HEALTH SAVINGS ACCOUNTS Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association

Transcription

1 HEALTH SAVINGS ACCOUNTS 2014 Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association 1

2 Overview Mechanics BNY Mellon Questions AGENDA 2

3 OVERVIEW Health Savings Account 3

4 WHAT IS AN HSA? Health Savings Account A bank account to use for medical expenses Money saved in an HSA is tax-free* Unused dollars remain in the account year after year Can be used as a medical 401(k) a way to save for retirement Yearly contributions are permitted up to the established IRS maximum contribution limit It s portable you own the account funds even after changing employers, retirements, etc. You are in control of your account- You decide how to spend your money Allows you to pay for medical expenses that may not be covered under your health plan *Tax references are for federal taxes only. State taxes vary. Consult your tax advisor. 4

5 HDHP + HSA = HEALTHY BENEFITS A High Deductible Health Plan (HDHP) and HSA work together to create your Healthy Benefits product. You must have an IRS-qualified HDHP in order to open an HSA Medical and prescription drug expenses accumulate to the same combined deductible The PPO medical plan covers medical expenses after the deductible has been met The Prescription Drug Plan covers drug costs after the deductible has been met Funds in the HSA can be used to pay for any IRS eligible expenses 5

6 DESIGN DIFFERENCES HSA VS. PPO The IRS requires design differences for HDHPs compared to standard PPO plans Deductible HDHP Medical and Rx are combined The deductible applies to ALL services (except preventive) Qualified plans only have two tiers of deductible coverage single or family (contracts of two or more) The deductible amount must be met before any family member is eligible for covered benefits Standard PPO Medical and Rx are not combined The deductible does not apply to services that take a copayment (such as OV, ER etc.) Plans can have various tier structures The family deductible amount may not need to be met to be eligible for benefits if an individual met the single deductible amount Out-of-Pocket Medical and Rx are combined Medical and Rx are not combined in large group products 6

7 WHO IS ELIGIBLE FOR AN HSA? HSAs are available to any individual that: Is covered by an IRS-qualified HDHP Is not enrolled in Medicare Can t be claimed as a dependent on someone else s tax return Is not covered by other health insurance, some examples of permitted/non-permitted coverage are: Permitted Limited FSAs and HRAs Auto, life, workers comp, or disability coverage Dental care, vision care or long-term care Specific disease insurance, and per diem hospitalization insurance Not Permitted General Purpose FSA or HRA Other Rx coverage Medical coverage under spouse plan 7

8 HSA CONTRIBUTIONS The IRS annually adjusts minimum deductible amounts and maximum contribution amounts based on Cost of Living (COLA) Minimum Deductible Maximum Contribution Maximum Out-of-Pocket 2014 Amount $1,250 single $2,500 family $3,300 single $6,550 family $6,350 single $12,700 family 55+ Catch up Contributions $1,000 8

9 HSA ELIGIBLE EXPENSES In addition to using HSA funds for your deductible, coinsurance and copayments, funds can also be used for any IRS-qualified medical expenses Qualified Medical Expense Hearing aids LASIK Surgery In vitro fertilization Long-term care premiums Eyeglasses/contacts Copayments Coinsurance and deductibles COBRA premiums Wheelchairs Nonqualified Medical Expense Life insurance premiums Health club fees Special food and beverages Cosmetic surgery Burial expenses Maternity clothes Cosmetics Medigap premiums Spa treatments For a complete listing of IRS qualified expenses, go to 9

10 YOUR RESPONSIBILITIES HSAs are an IRS program, and as such, require tax filing every year If funds are withdrawn or used for a nonqualified expense before age 65, taxes and a 20% penalty will apply Save receipts in the event of an audit Do not exceed contribution limits with personal and employer contributions Keep account in an open status to receive all applicable contributions Reconcile account regularly to ensure adequate funds are available to cover qualified expenses Members should contact their tax professional for more information on tax implications and filings. 10

