HDHP / HSA Educational Seminar Presented by Denise Perez- House Box - - PowerPoint PPT Presentation

HDHP / HSA Educational Seminar

Presented by Denise Perez- House Box Elder SD

Consumerism

HDHP / HSA Educational Seminar Box Elder SD

“Nobody spends someone else’s money as carefully as they spend their own.”

Milton Friedman

Consumer-Driven Health plans empower you to:

• Become more active in your health care decision-making
• Reduce unnecessary utilization
• Increase healthy behaviors
• Become better informed about your benefits
• Take care of your health

Consumer-Driven Healthcare

HDHP / HSA Educational Seminar Box Elder SD

Traditional vs. HSA Plan

HDHP / HSA Educational Seminar Box Elder SD

Monthly Premium Traditional Plan HSA-Based Plan Insurance Premium Insurance Premium Employee’s Spending Account This is used for regular medical expenses and employees keep what they don’t spend

Qualified High Deductible Health Plan

HDHP / HSA Educational Seminar Box Elder SD

Copays Coinsurance Deductible

Out-of-Pocket Max

• One bucket for all of your expenses
• Once your bucket is full, Insurance

pays your claims at 100% for the remainder of the plan year

HDHP / HSA Educational Seminar Box Elder SD

Qualified High Deductible Health Plan

• You pay the entire cost of medical

expenses (doctor visits, prescriptions, x-ray, lab, hospital services, etc.)

• You are responsible for the discounted

rate negotiated by your insurance carrier

• The exception. Preventive care services

are covered 100%! Until the deductible is met: After the deductible is met:

• Copayments and coinsurance apply

After the out-of-pocket maximum is met:

• All eligible claims are paid at 100%

A Health Savings Account is a savings account that YOU own and can use to pay for qualified health care expenses

What is a Health Savings Account?

HDHP / HSA Educational Seminar Box Elder SD

You and/or your employer deposit Your HSA Qualified Expense

HSA Components

HDHP / HSA Educational Seminar Box Elder SD

An HSA requires a qualified health plan

HDHP HSA

Health Savings Account

The account used to fund the deductible – tax-free

Financial Custodian Health Equity High Deductible Health Plan

Lower premium, you insurance plan

Insurance Company Cigna

What is a Health Savings Account?

HDHP / HSA Educational Seminar Box Elder SD

A Health Savings Account (HSA) is a consumer-owned, tax-advantaged savings account that can be used to pay for qualified medical, dental, and vision expenses when combined with a qualified consumer driven health plan.

Health Savings Accounts allow for:

• Tax-free contributions optional by employer and/or employee
• Tax-free growth of interest or investment earnings
• Tax-free disbursements to pay for qualified medical expenses
• Accumulation of unused funds
• Portability between employers
• Flexible use as consumers to choose whether or when to use the account
• Ownership by the employee. You keep the account!

Who is eligible for an HSA?

HDHP / HSA Educational Seminar Box Elder SD

You can open and fund a health savings account if you:

• Are 18 years of age or older
• Are covered by an HSA qualified HDHP
• Are not covered by any other non-HSA eligible plan including:
• Medicare
• Medicaid
• Spouse/Parent non-HDHP plan
• Tricare or Tricare for Life
• Flexible Spending Account
• Cannot be claimed as a dependent on someone else’s tax return

Advantages of an HSA

HDHP / HSA Educational Seminar Box Elder SD

Control

• You own the account
• No “use it or lose it”
• Change contributions mid-year
• Use it now or use it later…you decide
• Long-term investment opportunity

Tax Benefits On

• Contributions
• Earnings
• Distributions

Portable

• Funds follow you
• Tax-free even if qualifying coverage ends

Flexibility

• Change contribution mid-year
• Lump sum contributions
• One-time roll-in from an IRA

Considerations of an HSA

HDHP / HSA Educational Seminar Box Elder SD

You can only use what is in your account year-to-date

• No advance funding unless you do a

lump sum deposit Not compatible with other traditional insurance

• Must have a HDHP to have an HSA

High Deductible Health Plan

• No first dollar coverage, except

preventive care

HDHP / HSA Educational Seminar Box Elder SD

Funding Your HSA

You are encouraged to contribute to your own HSA

(up to the following maximums, including the company’s contributions) *Annual Contribution Limit 2016 2017 Single Coverage $3,350 $3,400 Two-Party Coverage $6,750 $6,750 Family Coverage $6,750 $6,750

If you are over age 55 and not enrolled in Medicare, you may contribute an additional $1,000 annually.

