M Murray School District Medical Insurance Plan & Health Savings Account Information September 1, 2013 through August 31, 2014.

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Presentation transcript:

M Murray School District Medical Insurance Plan & Health Savings Account Information September 1, 2013 through August 31, 2014

Choice in Provider Networks 34 Participating hospitals; 3,700+ Participating providers M Murray School District 9/ /2014 NOTICE: The network of providers will no longer be offered as of September 1, Participating hospitals; 1,200+ Participating providers

How To Find A Participating Provider M Murray School District 9/ /2014 Visit Call Member Advocates at (801) Refer to the printed provider and facility directory found within your SelectHealth materials

Monthly Premiums & HSA Contributions CLASSIFIED Murray School District 9/ /2014 M

Deductible & Out-of-Pocket Maximum M Murray School District 9/ /2014 In accordance with IRS regulations, the HealthSave plan has an individual deductible or a family (2 or more covered) deductible and out-of-pocket maximum. Unlike the traditional plans, when an employee selects a family plan (2 or more covered), the entire family deductible must be met BEFORE the copayment/coinsurance schedule goes into effect, even if all of the claims are accrued by just one individual in the family. * The deductible is included in the out-of-pocket maximum on all plans.

Office Visits M Murray School District 9/ /2014

Urgent Care, ER, Inpatient and Outpatient M Murray School District 9/ /2014

Rx Select Prescription Drugs M Murray School District 9/ /2014 Tier 1: Generic medication Generic substitution is required when a generic is available. Tier 2: Name brand preferred formulary medication Tier 3: Name brand non-preferred medication * Not applied toward medical out-of-pocket maximum.

How Do the Plans Work? M Murray School District 9/ /2014 Scenario 1: Linda is enrolled with family coverage. During the year, she has an annual exam, a colonoscopy, fills 5 prescriptions for family members (4 generic / 1 name brand) and has a visit to an urgent care clinic. How will each plan cover her expenses?

How Do the Plans Work? M Murray School District 9/ /2014 CONTINUED - Scenario 1 : Linda is enrolled with family coverage. During the year, she has an annual exam, a colonoscopy, fills 5 prescriptions for family members (4 generic / 1 name brand) and has a visit to an urgent care clinic. How will each plan cover her expenses?

How Do the Plans Work? M Murray School District 9/ /2014 Scenario 2: John is enrolled with family coverage. During the year, his wife has a baby. He later has five office visits and takes two prescriptions on a monthly basis (1 generic / 1 non-preferred name brand). How will each plan cover his expenses?

How Do the Plans Work? M Murray School District 9/ /2014 CONTINUED - Scenario 2: John is enrolled with family coverage. During the year, his wife has a baby. He later has five office visits and takes two prescriptions on a monthly basis (1 generic / 1 non-preferred name brand). How will each plan cover his expenses?

How Do the Plans Work? M Murray School District 9/ /2014 Scenario 3: Susan is enrolled with single coverage. During the year, she goes in for outpatient services from a skiing accident and takes a prescription monthly for pain. How will each plan cover her expenses?

How Do the Plans Work? M Murray School District 9/ /2014 CONTINUED - Scenario 3: Susan is enrolled with single coverage. During the year, she goes in for outpatient services from a skiing accident and takes a prescription monthly for pain. How will each plan cover her expenses?

WHY CHOOSE AN HSA Account?

