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HSA Open Enrollments Sample
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HSA Open Enrollments Sample

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A quick and simple overview of a Health Savings Account ENrollment Slide show. We use this for employee meetings to help explain the plan.

A quick and simple overview of a Health Savings Account ENrollment Slide show. We use this for employee meetings to help explain the plan.

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  • First, we will take a look at preventive care. Preventive care includes your annual physical, well child visits, diagnostic screenings (cholesterol screenings, colorectal screenings, influenza and pneumococcal vaccinations, annual mammograms, pap smears and pelvic exams, bone density tests for women age 65+). When accessing a Core Network Provider for preventive care, these services are covered at 100% and are not subject to the deductible. You have first dollar coverage with no deductible. When accessing a Standard Network Provider or a non-participating provider, your preventive care is subject to your deductible and coinsurance.
  • The annual deductible is the amount you are responsible for paying before the insurance begins paying. All medical and pharmacy claims, excluding your preventive care, are subject to the deductible. Meaning the deductible is combined for your medical and pharmacy benefits. If you have family coverage, no one in the family is eligible for the Health Coverage until the family deductible is satisfied. Once you have met your annual deductible (you can use the funds in your HSA to pay the deductible), your Definity Plan health coverage will begin paying.
  • The Health Savings Account (HSA) is a financial account that you can use to accumulate tax-free funds to pay for qualified health care expenses. This account is used to offset your liability. It could cover a portion of your deductible and any non-preventive services. It may also cover the expenses associated with pharmacy costs. The account is set up in your name and is funded by you and/or your Employer. The account acts like a regular checking account with a debit card and accrues interest. All money in the account is owned by you and is fully vested as soon as it is deposited. Plus it ’ s portable, so if you leave the company, the account is still yours. If you use the funds for qualified health care expenses, you will pay no taxes. If you use the money for other expenses, you will pay a tax and penalty fee. After the funds in your HSA have been exhausted, you will be responsible for the cost as defined by your benefit plan. We will go into more details on the Basics of HSA ’ s in a few minutes.
  • Giving you piece of mind is important. That ’ s why your plan will have an out-of-pocket maximum to protect you. So everything that you pay towards the annual deductible and coinsurance will be applied toward the out-of-pocket maximum. After this maximum has been met, the plan will pay 100% of covered services. Members rarely reach the maximum, but it ’ s nice to know that your family ’ s finances are secure.
  • Your spouse and dependents don ’ t need to be covered by the HDHP in order for you to use account funds to pay for their out-of-pocket health care expenses. Plus it ’ s portable, so if you leave the company, the account is still yours. Funds in your HAS bank account will grow and perhaps be larger than your deductible in future years depending on one ’ s spending.
  • Now let ’ s take a look at how you would access care in the UnitedHeatlhcare ’ s Definity consumer driven plan. You would present your member ID Card at the physicians office. the Physicians office would “ swipe ” your ID Card and verify benefits with UnitedHealthcare The Physicians will submit the bill to the UnitedHealthcare claim center for processing The claim will be processed and any member responsibility will be determined. UnitedHealthcare ’ s Definity claim center will issue an Explanation of Benefits (EOB) and Health Statement to the consumer and an Explanation of Payment (EOP) to the physician. The subscriber decides if available funds from the HSA will be used to pay for the qualified medical expense. If there were not enough funds in the HSA, then you – the consumer- will be responsible for making payment to the Physician. We encourage you to wait until you have received the Health Statement, so you will know the correct amount due the physician after the UnitedHealthcare network discounts have been applied for services rendered at a network physician.
  • All pharmacy claims are subject to the medical deductible. Once the deductible is satisfied, then $10/$30/$50 prescription coverage applies until the maximum out-of-pocket is reached. Once the MOOP is reached the prescriptions would be covered at 100%. When you need to get a prescription filled you simply: Go to the pharmacy and present you Health ID Card The Pharmacist will send the claim to the UnitedHealthcare Definity pharmacy vendor and the cost of the prescription will be applied to either your deductible or out of pocket costs. If you paid for your prescription out of pocket, you can reimburse yourself for those prescription expenses from your Health Savings Account

