Transcript Health Plan with a Health Savings Account

®
HEALTH SAVINGS
ACCOUNT
Your Health Plan plus a
Health Savings Account
Davidson College
2016
838559 d
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company
HEALTH SAVINGS ACCOUNT (HSA)
Open Access Plus:
• 667,400
doctors/specialists
• 5,600
hospitals/facilities
Deductibles:
2016
$2,600 individual
$5,200 family
Preventive care:
Covered at 100% (innetwork)
Pharmacy:
2016
Deductible –
20% generic
30% preferred brand
40% non-preferred
brand
50% specialty
2
HEALTH SAVINGS PLAN AND YOU
Qualified high
deductible
medical plan
+
Health
Savings
Account
=
Taxadvantaged
HSA Plan
• A tax-advantaged health plan that provides coverage for current health care expenses
with the option to save for future health care expenses
• Combines a qualified high deductible medical plan (medical/pharmacy coverage)
with a Health Savings Account
• You, your employer or both can contribute to the Health Savings Account which
is owned by you
• Money put in the Health Savings Account is generally not taxable*
• You have investment options with the Health Savings Account
* HSA contributions and earnings are not subject to Federal taxes and not subject to state taxes in most states. A few states do not allow pretax
treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state.
3
Make the Most of Your HSA – Individual 2016
HSA
Contributions
(from you or your
employer) can be
used to pay for
qualified health
expenses or
saved to pay for
future health
expenses
PLAN
$750
80%
+
+
YOU
YOU
$1850
20%
$2600
$5500*
DEDUCTIBLE
OUT-OF-POCKET
MAXIMUM
PLAN
100%
ALL EXPENSES
IN-NETWORK
PREVENTIVE CARE IS COVERED BY THE PLAN AT 100%
*Includes deductible
All plans have exclusions and limitations and some plans have pre-existing condition limitations. Please review your Benefit Summary for more information about what is and is not covered under your plan.
4
Make the Most of Your HSA – Family 2016
HSA
Contributions
(from you or your
employer) can be
used to pay for
qualified health
expenses or
saved to pay for
future health
expenses
PLAN
$1500
80%
+
+
YOU
YOU
$3700
$5200
DEDUCTIBLE
PLAN
100%
20%
$11,000 *
OUT-OF-POCKET
MAXIMUM
ALL EXPENSES
IN-NETWORK
PREVENTIVE CARE IS COVERED BY THE PLAN AT 100%
*Includes deductible
All plans have exclusions and limitations. Please review your Benefit Summary for more information about covered adn not-covered services under your plan.
With family coverage, an individual still only has to meet the individual deductible and out-of-pocket.
5
ARE YOU ELIGIBLE TO PARTICIPATE?
Because HSA plans have certain tax advantages, the IRS defines specific rules
for participation. To be eligible, you:
• Must be enrolled in an IRS-qualified high-deductible medical plan (high-deductible medical plan
offered by Davidson College meets IRS requirements)
• Cannot have any other health coverage
– Not covered by spouse’s medical or pharmacy plan
– Not covered through Medicare Part A or Part B
– Not covered through a general-purpose Flexible Spending Account (FSA) plan (either employer’s
or spouse’s)
• Cannot be claimed as a dependent on another person’s tax return
6
YOUR HSA MAXIMUM CONTRIBUTION
The IRS has set the following limits for 2016:
• Under age 55 and not enrolled in Medicare (based on a 12-month period):
– Up to $3,350 individual coverage
– Up to $6,750 family coverage
• Age 55 or older:
– Maximum contribution increases by $1,000 (considered a “catch-up” contribution)
– Up to $4,350 individual coverage
– Up to $7,750 family coverage
• To make the maximum contribution in a calendar year, you must:
– Meet all requirements to be eligible for HSA contributions on January 1
– Remain qualified through December 1
– If these criteria are not met, maximum contribution is prorated =
if 1/12 maximum contribution for each month then individual is qualified
$
*Contributions to your HSA that you receive from your employer and incentives count toward your maximum.
7
SAVING YOU TIME
myCigna.com
– Print forms or print/order ID cards
– Check your coverage and explanation of benefits
– Track claims, payments and deductibles
– Sign up for online coaching programs
– Keep track of your health history and records with a secure
online personal health record
– Find in-network doctors, hospitals, specialists and labs
– Learn about common health problems and treatment options
– Compare treatment and procedure costs
– Find cost and quality ratings for doctors and hospitals
– Switch a prescription to Cigna Home Delivery Pharmacy with
one easy phone call and have your medications delivered to
your door
Talk with a trained
nurse when you can’t
reach your doctor –
day or night
No claim forms
needed in-network
8
®
Ways to Save with
your HSA Plan
MD Live
Davidson College
2016
838559 d
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company
A doctor is
always in
MDLIVE provides immediate, on-demand 24/7/365 access to affordable, quality
non-urgent care through a national network of licensed,
board-certified U.S.-based doctors, including pediatricians.
Online video
consultations
Phone
consultations
Email communication,
post consultation
Prescription services
(sent directly to a pharmacy)
Health care services are delivered by MDLIVE participating doctors and not by Cigna.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
10
How it
works
BY PHONE
BY PHONE
Step 1: Call toll-free
Patient calls toll-free
hotline available
24/7/365 including
holidays.
Step 2: Speak
with a coordinator
Step 3: Speak
with the doctor
A consultation coordinator
locates the next available
doctor and prepares
patient for the consultation.
