Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA)

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1 Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA) Interact with this ebrochure. Here s how. This ebrochure is designed for onscreen viewing, allowing you to navigate through the document in a variety of ways. Roll your mouse over the buttons along the bottom of this page to learn what each button does. Click here to close this pop-up window. Click here for information on how to interact with this ebrochure EXIT EBROCHURE ON/OFF FULL SCREEN PRINT FIRST LAST 1/12

2 Comprehensive coverage, savings and so much more! When you enroll in the Consumer Driven Health Plan (CDHP) through Blue Cross Blue Shield of Massachusetts with a Health Savings Account (HSA) through Health Equity, you get comprehensive coverage, tax savings, HSA contributions from Hologic, and the lowest employee medical plan contributions. Plus, you get a unique opportunity to save for future health expenses with benefits similar to those of a 401(k) plan. The CDHP with HSA places a priority on consumerism and wellness and provides tools and resources for employees to adopt and sustain healthy behaviors. It s the only health plan that can give you a leg up on saving for future health expenses, even after you retire. To maximize benefits from the CDHP, it s important that you understand how the plan works. Read this ebrochure to learn more. For additional information about the plan, refer to the plan summary. 5 main components in a CDHP Low premium Savings account High-deductible medical coverage (includes 100% coverage for in-network preventive care) Access to educational tools and information Medical expense cost transparency 17.4 million Sharpen your healthcare consumer skills The number of Americans covered by a Consumer Driven Health Plan with a Health Savings Account as of January, To reap the greatest rewards from the CDHP with HSA you need to sharpen your skills as a healthcare consumer. See page 10 for tips on how to use the CDHP and HSA effectively to maximize tax savings and stretch your spending power. Source: 2014 America s Health Insurance Plans Census 2/12

3 Consumer Driven Health Plan Like the PPO and PPO Plus plans, the CDHP uses the same BCBS network of preferred providers and provides coverage for office visits, medical care, tests and prescription drugs. It has a plan year deductible, coinsurance and an out-of-pocket maximum to provide financial protection in the event of a serious illness or injury. What s different is that the CDHP has the lowest employee contributions and highest plan year deductible. Plus, when you enroll, Hologic automatically opens and contributes to a Health Savings Account (HSA) on your behalf with HealthEquity. You can use funds in your HSA to help pay for eligible healthcare expenses now or save for future healthcare expenses. Important! You must enroll in the CDHP to be eligible for a Health Savings Account as the two plans work together. If you enroll in the CDHP, you are not eligible to participate in the Health Care Flexible Spending Account (FSA). Preventive care Many preventive services, including annual physical exams, routine labs, immunizations and screenings, are covered at 100 percent in-network. If you use out-of-network providers, you pay 40 percent coinsurance after the plan year deductible. Plan year deductible The CDHP meets the IRS guidelines for a high deductible health plan and, therefore, qualifies for the accompanying Health Savings Account (HSA). You can use funds in your HSA to pay for out-of-pocket expenses that apply to your plan year deductible. In-network Out-of-network Employee only coverage $1,300 $3,000 Family coverage $2,600 $6,000 Any money you spend on eligible medical expenses covered by the plan, including prescription drugs, counts toward your plan year deductible. If you cover one or more family members, the entire family deductible must be met before the plan begins paying benefits. The plan year deductible applies toward the plan year out-of-pocket maximum. Coinsurance Once your plan year deductible is satisfied, the plan provides coverage for eligible expenses through coinsurance. Just like the PPO and PPO Plus plans, you receive the highest levels of coverage when you use the BCBS network of providers. In-network Out-of-network You pay 10% 40% Plan pays 90% 60% Plan year out-of-pocket maximum The plan provides financial protection for you and your family in the event of a catastrophic illness or injury. Once you reach the out-of-pocket maximum in a plan year, the plan pays 100 percent for covered benefits. In-network Out-of-network Employee only coverage $2,500 $5,000 Family coverage $5,000 $10,000 3/12