HSA Open Enrollments Sample HSA Open Enrollments Sample Presentation Transcript

  • Health Savings Account (HSA) An Exciting New Benefit for You and Your Family An Introduction
  • What is a consumer driven health plan?
      • A consumer driven health plan is a financial account for covered medical expenses paired with a high-deductible medical insurance plan
      • It provides YOU with choice, flexibility and independence with your healthcare decisions and dollars
      • And, it helps you work with your physician to make healthcare decisions that are best for YOU!
    Integrated CDHP = + Medical Plan Financial Account Used to provide some funding for member health care liabilities
      • High deductibles
      • Low premiums
      • More member responsibility
    Puts member in control of utilization & account balances
  • How preventive care works . . .
      • Prevention and early detection are important to living a healthy lifestyle
          • The better your health, the less your healthcare costs
      • Preventive care is the foundation of your new health plan and includes:
          • Annual physical
          • Annual well woman exams
          • Mammograms
          • Well child visits
          • Diagnostic screenings (Cholesterol, cancer)
          • Flu vaccines
  • How the annual deductible and health coverage work …
      • The annual deductible is the amount you are responsible for paying before the full insurance coverage begins
      • All medical and pharmacy claims, excluding your preventive care, are subject to the deductible
      • If you have family coverage, no one in the family is eligible for the health coverage until the family deductible is satisfied
      • Once you have met your annual deductible your health coverage will start paying
      • Like traditional health plans, it will have defined coinsurance levels and out-of-pocket maximums
  • How the Health Savings Account works . . .
      • This account contains money contributed annually by you and/or your employer.
      • The HSA is used to offset your liability.
        • It could cover a portion of your deductible and any non-preventive services.
        • It may also cover the expenses associated with your pharmacy costs.
      • You may choose to pay for certain health care related expenses tax-free from this account - or pay out of pocket and leave the money in the fund to earn tax-free interest … it is YOUR choice!!
  • How the out-of-pocket maximum works . . .
      • The HSA puts a cap on your total cost with an Out-of-Pocket Maximum - so you always know the most you would pay in a given year for your covered services
      • Everything that you pay towards the annual deductible and coinsurance will be applied toward the out-of-pocket maximum
      • After this maximum has been met, the plan will usually pay 100% of covered services
  • What is an HSA?
      • An HSA is an individually owned, financial account that you can use to accumulate tax-free funds to pay for qualified health expenses for yourself, your spouse, and dependents
      • Contributions are tax free and can be invested in a lump sum or periodic deposits by you or your employer
      • Unused HSA funds at the end of the year will continue to grow and earn tax-free interest and can be invested in a variety of investment options
  • Accessing Funds
      • Maximizing electronic card technology
        • MasterCard® branded debit card
        • Available for use at Point-of-Service with Signature or PIN
        • Withdraw cash at ATM to replenish funds paid out-of-pocket
        • Can elect to receive additional cards for your spouse or dependents to use
      • Other payment options
        • Online Bill Payment (pay the provider, pay yourself)
          • no fee, but limited to one transaction daily
        • Checks (available for purchase online in quantities of 6)
  • How Medical Claims are Processed Note: Timing of HSA fund withdrawal need not be associated with timing of claim Claim processed. If you are responsible for any payment, an explanation of Payment (EOP) is mailed to the physician 3 5 Payment is made by you to the physician $ $ $ $ $ $ You may withdraw money from Health Savings Account, using your HSA debit card or a check, to pay for claim 5 $ $ Present the Member ID Card Physician 1 Member EOB sent to you Physician receives EOP (Explanation of Payment) 4 4 2 Physician sends claim to health insurance carrier H.S.A Plan
  • How Pharmacy Claims are Processed Note: Timing of HSA fund withdrawal need not be associated with timing of claim Member $ $ $ $ $ $ 3 If you paid out-of-pocket for your prescriptions, you can reimburse yourself from your HSA $ You can use debit card to access HSA funds directly for payment $ Pharmacist 1 Present ID Card and pay for prescriptions 2 Pharmacist sends claim to Cost of prescription(s) applied to deductible /out-of-pocket maximum
  • Want more information?
    • If you would like more information on consumer driven health plans such as H.S.A’s, HRA’s, MERP’s and how your business could benefit from them, please contact us at 800/924-6718 or visit our website at http://www.emagrouponline.com
    • Note: This is a sample example, your plan may vary in it’s details.