Once an available
doctor is located, the
system automatically
calls and connects the
doctor to the patient.
BY VIDEO CONFERENCE
Step 1: Visit website
Step 2: Find a doctor
Patient visits website
and logs in with
username and
password.
System helps the patient
search for a doctor by a
criteria, such as specialty,
language, gender,
location, or simply finds
the next available doctor.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Step 3: See the
doctor online
Once an available doctor
is located, the system
automatically connects
the doctor to the patient.
11
Conditions
treated by
MDLIVE
doctors
General health
Acne
Allergies
Bronchitis
Cold & flu
Fever
Gout
Headache
Infections
Pediatric care
Joint aches & pains
Nausea & vomiting
Pink eye
Rashes
Sinus infection
Sore throat
Sunburn
Urinary tract infection
Cold & flu
Constipation
Ear infection
Fever
Nausea & vomiting
Pink eye
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
12
Cost of MD Live
• Each consultation for MD Live is $38
• This will process like any other office visit under the HSA
Plan.
• The charge will be subject to your deductible and
coinsurance under the plan.
13
®
Ways to Save with
your HSA Plan
Appropriate Place
of Service
Davidson College
2016
838559 d
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company
Where should I go to receive care ?
• Doctor’s Office – They know you the best. They can treat a
variety of urgent or immediate care needs in their office during an
office visit. You do have to make an appointment, but most
offices hold a certain number of appointments everyday for
urgent visits. They can provide services to treat ear infections,
sprains, flu, etc.
• Convenience Care Clinics – They are usually located in
pharmacies and other places where you shop. Many CVS
pharmacies have these and are called “Minute Clinics”. You can
go in at your convenience without an appointment for a quick
office visit. Their nurse practitioners and doctor’s assistants treat
simple conditions like ear aches, sore throats, flu, etc.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna
15
Where should I go to receive care ?
• Urgent Care Facilities – They are most like emergency rooms.
You would go in without an appointment for urgent situations.
Their doctor, assistants, and nurses treat broken bones, cuts,
fevers, and conditions that need immediate care, but are not life
threatening.
• Emergency Rooms – Located in hospital settings. They have
doctors, assistants and nurses that can treat a variety of life
threatening illness and injuries.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna
16
®
Ways to Save with
your HSA Plan
National Labs
Davidson College
2016
838559 d
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company
Cigna Preferred National Labs
At Cigna, it’s all about offering you quality, choice and lower out-ofpocket costs. That is why Cigna includes two of the nation’s
largest laboratories in our Open Access Plus network.
Cigna has agreements with two national lab vendors:
• Laboratory Corporation of America – LabCorp
• Quest Diagnostics - Quest
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna
18
What are the benefits?
• Using these preferred labs can result in cost savings for you and
for Davidson College.
• Looking at the average cost difference – at other regional labs
the average cost per procedure is $23.79 per occurrence. The
average cost at LabCorp/Quest is $9.43 per occurrence. The
savings is even greater when compared to hospital labs.
• By offering two of the largest national labs, Cigna gives
participating doctors and customers greater choice and greater
patient access.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna
19
®
Ways to Save with
your HSA Plan
Pharmacy
Davidson College
2016
838559 d
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company
How can I get the most out of my pharmacy benefits plan?
1
Learn what
drugs are
covered
Save money by
reviewing the
covered drug list
on Cigna.com or
myCigna.com to
know which drugs
are generic or
preferred and
cost less
2
3
Compare
prices
Use Cigna
Home
Delivery
Pharmacy
Use the
Prescription Drug
Quote Tool on
myCigna.com to
see what drugs
cost with your plan,
or compare prices
at over 60,000
retail pharmacies
and Cigna Home
Delivery Pharmacy
Have many of
your regular
medications
delivered right to
your door at no
additional cost –
there may even be
a cost savings
4
Use the
pharmacy
page of
mycigna.com
5
Call Customer
Service
Gives you
24/7/365 access to
pharmacy claim
history, benefit
details, drug and
pharmacy
comparison tools
and a pharmacist
to answer your
questions
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2011 Cigna
21
Product Disclosures
Rates will vary by plan design including the amount of plan deductibles, coinsurance, and out-of-pocket and lifetime maximums. Rates may vary based on age,
gender, geographic location and the plan deductible selected.
All insurance policies and general service agreements have restrictions, exclusions, limitations, reductions of benefits and terms under which the policies or
agreements may be continued in force or discontinued. Terms and conditions of coverage are set forth in the plan documents - the insurance certificate, plan
booklet, policy, contract and/or summary plan description.
“Cigna,” the “Tree of Life” logo, “GO YOU” and “Cigna Choice Fund” are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and
its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include
Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance Company (CHLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite
Health, LLC, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health,
Inc. In Arizona, HMO plans are offered by Cigna HealthCare of Arizona, Inc. In California, HMO and Network plans are offered by Cigna HealthCare of California, Inc. In
Connecticut, HMO plans are offered by Cigna HealthCare of Connecticut, Inc. In North Carolina, HMO plans are offered by Cigna HealthCare of North Carolina, Inc. All other
medical plans in these states are insured or administered by CGLIC or CHLIC. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C.
In Texas, Open Access Plus plans are considered Preferred Provider plans with certain managed care features. All models are used for illustrative purposes only.
838559d 07/13
© 2013 Cigna. Some content provided under license.