*contribution maximum assumes HDHP coverage the entire calendar year

HDHP / HSA Educational Seminar Box Elder SD

Eligible Expenses

Qualified Medical Expenses

• Doctor and hospital visits
• Medical equipment
• Chiropractic care
• Dental care, braces, dentures, implants
• Vision care, glasses, contacts, Lasik surgery
• Prescription medications

A complete list can be found in the IRS Publication 502 The penalty for using HSA funds for non-qualified expenses is 20% +taxes. Keep all itemized receipts in the event of an IRS audit.

HDHP / HSA Educational Seminar Box Elder SD

How an HSA Plan Works

• Provide your medical ID card, not

your HSA card At the Doctors Office Doctor Bills Insurance Carrier

Going to the Doctor

• Insurance carrier adjusts price based
• n network discounts
• Use your HSA dollars to pay the claim

after your insurance carrier processes the claim Health Savings Account

HDHP / HSA Educational Seminar Box Elder SD

How an HSA Plan Works

• Show your medical ID card

At the Pharmacy Pharmacist Bills Insurance Carrier

Going to the Pharmacy

• Insurance carrier processes your claim

at the point of service based on network discounts

• Use your HSA debit card to pay for

your Rx at the pharmacy Health Savings Account

HEALTH SAVINGS ACCOUNT

2016 Open Enrollment Box Elder SD

For Your Physical Health

Free Webinars

• Investing your HSA dollars
• Health Savings Account basics
• Tips to maximize your HSA savings
• HealthEquity member portal overview

Free Videos

• Winning with an HSA
• An introduction to Health Savings Accounts
• Building your health finance safety net

Even more tools found at www.healthequity.com

Health Equity Education

HEALTH SAVINGS ACCOUNT

2016 Open Enrollment Box Elder SD

For Your Physical Health

Convenient, powerful tools:

• On-the-go access
• Take a photo of documentation with phone & link to claims and payments
• Send payments and reimbursements from HSA
• Manage debit card transactions
• View claims status
• Access your account online
• Speak with member support 24/7

Expert friends… (866) 346-5800 www.healthequity.com

Health Equity Helpful Tools

HSA Optimization

19

Health Care Costs in Retirement

• The average couple will incur $245,000* to cover

medical expenses during retirement

• This is $350,000 gross withdrawal from traditional

401(k) plan to achieve net $245,000 medical expense in retirement**

• or-
• Only $245,000 tax free withdrawal from HSA

20

* Fidelity Benefits Consulting https://www.fidelity.com/about-fidelity/employer-services/health-care-costs-for-couples-retirement-rise** Assumes 30% tax rate

For Your Physical Health

Medical, Pharmacy, Dental, and Vision Insurance

MEDICAL

2016 Open Enrollment Box Elder SD

For Your Physical Health

Cigna Medical Plan Comparison

Provider Network Open Access Plus-HSA Plan Open Access Plus- HSA Plan Contract Year Deductible In-Network Out-of-Network In-Network Out-of-Network

Deductible- Included in OOP $2,000 / $4,000 $4,000/$8,000 $4,000/$8,000 $8,000//$16,000 Out-of-Pocket Maximum $3,000 / $6,000 $6,000/$12,000 $6,000/$12,000 * Embedded OOP $6,550 $12,000/$24,000 Preventive Care 100% Coverage 100% Coverage 100% Coverage 100% Coverage Office Visits Primary Care/Specialist Urgent Care $40 AD $50 AD $50 AD 50% AD 50% AD 59% AD $40 AD $50 AD $50 AD 50% AD 50% AD 50% AD Hospital Services Inpatient / Outpatient Emergency Room 20% AD 20% AD 20% AD 50% AD 50% AD 20% AD 20% AD 20% AD 20% AD 50% AD 50% AD 20% AD Prescriptions: 30-Day Retail Tier 1 Tier 2 Tier 3 Tier 4 Mail Order $5 AD $35 AD $75 AD $150 AD $10AD/$70AD/$225AD $5 AD $35 AD $75 AD $150 AD $10AD/$70AD/$225AD

AD = After Deductible

PHARMACY

2016 Open Enrollment Box Elder SD

For Your Physical Health

GBS Rx Comparison Tool

www.gbsbenefits.com/rxcomparisontool.html

PHARMACY

2016 Open Enrollment Box Elder SD

For Your Physical Health

GBS Rx Comparison Tool

www.gbsbenefits.com/rxcomparisontool.html

Enter the drug you are looking for & the desired location

QUESTIONS?

HDHP / HSA Educational Seminar Box Elder SD

Denise Perez-House Denise.house@gbsbenefits.com (801) 842-0130