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High Deductible Health Plans & Health Savings Accounts

 

 

Today with healthcare costs rising 15 - 25% per year, employers and employees are looking at alternative health plans to control premiums. One option is to consider offering a High Deductible Health Plan (HDHP).

 

 

What is a High Deductible Health Plan?

 

A HDHP is a major medical health plan that incorporates a large annual deductible on most covered benefits. The insured must satisfy the deductible and coinsurance before the insurance carrier starts covering any benefit. Member is responsible to pay the allowable charge not the billed amount when using a participating provider.   

 

 

Example:   

 

Annual Deductible:  Individual: $2,000 / Family: $4,000

 Coinsurance Amount: 100% of Usual Customary & Reasonable (UCR)

 Annual Maximum Out of Pocket: Individual: $2,000 / Family: $4,000

 Prescription: $10/25/50 after deductible has been satisfied

 

 

As a reminder:  A typical HDHP plan requires an annual deductible to be met before any benefits will be covered. Some plans waive the deductible for preventive care.  

 

 

What is a HSA?

 

A Health Savings Account (HSA) is a special account owned by an individual that is used to pay for current and future medical expenses. HSAs are used in conjunction with a High Deductible Health Plan (HDHP).

 

 

Features of an HSA:

 

• The HSA and the funds in the account are owned by your employee
•  An employee or an employer can contribute money into an HSA
• Contributions are tax deductible
•  HSAs earn interest, are tax free, and are FDIC insured
•  The annual maximum HSA contribution for an individual in 2011 is $3,050
•  The annual maximum HSA contribution for a family in 2011 is $6,150
• Individuals 55 or older can make an additional “catch up” contribution of $1,000
• Money taken out of your HSA for qualified medical expenses is tax-free
• The HSA account is portable
•  An HSA can be used for non covered benefits such as dental care, eyeglasses, laser eye surgery, contact lenses, chiropractic and much more.

 

In our ever changing marketplace, employers and employees are faced with increasing living expenses.  HDHP can provide rate relief not only to the employer, but also could reduce employees’ contribution amounts.

 

VIDEO: Stop / Play  Small Employers & the Affordable Care Act