4 Consumer Driven Health Plan (continued) Prescription drug coverage Unlike the PPO and PPO Plus plans, your prescription medication expenses are subject to the deductible when you are enrolled in the CDHP. You will pay the full cost of prescription medications less any discounts negotiated by CVS Caremark until you have satisfied your plan year deductible. Once you meet the deductible, you will pay the copay or coinsurance listed until you reach the plan year out-of-pocket maximum. Then, you will pay nothing for covered medications for the remainder of the plan year. You must use CVS Caremark s network of retail pharmacies or mail order for maintenance drugs. Note that the Maintenance Choice program lets you fill a 90-day supply of your prescription drug(s) at a CVS retail pharmacy for the cost of a 60-day supply. Note: Certain preventive drugs are not subject to the deductible, which means you pay only the copay or applicable coinsurance. For a list of preventive drugs, visit My Hologic or the benefitsopenenrollment.hologic.com site. Retail (30-day supply) Mail order or Maintenance Choice** (90-day supply) $4.02 billion Total spent in U.S. households on prescription drugs in Source: The Nursing Bible The CDHP with HSA provides incentives to keep you healthy and encourages you to spend your healthcare dollars wisely. For online consumer decision tools to help you make informed healthcare choices visit Generic (Tier 1) $10 copay* $20 copay* Preferred brand name (Tier 2) 25%* 25%* Non-preferred brand name (Tier 3) 35%* 35%* * After plan year deductible is met ** If you fill a prescription at a CVS retail pharmacy you may receive a 90-day supply for the cost of a 60-day supply. 4/12

5 How the Consumer Driven Health Plan works with the Health Savings Account _Consumer Driven Health Plan (CDHP) Health Savings Account (HSA) Enroll in the CDHP during your enrollment period Hologic opens an HSA on your behalf through HealthEquity In-network preventive care covered at 100% with no deductible Meet plan year deductible* $1,300 for employee only coverage in-network $2,600 for family coverage in-network Pay coinsurance 10% in-network* Meet out-of-pocket max* Plan pays 100% if plan year expenses exceed: $2,500 for employee only coverage in-network $5,000 for family coverage in-network Your pre-tax contributions (if any) and Hologic contributions are deposited into your HSA Hologic biweekly contribution amounts : $23.08 for employee only ($600 annually) $46.16 per family ($1,200 annually) Pay deductible and/or coinsurance out-of-pocket or use HSA funds if available Use Visa Health Account card to pay for healthcare expenses HSA balance You own your account; any funds remaining in your account at end of year roll over and earn interest for future eligible healthcare expenses Maximum contribution from all sources for 2015: $3,350 for employee only $6,650 for family * See page 3 for how to satisfy the family deductible and out-of-pocket maximum along with out-of-network costs associated with the CDHP. 5/12

6 Health Savings Account (HSA) If you participate in the CDHP, Hologic will automatically open a Health Savings Account (HSA) on your behalf with HealthEquity. The HSA is like a tax shelter that can save you money. In most states*, you don t pay taxes on the funds you or Hologic put into your HSA. You can use the money to pay for qualified current and future healthcare expenses, including deductibles, copayments and coinsurance, prescription drugs, COBRA premiums and even healthcare expenses during retirement with tax-free savings. You decide when to use your savings spend the money now on deductibles, copays and current expenses, or save it to cover future healthcare expenses. Unlike funds contributed to the Health Care Flexible Spending Account, you do not have access to this money until it is funded. You also don t lose unused HSA funds at the end of the year. Any unspent balance remains in your account earning interest until you spend it on qualified expenses. This provides a strong incentive for you to spend wisely on your healthcare. Your HSA funds are also portable, so if you leave Hologic, you can take your account balance with you. Eligibility for the Health Savings Account You are eligible for an HSA as long as you are: Enrolled in the Consumer Driven Health Plan (CDHP); Not covered by any other medical plan (as through your spouse or as a retiree), including a Health Care FSA; Not enrolled in Medicare or MediCal; and Not claimed as a dependent on another person s tax return. HSA contributions from Hologic As long as you are actively employed and enrolled in the CDHP, Hologic will provide biweekly contributions to your HSA to help offset your out-of-pocket costs. Coverage category Employee only Family Growing your HSA Company contribution $23.08 per pay period ($600 annually) $46.16 per pay period ($1,200 annually) The amount you and Hologic may contribute each year to your HSA is established by the IRS. For 2015, the maximum is $3,350 for employee only coverage and $6,650 for family coverage. You can contribute through biweekly payroll deductions, which will be deducted on a pre-tax basis.* You may also choose to make a deposit directly into your HealthEquity account on an after-tax basis and take an above the line deduction from your federal taxable income when you file your taxes. You are eligible to contribute the maximum amount for 2015/2016 provided that you maintain coverage in this plan for the entire plan testing period as defined by IRS publication 969. Please consult your tax advisor for information on the taxation of HSA contributions and distributions. If you do not have a personal tax advisor, you may contact your current Employee Assistance Program for referrals. * Your and Hologic contributions to your HSA are subject to state income taxes if you live in California, Alabama or New Jersey. Also, interest and investment earnings are subject to state taxes in the same three states plus New Hampshire and Tennessee. 6/12

