Transcript Title Page 35 Point Arial - Savannah State University

Board of Regents
of The University System of
Georgia
HSA PPO HDHP Plan
Plan Year 2010
October 2009
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SOMETHING FOR EVERYONE!
– For people with few health expenses
• Could have no up-front out-of-pocket costs (if HSA
funds are available and used), opportunity to save
for the future
– For people with occasional health expenses
• Save dollars from low expense years to help pay in
the future
• Online health site to prepare for medical procedures
– For people with ongoing health conditions
• Total out-of-pocket expenses similar to other health
plans
• Online tools to help manage an ongoing condition
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How Does the HSA PPO HDHP Plan
Work?
HSA PPO HDHP Plan
• Stay healthy with Preventive Care
coverage
Preventive Care
100% In-Network
• You and Board of Regents make
contributions to your account
• You can use your account dollars
to pay for medical care and
prescription drugs
•HSA
Funded by annual
employee and BOR (onetime) allocation
• You pay a deductible spending
any dollars you choose to from
your HSA
DEDUCTIBLE
• Traditional Health Coverage then
kicks in after you have satisfied
your deductible (co-insurance)
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•Traditional Health
Coverage
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HSA PPO HDHP PLAN- At a Glance
HSA Plan
Preventive
HSA
Traditional
Health
Coverage
Single Coverage
Nationally recommended services
Family Coverage
No cost, no deduction from HSA with
in-network providers
BOR’s (one time seeding)
allocation
Annual HSA contribution
maximum
$750
$3050
$1500
$6150
Deductible
$1500
$3000
Then, you pay coinsurance for
covered services
Plan pays 100% after annual outof-pocket maximum (includes
deductible and coinsurance)
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90% for in-network services
70% for out-of-network services
$3,000- InNet
$6,000 OutNet
$6,000- InNet
$12,000- OutNet
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Provider Choice
• Visit any licensed provider; however, if you select an
in-network doctor, hospital or pharmacy, you take
advantage of lower out of pocket expenses
– Network Doctors and Hospitals: Local access to
BCBSGa PPO network of doctors and hospitals,
and nationwide access to more than 650,000
doctors and thousands of hospitals and other
facilities through the BlueCard® PPO Network
– Prescription Drug Plan: Discounts on your
prescription drugs are available at 95% of the retail
pharmacies.
• Use the online ProviderFinder to find and compare
network doctors and hospitals
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COMPARING
THE HSA PPO HDHP PLAN
2010 Annual Premium Savings When
Switching to HSA PPO (HDHP)
Tier
HMO Premium
PPO Premium
HDHP Premium
Employee Only
$113 x 12 = $1356
$151.94 x 12 =
$1823.28
$25.25 x 12 =
$303
Employee +
Child
$203.40 x 12 =
$2440.80
$273.48 x 12 =
$3281.76
$44.12 x 12 =
$529.44
Employee +
Spouse
$237.30 x 12 =
$2847.60
$319.07 x 12 =
$3828.84
$51.20 x 12 =
$614.40
Family
$327.70 x 12 =
$3932.40
$440.60 x 12 =
$5287.20
$70.07 x 12 =
$840.84
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Meet Carol Lewis | Single Coverage
HMO
Product
HMO Employee Only Policy
HDHP Employee Only Policy
Premiums
$113 x 12 = $1356
$25.25 x 12 = $303
Preventive Services - Ob/Gyn
$15
$0
Prescription drugs - $150 (3 brand
name prescriptions)
$75
$150
Total
$1446
$453 - $750 = +$297
Annual preventive visit & lab tests
- $350
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Meet the Wilson's | Family Coverage
PPO
Product
PPO Family Policy
HDHP Family Policy
Premiums
$440.60 x 12 = $5287.20
$70.07 X 12 = $840.84
Preventive visits & lab tests - $500
$0 ($750 wellness maximum)
$0
Hospital and surgery fees $14,300
$300 deductible 10% coinsurance = $1000 maximum
individual out-of-pocket
$3000 towards deductible
+10% = $4130
2 Prescription drugs – generic
$200
Medco = $20
10% = $20
Total
$6307.20
$4990.84 - $1500 one-time
seeding = $3490.84
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Using Your HSA PPO HDHP Plan to
Get Care
• When you visit an in-network doctor:
– Show your ID card
– Take advantage of discounts provided
– In most instances, a claim is filed for you
– Payments from your Traditional Health Coverage made directly
to your doctor (you will receive and EOB or you can review
claim payments online)
– May use your HSA checkbook or debit card to pay your doctor
for any amounts you owe (provided you have the funds
available)- Depending on the Bank you chose to set-up your
account with
• When you visit a doctor that is not in the network:
– Show your ID card
– Use your HSA checkbook or debit card to pay your provider for
services (provided you have the funds available)
– File a claim
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Using Your HSA PPO HDHP Plan to
Get Care
• When you visit a pharmacy:
– Show your ID card
– Take advantage of our discounts at over 95% of
pharmacies nationwide
– Payments from your account are made directly to
the pharmacy
– If you don’t have available funds in your account,
you pay the discounted rate
– To get the lowest cost, visit our online health site to
learn about generics or other low-cost alternatives
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FAQ’S
Am I Eligible for the Health Savings
Account?
