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 Healthcare HDHP / HSA Educational Seminar Box Elder SD 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

Traditional vs. HSA Plan HDHP / HSA Educational Seminar Box Elder SD This is used for regular medical Employee’s expenses and Spending employees keep Account what they don’t spend Monthly Insurance Premium Premium Insurance Premium Traditional HSA-Based Plan Plan

Qualified High Deductible Health Plan HDHP / HSA Educational Seminar Box Elder SD Out-of-Pocket Max • One bucket for all of your expenses • Once your bucket is full, Insurance pays your claims at 100% for the Copays remainder of the plan year Coinsurance Deductible

Qualified High Deductible Health Plan HDHP / HSA Educational Seminar Box Elder SD • Until the deductible is met: 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%! After the deductible is met: • Copayments and coinsurance apply After the out-of-pocket maximum is met: • All eligible claims are paid at 100%

What is a Health Savings Account? HDHP / HSA Educational Seminar Box Elder SD A Health Savings Account is a savings account that YOU own and can use to pay for qualified health care expenses You and/or your Your HSA Qualified Expense employer deposit

HSA Components HDHP / HSA Educational Seminar Box Elder SD An HSA requires a qualified health plan Health Savings High Deductible HDHP Account Health Plan The account used to Lower premium, you fund the deductible – insurance plan tax-free HSA Insurance Company Financial Custodian Cigna Health Equity

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 Flexibility • Change contribution mid-year • Lump sum contributions • One-time roll-in from an IRA • Portable Funds follow you • Tax-free even if qualifying coverage ends

Considerations of an HSA HDHP / HSA Educational Seminar Box Elder SD High Deductible Health Plan • No first dollar coverage, except preventive care You can only use what is in your • No advance funding unless you do a account year-to-date lump sum deposit Not compatible with other • traditional insurance Must have a HDHP to have an HSA

Funding Your HSA HDHP / HSA Educational Seminar Box Elder SD 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

Eligible Expenses HDHP / HSA Educational Seminar Box Elder SD 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.

How an HSA Plan Works HDHP / HSA Educational Seminar Box Elder SD Going to the Doctor At the Doctors Office • Provide your medical ID card, not your HSA card Doctor Bills Insurance Carrier • Insurance carrier adjusts price based on network discounts • Health Savings Account Use your HSA dollars to pay the claim after your insurance carrier processes the claim

How an HSA Plan Works HDHP / HSA Educational Seminar Box Elder SD Going to the Pharmacy At the Pharmacy • Show your medical ID card • Pharmacist Bills Insurance Insurance carrier processes your claim Carrier at the point of service based on network discounts • Health Savings Account Use your HSA debit card to pay for your Rx at the pharmacy

HEALTH SAVINGS ACCOUNT 2016 Open Enrollment Box Elder SD Health Equity Education 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 For Your Physical Health

HEALTH SAVINGS ACCOUNT 2016 Open Enrollment Box Elder SD Health Equity Helpful Tools 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 For Your Physical Health

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 * Fidelity Benefits Consulting https://www.fidelity.com/about-fidelity/employer-services/health-care-costs-for-couples-retirement-rise** Assumes 30% tax rate 20

For Your Physical Health Medical, Pharmacy, Dental, and Vision Insurance

MEDICAL Cigna Medical Plan Comparison 2016 Open Enrollment Box Elder SD Open Access Plus-HSA Open Access Plus- HSA Provider Network Plan Plan Contract Year In-Network Out-of-Network In-Network Out-of-Network Deductible Deductible- Included in $2,000 / $4,000 $4,000/$8,000 $4,000/$8,000 $8,000//$16,000 OOP $6,000/$12,000 Out-of-Pocket Maximum $3,000 / $6,000 $6,000/$12,000 $12,000/$24,000 * Embedded OOP $6,550 Preventive Care 100% Coverage 100% Coverage 100% Coverage 100% Coverage Office Visits Primary $40 AD 50% AD $40 AD 50% AD Care/Specialist $50 AD 50% AD $50 AD 50% AD Urgent Care $50 AD 59% AD $50 AD 50% AD Hospital Services Inpatient / 20% AD 50% AD 20% AD 50% AD Outpatient 20% AD 50% AD 20% AD 50% AD Emergency Room 20% AD 20% AD 20% AD 20% AD Prescriptions: 30-Day Retail Tier 1 $5 AD $5 AD Tier 2 $35 AD $35 AD Tier 3 $75 AD $75 AD Tier 4 $150 AD $150 AD Mail Order $10AD/$70AD/$225AD $10AD/$70AD/$225AD For Your Physical Health AD = After Deductible

PHARMACY 2016 Open Enrollment Box Elder SD GBS Rx Comparison Tool www.gbsbenefits.com/rxcomparisontool.html For Your Physical Health

PHARMACY 2016 Open Enrollment Box Elder SD GBS Rx Comparison Tool www.gbsbenefits.com/rxcomparisontool.html Enter the drug you are looking for & the desired location For Your Physical Health

QUESTIONS? HDHP / HSA Educational Seminar Box Elder SD Denise Perez-House Denise.house@gbsbenefits.com (801) 842-0130