11 BE IN CONTROL OF YOUR HEALTH When you are in control of your health care dollars you will become an active and informed participant in the process of caring for your health Be Proactive Be Aware Know your Numbers Increases the likelihood of receiving preventive screenings and appropriate and necessary care It s easier and less expensive to prevent a health issue from occurring than it is to treat it Have a plan and find the programs that support improving lifestyle choices Awareness and understanding of your current health status aids in the development of a plan for change Knowing these numbers develops an awareness Early detection may prevent serious illness or diseases Know the Value Is an MRI really necessary or is an x ray sufficient? Will the hospital be less expensive or a free standing facility? How many procedures has each facility performed? 11

12 HSA MECHANICS How does it work? 12

13 HSA PROCESS FLOW You go to the doctor s office and pay a copay at time of service Provider submits a claim to Capital BlueCross Capital BlueCross determines if deductible is met Deductible is met: Capital BlueCross processes claim Capital BlueCross mails check to provider and EOB to you No further action is needed Deductible is not met: Claim is processed and applied to deductible Capital BlueCross mails EOB to you, and SOR to provider Provider bills you for the service Payment options: HSA funds debit card, check, or online bill pay OR Non- HSA money - thus saving HSA funds for future use EOB = Explanation of Benefits SOR = Statement of Remittance 13

14 HOW THE PLAN WORKS SINGLE WITH MINIMAL NEEDS HSA YEAR ONE Contribution/Expense Your employer contribution HSA Balance +$750 $750 Your contribution +$1,000 $1,750 You see your doctor for a sick visit A minor hiking accident sends you to the emergency room Monthly prescription filled at $25/month -$85 $1,665 -$638 $1,027 -$300 $727 HSA YEAR TWO Contribution/Expense HSA Balance Roll over from year one $727 $727 Your employer contribution +$750 $1,477 Your contribution Starting balance +$500 $1,977 See your doctor for a cold -$85 $1,892 You fill a prescription for antibiotics and purchase some Over-The-Counter (OTC) cold medicine with a prescription Monthly prescription filled at $25/month -$76 $1,816 -$300 $1,516 HSA balance at the end of year two $1,516 Costs and expenses are for example purposes only. 14

15 HOW THE PLAN WORKS FAMILY OF SEVEN WITH MANY NEEDS HSA YEAR ONE HSA YEAR TWO Contribution/Expense HSA Balance Contribution/Expense HSA Balance Your employer contribution +$1,500 $1,500 Your contribution +$1,000 $2,500 Roll-over $1,583 $1,583 Your employer contribution + $1,500 $3,083 Your child has strep throat you do not use HSA $75 $2,500 Your contribution +$1,000 $4,083 Three kids visit doctor for a case of pink eye ($75 each) -$225 $2,275 Antibiotics for pink eye -$53 $2,222 Youngest sees a speech therapist -$125 $2,097 You visit the doctor for the flu -$75 $2,022 OTC cold medicine (with a prescription) -$18 $2,004 Youngest sprains a wrist and visits the ER -$421 $1,583 Youngest sees a speech therapist -$175 $3,908 Fourth child goes to emergency room after bike accident Your husband/wife has their gall bladder removed (total bill is $4,100). You pay out of your HSA to meet your remaining family deductible You pay out of your own pocket for coinsurance (0%) Remaining cost of surgery plan pays 100% -$850 $3,058 -$1,975 $1,083 $0 $1,083 $2,125 $1,083 HSA Balance at the end of year two $1,083 Costs and expenses are for example purposes only. 15

16 BNY MELLON 16

17 WHO IS BENEFIT WALLET? Capital BlueCross partners with Benefit Wallet to provide you with a banking solution for your HSA BNY (Bank of New York) Mellon is a Fortune 500 company Largest HSA administrator in the country with 900,000+ total accounts Dedicated customer service that specializes in HSAs Simple, easy-to-use online tools Access to account information 24/7 Benefit Wallet is an independent company whose products and services are not BlueCross products and services. Benefit Wallet is solely responsible for these financial services. 17

18 KEY FEATURES Benefit Wallet offers many convenient capabilities, features, and dedicated support Funding Simple online funding tool Fully automated processes No minimum deposit Unlimited funding frequency Investing 22 highly-rated mutual funds Multiple fund families Automatic investing Integrated investing Support HSA dedicated customer service Spending Free checkbook Free check writing Free online bill pay No claim forms No minimum withdrawal No minimum balance Benefit Wallet does not cross-sell any other banking products 18