7 Health Savings Account (HSA) (continued) Eligible expenses Use your HSA funds to pay for any qualified medical expense according to IRS rules. This includes most medical care and services (including deductibles, copayments and coinsurance), and dental and vision care, as well as prescriptions. Eligible expenses include those incurred by you or your eligible tax dependents even if they are not covered by a Hologic medical or dental plan. You may have dependents that qualify for coverage under the CDHP whose expenses will not be covered under the HSA, if you do not claim them on your tax return, such as a domestic partner or adult children. HSA withdrawals for non-qualified expenses, such as cosmetic surgery or non-medical services, will be subject to a 20 percent penalty tax. If you are age 65 or older, you will be taxed on the money used for non-medical expenses, but you will not have to pay a penalty. Pay for hundreds of eligible expenses without the tax bite Medical, dental and vision out-of-pocket expenses Prescriptions drugs Glasses and contact lenses not already paid for by the medical plan as well as LASIK eye surgery Physical therapy, counseling and psychology Some insurance premiums, such as COBRA and health care coverage premiums while receiving unemployment compensation See the complete list of qualified medical, dental, vision and pharmacy expenses in IRS Publication 502 Medical and Dental Expenses. 7/12

8 Health Savings Account or Flexible Spending Account what s the difference? Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) both offer tax savings, but there are some important differences between the accounts, as shown here. Account Feature Health Care FSA HSA Eligibility Tax savings and interest Available to employees not enrolled in a Health Savings Account Your contributions are pre-tax; funds do not accrue interest Available to employees enrolled in a CDHP You must not be participating in a Health Care FSA, including one through your spouse s employer Your contributions are pre-tax, interest and investment earnings are tax-free; and distributions for qualified healthcare expenses are tax-free (in most states) even when you retire. Annual contribution from Hologic None $600 for employee only $1,200 for family 2015 contribution maximums Health Care FSA: $2,550 $3,350 for employee only $6,650 for family Eligible expenses Qualified healthcare expenses incurred during the plan year Qualified healthcare expenses incurred now or in the future, including Long Term Care and COBRA premiums, among other expenses Rollover balance from year to year Not permitted Yes. You can roll over unused funds from year-to-year Portability if you leave Hologic Account balance forfeited unless contributions continue on a post tax basis through COBRA You take account balance with you. Catch-up contribution None Employees age 55 to 65 can contribute $1,000 more each year. Unused HSA funds stay with you from year to year Unlike with the Health Care FSA, there s no use it or lose it rule with the HSA. Unused HSA funds roll over from year to year and even stay with you if you change jobs or retire. 8/12

9 Health Savings Account (HSA) (continued) Convenience, learning tools and investment options with HealthEquity Once you enroll in the CDHP medical plan, Hologic will open an HSA on your behalf with HealthEquity. Once enrolled, you ll receive a convenient Visa Health Account card to use for eligible healthcare services and expenses. Be sure to save all of your receipts, as you may need them for tax purposes. You will also receive access to the HealthEquity online member portal which provides real-time account information, claims and payment tools, learning tools, and calculators to help you make informed decisions. The HealthEquity Member Services team is available 24/7 to answer your questions and help you find safe, effective ways to save on healthcare costs. Need help maximizing your savings? Visit the member portal at or contact your HealthEquity Member Services team at for tips and advice. Interest and investments Your HSA funds are deposited in an interest-bearing account that is FDIC insured. Once you reach a minimum balance, you can invest in stocks/bonds, mutual funds, CDs and/or annuities. Any monies you elect to invest are not FDIC-insured. HealthEquity calculates, compounds and credits interest monthly based on the applicable rate for different account balance tiers. You must name a beneficiary for your Health Savings Account. Visit the My Profile page at or call Member Services at You may also download a Beneficiary Form with instructions from the Forms and Docs section of the member portal. 9/12

10 Sharpen your healthcare consumer skills The best medicine for rising healthcare costs is a work force committed to staying healthy. Become an informed healthcare consumer so when you need medical services you can access the right care in the most appropriate setting. Reach for your Blue Cross Blue Shield of Massachusetts ID card for important phone numbers and visit for a wealth of tools and free information. Start practicing healthy habits to live longer and better, minimizing the need for expensive medical treatments down the road. Here are other quick tips to sharpen your healthcare consumer skills: Learn how your medical plan works to maximize savings and benefits. Practice prevention by getting regular checkups. Treat problems early by getting medically necessary care when you need it. Always use in-network providers. Become familiar with the healthcare treatment options in your area, including physicians, hospitals and urgent care clinics. The number for the BCBS 24-hour nurse line can be found on the back of your medical ID card. Keep the number handy and use it when you have questions. Monitor the claims and payment process and always check for errors. Save the emergency room for true emergencies. For less serious situations, call your doctor or the nurse line, or use an urgent care center. Request generic drugs whenever available. Take charge of your care and ask questions. Don t be afraid to ask your doctor about the cost of procedures or treatment options. 10/12

