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Healthy Employees . . . Healthy Business1
High Deductible Health Plans
&
BlueAccount Health Savings Accounts
2012
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Healthy Employees . . . Healthy Business2
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.
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Healthy Employees . . . Healthy Business3
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.
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Healthy Employees . . . Healthy Business4
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.
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Healthy Employees . . . Healthy Business5
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!
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Healthy Employees . . . Healthy Business6
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.
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Healthy Employees . . . Healthy Business7
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)
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Healthy Employees . . . Healthy Business8
BlueAccount HSA
How does it work?
www.highmarkbcbs.com
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Healthy Employees . . . Healthy Business9
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
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Healthy Employees . . . Healthy Business10
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!
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Healthy Employees . . . Healthy Business11
Health Savings AccountEstablishment & 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
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Healthy Employees . . . Healthy Business12
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
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Healthy Employees . . . Healthy Business13
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.
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Healthy Employees . . . Healthy Business14
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.
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Healthy Employees . . . Healthy Business15
BlueAccount HSA
Consumerism Tools & Resources
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Healthy Employees . . . Healthy Business16
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 EducationAvailable 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
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Healthy Employees . . . Healthy Business17
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