Together for a great state of health Health Savings Plan (HSP) with a Health Savings Account (HSA)

Transcription

1 Together for a great state of health Health Savings Plan (HSP) with a Health Savings Account (HSA) 2016 Benefits

2 About Blue Shield of California Not-for-profit health plan with over 70 years of experience. Committed to providing Californians with access to affordable, high-quality health care. One of the largest networks in California with more than 70,000 providers and over 370 hospitals. Access to BlueCard national network, including 92% of all physicians and 97% of all hospitals in the country more than any other insurer.

3 About the Health Savings Plan (HSP) High-deductible PPO paired with a Health Savings Account (HSA). All covered services, excluding preventive care, are subject to the medical deductible. (Deductibles and out-of-pocket maximums set by the IRS.) For individual and family coverage, the full deductible is met before the enrollee or covered dependents can receive benefits for covered services (except for preventive care). Flexibility of network and non-network providers.

4 HSP: 2016 Benefits overview 2016 Benefit Type Network Non-Network Calendar year deductible (medical/pharmacy services) Out-of-pocket maximum (medical/pharmacy services) Physician/specialist Office Visits (includes behavioral health) Preventive health benefits Hospital care - outpatient surgery (includes behavioral health) 1,300 per individual coverage/ $2,600 per family coverage $4,000 per individual coverage/ $6,400 per family coverage $2,500 per individual coverage/ $5,000 per family coverage $8,000 per individual coverage/ $16,000 per family coverage 20% 40% No charge (not subject to the calendar-year deductible) 40% 20% 40% Hospital care - inpatient non-emergency facility services (includes behavioral health) 20% 40% Emergency room services (not resulting in admission) Chiropractic /Acupuncture benefits (up to 24 visits per calendar year combined with Chiropractic visits) 20% 20% 20% 40% Outpatient Prescription Drug Retail -No charge for contraceptives UC Maintenance Drug Program (90 day supply at UC and select pharmacies) Mail Service -No charge for contraceptives Other drugs 20% per prescription (after deductible is met) 20% per prescription (after deductible is met) 20% per prescription (after deductible is met) Other drugs 40% per prescription Not Covered Not Covered

5 HSP member profile: Meet Carlotta 2016 Medical/Rx Costs Carlotta Pays: Deductible Remaining Preventive Exams (Carlotta, Paul, Judi) Judi s asthma med (90 day supply) Carlotta, 42, married to Paul, 45, with daughter Judi, 14. Medical plan: $2600 annual deductible; $6400 out-of-pocket maximum (OOPM) HSA Balance: $5000 (2 years with $2k from UC) HSA Balance $5000 $0 $0 $2600 $5000 $120 $120 ( from HSA using health account debit card) $2480 $4880 Paul s specialist visit $400 $400 $2080 $4480 (Additional $1k HSA pre-tax contribution from Carlotta) Paul s back surgery $20,000 $5664 ($ % of $17920 balance or $3584) Total OOP = $184 Deductible satisfied $5480 $0 Judi s asthma med (90 day supply) $120 $24 0 $0

6 The health savings plan: How it works for you 6

7 HSP: Medical coverage + savings Your high-deductible Blue Shield medical plan is paired with a HealthEquity health savings account (HSA). An HSA is an interest-bearing financial account owned by you and used to pay for qualified medical expenses. Funds can be used for preand post-deductible charges or left in the account to earn tax-free interest. There is no HSA annual rollover limit. HSP COMPONENTS Qualified PPO Savings Plan Lower-premium*, high-deductible health plan HSA Health Savings Account Account used to to pay pre- and post- deductible medical expenses with multiple-tax savings advantages Blue Shield of California Insurance Provider HealthEquity Financial Administrator

8 Why an HSA? You control how funds are deposited/spent/saved. You take account with you if you leave UC. (You can keep contributing to your HSA as long as you have a qualified high deductible health plan.) UC contributes annually to its employees HSAs ($500 individual; $1,000 family). Pre-tax payroll contributions to your HSA lower your federal tax liability. Contributions (payroll, employer) are untaxed by the IRS. Interest earned is untaxed by the IRS. Withdrawals for qualified medical expenses (QME) for you and/or your dependents are untaxed by the IRS. Balances over $2,000 can be invested in HealthEquity mutual funds and later returned to the HSA. Can provide significant retirement savings. After age 65, HSA funds can be used for anything (including Medicare premiums). Withdrawals for non-qme only incur standard income tax. You and/or Employer Contributes Your HSA Cover Qualified Medical Expenses

9 How your HSA works Blue Shield and HealthEquity power a fully-integrated platform with a customized Member Portal. Once your account is set-up, you access your HSA anytime through the portal or through dedicated 24/7 live member support. The Member Portal tracks all of your medical account activity in one convenient, secure location. Blue Shield processes claims and submits them to your account on the Member Portal. You get notice a claim is waiting. Multiple claim resolution options inside the portal: Use your HSA funds to pay the claim in full/in part/at once/in installments. Use funds from your personal bank account (can be linked to your HealthEquity account for easy access). Reimburse yourself for qualified out-of-pocket medical expenses. Or call member support. HealthEquity tracks any HSA expenditures that apply to your medical plan deductible.