• The IRS and the U.S. Department of the Treasury have
specific rules on who can open an HSA.
• You can open an HSA if you:
– Are enrolled in the HSA plan, because it includes an
HSA-compatible health plan
– Are a U.S. resident and not a resident of Puerto Rico
or American Samoa
– Are not enrolled in Medicare
– Are not claimed as a dependent on another
individual’s tax return
– Are not active military
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How Much Can I Contribute to a
Health Savings Account (HSA)?
• Each plan year, you may contribute money to your HSA
up to a maximum contribution limit set by the U.S.
Treasury and the IRS.
• All combined contributions to your account cannot
exceed your annual contribution maximum.
• For 2010, the annual contribution maximum set by the
U.S. Treasury and the IRS is $3,050 for individual
coverage and $6,150 for family coverage.
• The contribution maximums set by the U.S. Treasury
and the IRS may be increased for inflation annually.
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Can I Have My HSA at a Bank Other
Than US BANK?
• Yes, as long as you are enrolled in an HSA-compatible
plan, you can set up an HSA and make contributions up
to the maximum annual allowed amount as defined by
the IRS.
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Can I Use My HSA to Pay for NonQualified Medical Expenses?
• Yes, but…
– Any amount you spend will be considered taxable
income (you will have to pay taxes on the amount
used), and you will have to pay a 10% penalty on
the amount
– Non-qualified expenses will not count toward your
out-of-pocket responsibility under the Traditional
Health Coverage
– Once you are 65, you can withdraw the money
without penalty, but it will be considered taxable
income
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Can I Still Have an FSA?
• You can, if your FSA:
– Is a special-purpose FSA (e.g. for dental/vision or
dependent care); or,
– Limits payment to those expenses incurred after
coverage from the HSA-compatible medical plan
begins (e.g. coinsurance)
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How Do I Make Contributions to My
HSA?
• There are several ways you can contribute to your
account:
– Tax-free through payroll deductions
– Post-tax by personal check
– Anyone may contribute to your HSA, provided the
total contributions to your HSA do not exceed your
maximum allowable annual limit
– You can make catch-up contributions if you are 55
years of age or older ($1,000 for 2009 and after)
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What About My Taxes?
• Contributions made via payroll deduction are pre-tax
• Contributions made by personal check are post-tax
– You will need to make an adjustment on your gross
income when you file your taxes to receive the tax
benefit
• If you use your HSA for a non-qualified expense (e.g.
not covered services or qualified medical expenses),
you will have to pay tax on the expense and are subject
to a 10% penalty on the amount.
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360 Health
360°Health
A comprehensive suite of health management
programs, tools and resources
• Proactive care management programs for impactable health
conditions, such as diabetes or asthma
• Online health and wellness information and tools
• Discounts on health-related items and services
A member-centric health services model
• Surrounds members with resources whether healthy or in
need of specialized care
• Empowers members to better manage their own health
• Provides information and educational resources to help
members make informed health care decisions
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One of the most
comprehensive health
management
programs in the
industry.22
360º Health Programs
 Programs Available to HSA Members:
– Asthma (Adult & Pediatric)
– Coronary Artery Disease (CAD)
– Chronic Obstructive Pulmonary Disease (COPD)
– Heart Failure
– Diabetes (Adult & Pediatric)
– 24/7 NurseLine (BlueChoice On-Call)
– Future Moms
– Kidney Disease
– ComplexCare
– NICU
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Consumer Web Tools
www.bcbsga.com\bor
The Overview tab is designed
to give quick access to the
most commonly used tools and
resources “at a glance”
Overview Page
 Secure Message Center
 Request ID card
 View benefits
 Manage Profile
 Recently processed claims
 Contact Us
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Search the online Provider Directory
to find network physicians,
hospitals, specialists, and many
other healthcare professionals,
refine the search by gender and/or
office availability, print a map and
driving directions.
Provider Finder Page
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Order new prescriptions or
prescription refills online with
BCBSGa. Find a local pharmacy,
search the drug formulary, estimate
drug costs, and research possible
drug interactions.
Prescriptions Page
HMO/HDHP
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360˚Health
360°Health - Overview
The gateway into leading a
better, healthier life and
becoming a more informed
healthcare consumer
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Compare Hospitals
Health Risk Assessment
Explore the Condition Center
Animated Surgery Guide
3D Symptom Checker
MyHealth Record
Online Communities
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Questions
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