TRADITIONAL PLAN VS. HSA PLAN Employee’s Spending Account Insurance Premium Insurance Premium Monthly Payment This is used for regular medical expenses and employees keep what they don’t spend. Save and keep your money year-over-year with an Health Savings Account! Lower medical plan premiums, tax-free contributions and long-term saving Contributions roll over from year-to-year with the potential to invest at a certain balance level

HSA COMPONENTS TO HAVE A HEALTH SAVINGS ACCOUNT, YOU MUST HAVE A QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN HDHP Low-Premium, High-Deductible Health Plan THE INSURANCE PLAN PIECE FROM SELECTHEALTH HSA Health Savings Account THE SAVINGS ACCOUNT USED TO FUND EXPENSES, TAX-FREE

WHO’S ELIGIBLE TO HAVE A HEALTH SAVINGS ACCOUNT ? To qualify for an HSA, you must: Participate in a qualified high- deductible health plan (HDHP) Must be 18 years or older Have no other coverage except what is permitted by the IRS as other health coverage (i.e., Tricare. See IRS Publication 969) Not be enrolled in Medicare Not be claimed as a dependent on someone else’s tax return

What is a Health Savings Account (HSA)? It is a savings account that you own to pay for your qualified medical expenses. Employee’s HSA Qualified Medical Expense Qualified Medical Expense

IRS ALLOWABLE CONTRIBUTIONS 2013 maximum contributions allowed by the IRS: Single-coverage $3,250 Family-coverage (2 or more family members)$6,450 Catch-up contribution, age 55+$1,000 Employees can fully fund the HSA on day one (subject to the annual maximum) You can make contributions anytime after your HSA is open You can make pre-tax contributions through payroll deduction, online, or directly to HealthEquity Money rolls over from year-to-year. You don’t lose the money left in your HSA or the interest it’s earned. It’s your money.

Murray School District’s annual contribution to your account: Single Coverage: $1, per year Couple Coverage: $2, per year Family Coverage: $ per year You too, can contribute pre-tax dollars! HOW DO I GET STARTED BUILDING AN HSA?

Triple tax-savings Contributions aren’t taxed and reduce your annual taxable income Withdrawals are never taxed or penalized when used for qualified medical expenses; including Rx, dental, vision Earnings aren’t taxed An HSA is your account You own the account and the money stays with you, even if you change jobs or retire Most HSA-qualified plans have maximum out-of-pocket limits -Before you reach your out-of-pocket limit, use your HSA balance to pay expenses -Reach your out-of-pocket limit, and expenses are fully covered Cover spouse/dependent expenses, even if on another health plan -The money in your HSA can be used to pay for qualified medical expenses of any family member who qualifies as a dependent on your tax return. However, if the dependent isn’t covered under your medical plan, their expenses will not be applied toward meeting your deductible and out-of-pocket maximum MAXIMIZE YOUR MONEY

How the HSA Plan Works: Going to the Doctor Go to the doctor Doctor sends SelectHealth the bill Claim integrated from SelectHealth to HealthEquity website Try not to pay at point of service, since you may not know the exact charge of the claim and want SelectHealth discounts applied to the service. Health Plan adjusts price based on network discounts. Go to HealthEquity website to pay the claim directly to the provider. If funds aren’t available, pay out of pocket and reimburse yourself later. SelectHealth Medical Plan ID Card Member Name: ID Number: Rx Bin Number:

How the HSA Plan Works: Going to the Pharmacy Go to the pharmacy Pharmacy automatically applies discounts Pharmacy sends claim to SelectHealth Show your SelectHealth ID card. Pharmacy discounts are automatically applied at point of service. Pay with your HealthEquity HSA Card. SelectHealth applies the amount toward your deductible.

Order additional ID cards and update your personal information including address View your medical plan benefits as an employee of Murray School District View your claims and EOBs, including year-to-date totals toward meeting your deductible and out-of-pocket maximum Access your pharmacy benefit information, review your pharmacy claims, your prescription drug history, and lower-cost drug alternatives Go green! Switch to paperless explanation of benefits (EOB) when your claims are processed View your Intermountain medical records including lab results and imaging reports Securely message with SelectHealth’s Member Services team HealthEquity website prepopulated with your claims information View and pay your claims online from HealthEquity website Helping you manage the financial side of health care

Together, HealthEquity and SelectHealth look forward to another year serving you! M Murray School District 9/ /2014 Visit Questions? (866) Visit Questions? (801)