19 HSA ACCOUNT SET-UP Enroll in a Capital BlueCross HSA plan Activate your Benefit Wallet HSA benefitwallet.com Welcome Kit is mailed within two business days of activation Debit card mailed four to seven days after account activation PIN mailed three to five days following debit card Mail in beneficiary designation signature card Checkbook mailed four to seven days after signature card is processed 19

20 INVESTMENT OPTIONS Benefit Wallet offers a large investment portfolio Integrated investments via HSA website $1,000 balance to start investing Twenty-two highly-rated funds from multiple fund families Automatic investing No minimum investment No transaction fees All options are no-load or load-waived mutual funds Ready access to funds via checkbook or debit card Balances and transaction info available via IVR Transaction Account Investment Account Fund Category Benefit Wallet Investment Fund Ticker Money Market DREYFUS CASH MGMT PLUS INVESTOR SHS DVCXX Intermediate-Term Bond CALVERT INCOME FUND CLASS A CFICX.LW Short-Term Bond CALVERT SHORT DURATION INC CLASS A CSDAX.LW High Yield Bond FIDELITY ADV HIGH INC ADVANTAGE CLASS T FAHYX Short Government GOLDMAN SACHS SHORT DURATION GOVT CL A GSSDX.LW World Bond TEMPLETON GLOBAL BOND CLASS A TPINX.LW Mid-Cap Growth AMERICAN CENTURY HERITAGE CLASS A ATHAX.LW Large Blend DREYFUS APPRECIATION FUND DGAGX Large Blend Index VANGUARD TOTAL STOCK MARKET INDEX VTSMX Large Value DREYFUS PREMIER STRATEGIC VALUE CLASS A DAGVX.LW Diversified Emerging Markets FIDELITY ADVISOR EMERGING MKTS CLASS A FAMKX.LW Mid-Cap Blend GABELLI ASSET FUND CLASS AAA GABAX Large Growth MFS AGGRESSIVE GWTH ALLOCATION CLASS A MAAGX.LW Foreign Large Growth MARSICO INTERNAT'L OPPORTUNITIES MIOFX Foreign Large Blend MFS RESEARCH INTL CLASS A MRSAX.LW Small Growth FIDELITY ADVISOR SMALL CAP CLASS A FSCDX.LW Small Blend KEELEY SMALL CAP VALUE FUND KSCVX.LW Small Blend Index VANGUARD SMALL CAP INDEX NAESX World Stock MUTUAL SERIES MUTUAL DISCOVERY CLASS A TEDIX.LW Moderate Allocation AMERICAN CENTURY STRAT ALLOC CLASS A ACVAX.LW World Allocation IVY ASSET STRATEGY CLASS A WASAX.LW Real Estate T ROWE PRICE REAL ESTATE FUND ADV CL PAREX 20

21 DISTRIBUTION AND REIMBURSEMENT How to access your HSA funds Debit Card Use a signature or pin to make a purchase Can use card at ATMs to withdraw funds Card is automatically issued when the account is opened First two cards are free, additional cards are $5 each Direct Pay HSA Generate payments online 24/7 Create one-time or recurring payments No postage or transaction fees Checkbook No manual claim forms or receipts need to be submitted Signature card in the welcome kit must be signed and returned for checkbooks to be issued First 40 checks are free, additional checkbooks are $5 each 21

22 CHECK YOUR BALANCE Capital BlueCross customers with a Benefit Wallet HSA, can view their account balance on mycapbluecross.com 22

23 ACCOUNT FEES Description Account Set-up Fee (one-time) Monthly Service Charge Paid by member with account balance <$1,000 Paid by employer regardless of account balance (must have 100 or more HSA accounts) Transaction Fees for Debit Card and Checks Fee None $3.50 $2.25 None Monthly Service Charge for HSA Investment Account $2.90 Market-based Interest Rate Variable Fees and rates are subject to change. 23

24 CUSTOMER SERVICE For medical or Rx questions call the Capital BlueCross customer service number on the back of your ID card For Specific HSA questions, Capital BlueCross customer service will transfer you to Benefit Wallet or call them direct at Benefit Wallet Customer Service is available Monday thru Friday 8:00 a.m. to 11:00 p.m. 24

25 QUESTIONS? Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association 25