Presentation on theme: "Healthy Employees... Healthy Business 1 High Deductible Health Plans & BlueAccount Health Savings Accounts 2012."— Presentation transcript:
Healthy Employees... Healthy Business 1 High Deductible Health Plans & BlueAccount Health Savings Accounts 2012
Healthy Employees... Healthy Business 2 What is an HSA? A Health Savings Account, or HSA, is a tax-advantaged savings account that's available to partners whose only health care coverage is provided through a qualified high-deductible health plan. Since the deductible — or amount you must pay out of pocket before these plans begin to cover benefits — is high, establishing an HSA to self-fund your out-of-pocket care expenses may help you save money.
Healthy Employees... Healthy Business 3 Who Is Eligible? Individuals covered under the a Qualified High Deductible Health Plan. Can NOT be covered by any other health plan that is not a high-deductible plan. Can NOT be eligible & enrolled in Medicare. Can NOT be claimed as a dependent on another person’s tax return.
Healthy Employees... Healthy Business 4 Advantages of an HSA Tax Advantages Federal tax advantages apply –Contributions to BlueAccount Health Savings Account are tax deductible. –Interest earned in BlueAccount Health Savings Account is not taxable. –Investment gains from BlueAccount Health Savings Account are not taxable. –HSAs have been exempt from federal income tax since they were created in 2003. Withdrawals from BlueAccount Health Savings Account for eligible expenses are not taxable.
Healthy Employees... Healthy Business 5 Advantages of an HSA Personal Advantages Owned by the Employee Managed by the Employee Follows the Employee, wherever they go Accumulated balances can also be used for: Continuation of coverage Premiums Long-term care insurance Certain coverage for Medicare eligible employees Requirement that money be used only for qualified expenses or income tax and a 20% penalty applies. Penalty is waived at age 65. This account belongs to you, just like your checking or savings account. The employer does not have access!
Healthy Employees... Healthy Business 6 Qualified High Deductible Health Plans In-network preventive office visits; not subject to the deductible. Deductible applies to ALL non-preventive medical services AND prescriptions. Deductibles are non-embedded. The family deductible must be met by one or more family members for benefits to begin. The Blue Cross network-negotiated discounted rate for all in-network medical services and prescription drugs is the members responsibility until the deductible is satisfied. Reimbursement may be made from your BlueAccount Health Savings Account.
Healthy Employees... Healthy Business 7 The High Deductible Health Plan of the EPC Deductible - $3,500 Employee Only, 7,000 Family; Non-embedded Plan Coinsurance (Pays after satisfaction of deductible) –90% Network, 80% Out-of-Network Out-of-Pocket Maximums (Includes Coinsurance) –Network – $1,400 Employee Only, $2,800 Family –Out-of-Network - $2,800 Employee Only, $5,600 Family Prescription Drug (through BCBS with MEDCO) –90% after deductible - Retail Medications –90% after deductible - Mail Order Medications Preventive Care Services –100%, $0 Co-pay (see Plan document for details) Deductible applies to ALL non-preventive medical services AND prescriptions Dental & Vision plan deductibles are separate and above deductibles do not apply. (Out of Pocket expenses may be reimbursed from your HSA)
Healthy Employees... Healthy Business 8 BlueAccount HSA How does it work? www.highmarkbcbs.com
Healthy Employees... Healthy Business 9 The Member Portal Provides Consumerism Tools that …… Promote understanding of health care options Provide eResources including cost and quality tools Encourage use of health education resources
Healthy Employees... Healthy Business 10 Access highmarkbcbs.com Click “Members” tab Enter User ID & Password in the Log In box, or For new registrants click “Register Now” New Registrants will receive a PIN in the mail to allow complete access Getting started is easy!
Healthy Employees... Healthy Business 11 Health Savings Account Establishment & Customization Opening your Health Savings Account –Online through the Member Portal Personalize your Health Savings Account –Opening the account takes 20 minutes, confirmation is immediate Specify Method of Contribution –Payroll Contribution –Personal Check –ACH Debit Specify Method of Claims Submission –Auto-Submission –Claim-by-Claim Authorization –Debit Card Specify Method of Reimbursement –Direct Payment to Provider –Direct Deposit –Check to Member
Healthy Employees... Healthy Business 12 Contributions & Distributions Regulations determined & enforced by the Internal Revenue Service Contributions –For 2012 contributions from all sources are limited to $3,100 Single Coverage $6,250 Family Coverage Catch-up contributions of $1,000 allowed for members over age 55 Distributions –Intended use is for “qualified medical expenses” as defined by section 213(d) of the Internal Revenue Code –Only prescribed medicines or drugs (including over-the-counter medicines and drugs that are prescribed) and insulin (even if purchased without a prescription) will be considered a qualifying medical expense and subject to preferred tax treatment –If money from the HSA is used for qualified medical expenses, then the money is spent tax-free –Unqualified distributions are subject to income tax and 20% penalty
Healthy Employees... Healthy Business 13 BNY Mellon HSA BNY Mellon is the BCBS preferred custodian. Employees may open an HSA with the financial institution of their choice, but will lose the integrated features provided within the Highmark member portal. Employees may authorize supplemental payroll deductions to their account up to the annual contribution limits. Employees can invest in an FDIC insured account and nine mutual fund options. Employees manage their Claims & BNY Mellon account online at www.highmarkbcbs.com.
Healthy Employees... Healthy Business 14 BNY Mellon Account Management The fee structure is $3.50/month with no calendar year or annual fee. Fees are taken from the HSA at month-end. Debit cards are available at the discretion of the account owner and at no additional charge. An FDIC interest bearing commercial BNY Mellon account is the transaction account.
Healthy Employees... Healthy Business 16 Transparency of Information a Key Focus The “Right” information must be available for the consumer The information must be and Useful & Understandable Critical to success is Education Available information must include: –Treatment options - Healthwise Knowledgebase –Provider performance and outcomes - Hospital and Physician Quality Measures –Useful Cost Information - Cost By Condition –Wellness initiatives- Health Risk Assessment
Healthy Employees... Healthy Business 17 Should You Choose the Consumer Directed Health Plan Determine the difference in your premium contribution for each medical plan option Compute potential tax savings from your HSA contributions Calculate potential earnings from accumulated funds in your HSA Review your out-of-pocket expenses and compare to the premium cost of each plan Use the tools on the BCBS website to estimate your costs –Plan Cost Advisor –My Expense Summary –Cost By Condition –Rx Pricing