11 Is the Consumer Driven Health Plan with HSA a good fit for you? The CDHP with HSA is generally a good fit for people who: Want more control over their healthcare spending; Can meet eligibility requirements; Want the lowest biweekly premium; Want the company contribution from Hologic; Can afford to pay the higher deductible if high-cost medical services are needed; Can pay out-of-pocket for needed treatments through coinsurance and copays, if there are not sufficient funds in the HSA; Are willing to maintain records (receipts, explanation of benefits, etc.) so documentation can be provided in the event of an IRS audit; or Want a tax-favorable way to pay for healthcare expenses now and in the future. Learn more about the Hologic medical plans To learn more about the Hologic medical plans, refer to the carrier plan summaries, plan documents, videos, the 2015/2016 Benefits ecatalog and a set of personal healthcare decision profiles that will help you choose a medical plan. You can also contact your HealthEquity Member Services team at for questions. Disclaimer: This ebrochure is for informational purposes only and is neither an offer of coverage nor medical advice. It contains only a partial, general description of the Hologic Consumer Driven Health Plan (CDHP) and Health Savings Account (HSA) and does not constitute a contract. Consult your plan documents (Summary Plan Descriptions and Group Insurance Certificates) for a complete description of all governing contractual provisions, including benefits, exclusions, limitations and procedures relating to your plans. All of the terms and conditions of the plans are subject to applicable laws, regulations and policies. In case of a conflict between your plan documents and the information contained in this ebrochure, the plan documents will always govern. 11/12

12 Frequently asked questions What is a Health Savings Account (HSA)? An HSA is a tax-advantaged savings account that allows you to set aside pre-tax dollars to pay for qualified healthcare expenses. In most states*, contributions are tax free, interest and investment earnings are tax free and distributions for qualified healthcare expenses are tax free, even after you retire. Do I have to have health insurance to open a Health Savings Account (HSA)? Yes. To participate in an HSA, you need to be enrolled in the Consumer Driven Health Plan (CDHP). Who owns my HSA? You own the HSA as soon as funds are contributed whether you make the contribution or it comes from Hologic. How much can I contribute to my HSA? The IRS limits how much you and Hologic can contribute to your HSA. For 2015, the maximum contribution from all sources, including your pre-tax contributions, Hologic contributions and any additional after-tax amounts you may deposit directly with HealthEquity, is $3,350 for employee only coverage or $6,650 for family coverage. If you are age 55 or older during the calendar year, you can contribute an additional $1,000 in catch-up contributions. * Your and Hologic contributions to your HSA are subject to state income taxes if you live in California, Alabama or New Jersey. Also, interest and investment earnings are subject to state taxes in the same three states plus New Hampshire and Tennessee. Does Hologic contribute to my HSA? Yes. Hologic will make biweekly contributions to your HSA. If you are enrolled in employee only coverage, you will receive $23.08 per pay period ($600 annually). If you are enrolled in family coverage, you will receive $46.16 per pay period ($1,200 annually). The family coverage contribution is based on one or more tax dependents enrolled in the CDHP. Can I be reimbursed for an amount greater than my account balance? No. You can only be reimbursed up to the amount in your account at the time of your reimbursement request. Can I use my HSA to pay expenses for dependents not enrolled in a Hologic medical plan? Yes. You can use your HSA to pay eligible healthcare expenses for any tax dependent even if the dependent is not enrolled in a Hologic medical or dental plan. What if I don t use all of the money in my HSA? Once the money is deposited into your account, it is yours until you spend it. Your HSA balance will roll over from year to year and earn interest. Unlike funds in a flexible spending account, the use it or lose it rule does not apply. Can I enroll in the HSA and also participate in the Health Care Flexible Spending Account (FSA)? No. If you enroll in the CDHP with HSA you are not eligible to participate in the Health Care Flexible Spending Account (FSA). However, there are no restrictions on Dependent Care FSA participation. Can I access my HSA online? Yes. Once your account has been established, you can see your account balances, Visa Health Account card activity, transaction history and more online. You can also pay providers, request reimbursements and manage your personal information. Visit Where can I find more information? For more information about the Consumer Driven Health Plan (CDHP): Blue Cross Blue Shield of Massachusetts, the CDHP plan administrator For more information about the Health Savings Account (HSA): HealthEquity, the HSA plan administrator /12