10 Simplified transactions You get an HSA welcome kit and a HealthEquity Visa health account card. You can use your card with providers and pharmacies. HealthEquity provides up to three cards at no cost.

11 HSA provider process overview Member visits provider Provider submits claim to Blue Shield Claim is displayed on HealthEquity Member Portal Member presents medical ID card. Blue Shield applies discounts and sends claim to HealthEquity Member Portal. Member settles claim with HSA or personal funds. If personal, member can later self-reimburse with HSA.

12 HSA pharmacy overview Member visits pharmacy Pharmacy applies network discounts Card transaction and claim is displayed on HealthEquity Member Portal Member presents medical ID card. Member pays using HealthEquity Visa health account card (or pays outof-pocket and reimburses self with HSA dollars on Member Portal). Blue shield processes and sends claim to HealthEquity Member Portal after pharmacy has settled and submitted charge.

13 Build savings by investing Trades with HealthEquity are transaction-free You can invest HSA balances of $2000 or more. HealthEquity offers Best-in-class funds. Thee is no charge any commissions or trading fees. You can buy and sell shares at no cost to you. There are no fund minimums.

14 A word about HealthEquity One of the nation s oldest and largest dedicated health savings trustee. Treasury approved custodial trustee. Licensed and audited by the IRS. Regulated by FDIC and US Treasury. Proprietary software platform built to administer health accounts. $1 billion+ in AUM; 620,000+ HSA accounts; 125,000+ RA accounts; 23,000+ employer groups.

15 2016: How much can you contribute? 2016 IRS allowed contributions to HSA (all sources) Single/Individual Coverage Family Coverage $3,350 $6,750 UC contribution made in January into HSA ($500) ($1000) You (employee) maximum pretax contributions from your payroll Up to $2,850 Catch-up contribution, age 55+: additional $1,000 up to $ 5,750 Catch-up contribution, age 55+: additional $1,000 Federal Tax-Free Deposits What you need to do: Enroll in the Health Savings Medical Plan Receive FREE UC contributions to start your HSA and help you meet your medical deductible Make pretax contributions through payroll deductions if you choose and/or can make post-tax contributions directly to your HSA.

16 Health savings account (HSA) vs. flexible spending account (FSA) 16

17 HSA vs. FSA Compatible UC Plans Who is eligible? UC contributes funds HSA (Health Savings Account) Health Savings Plan Members enrolled in a the HSP who do not have any other non- HDHP health plan, including coverage under Medicare, a spouse s health plan or flexible spending account (FSA). Yes UC provides $500 Individual coverage and $1,000 Family. Health FSA (Flexible Spending Account) UC Care, Health Net, Kaiser and Western Health Advantage. Members enrolled in the medical plans above. No need to enroll in a medical plan to have FSA. No Who owns the account? HSP Member UC

18 HSA vs. FSA HSA (Health Savings Account) Health FSA (Flexible Spending Account) Who can contribute? Contributions subject to federal income tax? 2016 Election/contribution limits Do unused funds carry over to the next year Employers, employee/account holder, or any third party No Single Coverage $3,350 Family Coverage $6,750 Age 55+ $4,350 single / $7,750 family. Yes Entire balance rolls over. No limit on balance roll over. Employee No $2,550 regardless of self or family coverage. UC may choose a lower limit. Only funds up to $500 roll over. Does interest accrue? Yes No

19 HSA vs. FSA Changes to contributions Expiration Disbursement of funds Can you use the account for retirement income? HSA (Health Savings Account) On a monthly basis. Never expires or lost. Only funds deposited are available for healthcare expenses. Can change contribution to cover unexpected or higher expenses. Yes. After age 65, you can withdraw funds for any reason with no penalty. Health FSA (Flexible Spending Account) Only for qualifying events, such as a marriage, divorce, birth, or during open enrollment. All money in an FSA (with no rollover feature) expires and is lost at the end of the year. Entire annual contribution amount available from the beginning of the year. Cannot add to the funds if you incur more expenses. No

20 Access to benefit and HSA information 24/7 blueshieldca.com/uc healthequity.com/ed/uc

21 Member Services: Dedicated support Shield Concierge (855) a.m. to 7 p.m. PT, Monday Friday Phone number conveniently located on the back of member ID cards. HealthEquity (866) /7/365

22 blueshieldca.com/uc Access to benefit information 24/7 Get information about medical and pharmacy benefits. Learn more about the HSA or log in to get HSA balances. Search for network doctors, hospitals and other facilities. Access tools and resources. Learn about Blue Shield programs and services.

23 HSP Webinars Learn more about the HSP and HSA. Register by going to blueshieldca.com/uc (Recordings of previous webinars also available)

24 Questions?