution page during your online enrollment session. In some circumstances (if you recently changed your home address, changed your last name, etc., and do not provide updated information to Optum Bank when requested), an account may not be set up for you. If this occurs, you can still access your high deductible health plan coverage, but you will not be able to make voluntary pre tax health savings accounts contributions. 6. If I change my mailing address or name mid year, do I need to tell Optum Bank? Yes. Changes made to names and address in WINPay will NOT be sent automatically to Optum Bank. You ll need to contact them directly to update your account information. 7. How much can I contribute to the HSA? The maximum IRS health savings account contribution limit (your Health Savings Option Voluntary Contribution) is $3,300 for single coverage and $6,550 for families. Account holders age 55 and older can make additional $1,000 catch up contributions annually. 8. Once I choose how much I want taken out of my paycheck for my Health Savings Option Voluntary Contribution, can I ever change it? Yes. You will be able to change your contribution throughout the year through the Web Benefits System. However, you are responsible for making sure your annual voluntary contribution does not exceed the annual limits set by the IRS. 9. Are my pay period premiums for the Health Savings Options medical plan contributed to the Health Savings Account? No. Your premiums help pay for your health plan coverage provided by the plan. They are not deposited into your Health Savings Account. The funds in your Health Savings Account are used to pay for your out of pocket medical expenses.

3 10. How do I pay medical claims from my HSA? You have several options for making payments out of your Optum Bank account: Use your Optum Bank Health Savings Account Debit MasterCard Pay for an expense with personal funds and reimburse yourself from your HSA Sign up for automatic bill pay and online banking Use HSA checks, which you can order from Optum Bank If you enroll in the Health Savings Option with an HSA, you will receive a Welcome Packet in late December with more information about your account and all of your options. Your debit card will be mailed separately from your Welcome Packet in late December. 11. Do I have access to my full annual voluntary HSA election on Jan. 1? No. A health savings account is a savings account. You are only able to use the funds that you have contributed to your account. 12. How long does it take for my Health Savings Option Voluntary Contributions to be deposited into my HSA? Your contributions will be credited within 5 7 business days after your paycheck date. This allows time for Windstream s bank to send your contributions to Optum Bank for deposit. 13. If I used my personal funds for a qualified medical expense, what is the deadline for requesting reimbursement from my HSA? You can use your HSA to pay for eligible expenses incurred any time after your HSA is established. There is no time limit between when you incur the qualified expenses and when you withdraw the corresponding amount from your HSA. 14. If I enroll in the Health Savings Option with HSA for next year, can I get reimbursed for this year s medical expenses from it? No. You can only use your HSA for qualified expenses incurred after the effective date. 15. Can I transfer funds from an IRA to my HSA? How much can I transfer? The IRS allows a one time transfer of Individual Retirement Account (IRA) funds to an HSA. This amount, when combined with other HSA contributions for the year, is subject to the annual HSA maximum contribution. In other words, the amount of the rollover cannot exceed the applicable annual HSA contribution limit (which would vary depending on whether the person has individual or family HDHP coverage) when combined with any other HSA contributions you made for that year. The contribution limit for 2014 is $3,300 for an individual, and $6,550 for a family plan. If you are over age 55, you are allowed to make an additional $1,000 catch up contribution. 16. Are there fees associated with a Health Savings Account? No. While Optum Bank charges a small, monthly fee to maintain accounts, the fee is included in the total cost of the plan. Upon termination you will pay the fee only if you retain your account with Optum Bank.

4 17. What information do I need to keep when I withdraw funds? Save all receipts and records of withdrawals for tax reporting to the IRS. If you use your funds for non health related expenses, you must report those withdrawals. You are responsible for maintaining all records associated with your HSA. 18. Are there tax penalties if I make a withdrawal from my account for non qualified expenses? Yes. If you pay for anything other than qualified medical expenses with your HSA funds, the amount will be taxable as income, and you will pay an additional 20 percent tax penalty. The tax penalty does not apply if you are age 65 or older or disabled, but the amount still must be reported as taxable income. 19. What are qualified expenses? In general, the IRS requires that expenses must be for the diagnosis, cure, mitigation, treatment or prevention of disease, and for treatments affecting any part or function of the body. IRS Publication 969, "Health Savings Accounts and Other Tax Favored Health Plans," explains that qualified medical expenses are those that would generally qualify for the medical and dental deduction, as listed in IRS Publication 502. These publications are available on the IRS website, The Welcome Kit that you will receive in late December (if you enroll in the Health Savings Option medical plan) will contain a summarized list of qualified expenses for your reference. 20. Can I invest my savings? Yes. However, you must meet the investment threshold of $2,100 in your HSA before you can make investments. The minimum investment buy is $100. Invested funds are not available for paying bills until the investment is sold. 21. What options do I have for investing savings funds? You can choose from a wide variety of mutual funds for investment. Investments are not FDIC insured, are not guaranteed by Optum Bank and may lose value. A list of available investments is available at under the Using Your Health Savings Account menu. Select Investment Opportunities, then click on Mutual Funds on the left menu. 22. What happens if I don t use all of my contribution? Will I lose it? No. The money in the account is yours until you spend it, and unused dollars remain in your account from year to year and also earn interest. You are not taxed on your health savings account unless you use the money to pay for nonqualified expenses. 23. I m an employee under age 65, but my spouse is over age 65 and is Medicare eligible. Can I contribute to a Health Savings Account? Yes. The Health Savings Account eligibility rules pertain to accountholders only. This means that if you (the employee) meet all of the federal eligibility guidelines, you can enroll in the Health Savings Option and make voluntary contributions to a Health Savings Account. You will be able to use your Health Savings Account for qualified expenses incurred by you and your federal tax dependents, even if those dependents are Medicare eligible.

5 24. I m an employee over age 65 or am eligible for Medicare due to disability, but my spouse and dependents are under age 65. Can I contribute to a Health Savings Account? No. Since you, the potential accountholder, are over age 65 or are eligible for Medicare, federal regulations will not allow you to contribute to a Health Savings Account. This same rule would apply if you, the employee, do not meet any one of the other federal eligibility guidelines. 25. What happens if I change medical plans, retire, or leave Windstream? Your HSA is an individually owned account and is yours to keep even if you change medical plans or jobs. Your account can be used to pay for qualified medical expenses tax free, even if you no longer have high deductible health plan coverage. The funds in your account remain indefinitely until used. There is no time limit on using the funds. If you are no longer covered by a high deductible health plan, you will not be able to make new contributions to your account; however, you ll be able to use the funds you ve already contributed. Optum Bank may charge you a small monetary fee to maintain your account. 26. Can I use the account to pay for my medical premiums? While you are an active employee you may not use the account to pay for your bi weekly premium deductions. However, if you retire or leave Windstream, the funds will be available to pay for future qualified medical expenses, retiree medical premiums or COBRA premiums. 27. How do I designate a beneficiary for my account? Complete and mail or fax a Designation of Beneficiary Form, which can be downloaded at What income tax forms will I need to file when I have an HSA? You'll need to file IRS form 8889, along with the standard Form 1040 individual income tax return, to report any contributions made to your HSA as well as any distributions from your HSA for contributions you ll receive a 5498 SA and for distributions you ll receive a 1099 SA (if you do not make any distributions during the year, you will not receive a 1099 SA).

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