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MEDICAL ���������������������������������������������������������������
We recognize healthcare coverage is an important part of your benefits package because it protects you and your family from severe financial loss or hardship if an illness or injury occurs. We have designed a program that provides excellent options at affordable costs. The choice in options allows you to choose the coverage level that best meets your needs.
You can choose from two medical/prescription drug/vision plans. Both plans are alike in many ways and differ in some.
Alike:
• Large network of doctors and hospitals • No referrals needed
• Flexibility of out-of-network coverage, if needed • All plans cover the same services/treatments • Deductibles and out-of-pocket maximums are nonembedded
Different:
• Your out-of-pocket costs when you visit a doctor or hospital through your deductibles, out-of-pocket maximum, etc.
• Your out-of-pocket costs through your paycheck (your employee contributions) • The company contributes $500 for single or $1,000 for other coverage levels into your HSA. If you are enrolled in Medicare Part A, government regulations do not allow you to have an HSA, therefore your company contributions will be funded to a healthcare FSA (see
Page 20 for details on healthcare FSA). If you are a new hire, these monies will be prorated based upon the month benefits begin.
Non-embedded means that all out-of-pocket expenses are applied to the family deductible and out-of-pocket maximum until satisfied.
It doesn’t matter if one person in your family incurs all the expenses that meet the deductible and/or out-of-pocket maximum or if it is a combination of two or more of your family member’s expenses.
Example
Mary, Bob and their child John, purchase an HSA plan with a non-embedded deductible and out-of-pocket maximum. The plan design is:
Individual
Family Deductible
$2,750
$5,500 Out-of-pocket Maximum $6,650
$7,350
Note: This example does not include the employer funding that we provide to your H.S.A
Mary has a hospitalization where she incurs $3,000 in out of pocket expenses. Even though the HSA has an individual deductible of $2,750, she will be responsible for the full $3,000 since the family deductible is $5,500.