1. High Deductible Health Plans & Health Savings Account

2. Today’s Agenda Review of High Deductible Health Plan (HDHP)
What is an HSA & Who is eligible
Advantages of an HSA
How it works
Tools to help you with your decision making
Be an educated consumer

3. High Deductible Health Plan (HDHP)

4. Your Benefits - HDHP In-Network Out-of-Network Deductible
$3,500 Individual
$7,000 Family
Payment Level
90% after deductible
80% after deductible
Out-of-Pocket Limit
$1,400 Individual
$2,800 Family
$2,800 Individual
$5,600 Family
Lifetime Maximum
Unlimited
Primary Care Physician
Specialist
Emergency Room/Urgent Care

5. Preventive Care Benefit Highlights
In-Network (
Preventive Visits (adult & pediatric)
100%
Deductible does not apply
Pediatric Immunizations
Routine Gynecological Exam
Routine Mammograms
Preventive Diagnostic Screening

6. Prescription Drug Program
Retail (31/60/90) day supply
Plan pays 100% after deductible
Mail Order (90-day supply)

7. Qualified High Deductible Health Plans
Plan Highlights
100% coverage on in-network preventive office visits; not subject to the deductible.
Deductible applies to ALL non-preventive medical services AND prescriptions.
Deductibles are aggregate. This applies to only those in a Family plan. One person or a combination of family members must meet the family deductible before benefits begin to pay.
Same access to doctors and hospitals that you have today
The Blue Cross network-negotiated discounted rate for all in-network medical services and prescription drugs is the member’s responsibility until the deductible is satisfied.
Reimbursement may be made from your Highmark HSA
Talking Points:
Deductible includes both medical and Rx expenses
Family deductible administered as true “aggregate” deductible
No embedded “individual” deductible exists in this plan design

8. What is an HSA?
A Health Savings Account, or HSA, is a tax-advantaged savings account that's available to people 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.

9. Who Is Eligible?
Individuals covered under the High Deductible Health Plan:
Can NOT be covered by any other health plan that is not a qualified high- deductible plan
Can NOT be enrolled in Medicare
Can NOT be claimed as a dependent on another person’s tax return

10. THE BASICS ON HEALTH SAVINGS ACCOUNTS
It’s your money. You choose how to pay for care services.
It’s portable. It goes where you go, even if you change jobs.
Account funds roll over from year to year.
You can pay for an exceptional range of health care services and products. That includes services – such as dental and vision care – that may not be covered under your health plan.
You get “triple-tax savings.” HSA contributions and earnings are tax exempt as long as they are used for qualified medical services.
Once you reach a $500 account balance, you can invest in a wide range of mutual funds for short- or long-term growth potential.
It’s convenient. You access and track all of your health care spending online at your Highmark member website.
Your account is offered through a trusted industry leader, Bank of America, who serves as the custodian.

11. Preferred Custodian Review
Let’s talk about the HSA Custodian…
Bank of America
Highmark’s preferred Custodian
Advantages of choosing Bank of America:
Authorization of pre-tax payroll deductions into your account
Integration of CDHP and HSA
Investment opportunity for over 20 Mutual Fund options
Must reach a $500 balance in your account prior to purchasing funds
When an employee invests, the responsibility is solely on them.  Whether there are gains from the market or losses, it’s no different than someone investing on their own.  As the taxpayer, the HSA account holder is solely responsible for the money in their account and how it is used
Maintenance fee of $3.50 per month covers all transactions and debit card

12. Contributions & Distributions
Regulations determined & enforced by the Internal Revenue Service
Contributions
For 2013 contributions from all sources are limited to
$3,250 Single Coverage
$6,450 Family Coverage
Catch-up contributions of $1,000 allowed for members over age 55 in 2013
Distributions
Intended use is for “qualified medical expenses” as defined by section 213(d) of the Internal Revenue Code
Same ‘Qualified Medical Expenses’ List for a Flexible Spending Account
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

13. Highmark HSA How does it work? www.highmarkbcbs.com

14. Health Savings Account Options
Your Health Savings Account will be established automatically upon enrollment in the HDHP
Can be managed online through the Highmark Blue Cross Blue Shield website
Must go to website and accept terms and conditions
Different Methods of Contribution
Payroll Contribution
Personal Check
ACH Debit
Different Methods of Claims Submission
Debit Card
All HSA participants will receive a debit card tied to account
Additional cards can be requested for family members
Claim-by-Claim Authorization
Different Methods of Reimbursement
Direct Payment to Provider
Direct Deposit
Check to Member

15. Website Login and Registration
Enter User ID & Password in the Log In box, or
For new registrants click “Register Now”
New Registrants will receive a PIN to allow complete access
Getting started is easy!

16. To Open an HSA
Click on the link “Start a Health Savings Account and Save”

17. Please wait 7-10 business days for your HSA to be open
Once your HSA is open you will automatically receive:
1) A Welcome Kit
2) A Debit Card

18. Tools & Resources

19. ONLINE TOOLS ENCOURAGING SMART CARE DECISIONS
Provider Search: Simplifies choosing the right provider
Care Cost Estimator: Estimates the portion you may have to pay for services
Patient Experience Review: Lets you rate your provider and review other opinions
Hospital Advisor: Helps you choose the right hospital based on national quality ratings
Mobile Site: Helps you find providers, view new claims, and can pull up your ID card
Our tools include a Provider Search with Patient Experience Review…
…Hospital Advisor, which helps members understand the quality ratings available for hospitals…
…A new online Member Health Statement…
…A Compare Care Costs tool and an Out-of-Pocket Cost Estimator…
…And they’re all easy to access, located right on your member website.
Confidential and Proprietary

20. See overall patient ratings based on five criteria:
Provider Directory: Patient Experience Review
See overall patient ratings based on five criteria:
Experience: Was it good or bad?
Recommendation: Would you recommend the doctor to family and friends?
Communication: Did you understand what the doctor said?
Availability: Was it hard to get an appointment?
Environment: What was the office like?
Members can see ratings based on five criteria...
How was the experience?
Would you recommend the doctor, physical therapist, occupational therapist, nurse practitioner or other provider?
Did you understand what he or she said?
How hard was it to get an appointment?
And what was the office like?
Confidential and Proprietary

21. Confidential and Proprietary
Care Cost Estimator
Estimate the portion you could have to pay based on your cost sharing.
The Out-of-Pocket Cost Estimator will let members see roughly how much they’ll owe for the selected procedures, based on their specific cost-sharing plan. 21
Confidential and Proprietary 21

22. Online HSA Savings Calculator
Calculate how much you can save over time on a pre-tax basis

23. Additional Consumerism Tools & Resources
Expense Summary & View Your Claims
Plan Activity Statement
Wellness and Research Tools Through Partnership with WebMD®
Blues on Call
My Care Navigator

24. 5 Money Saving Actions
Choose generic drugs over brand name drugs.
You can save up to 6 times the cost of brand name drugs and get the same results
Go to Urgent Care Centers rather than the ER for common, non life threatening health concerns.
ER visits for common conditions like the flu, colds, rashes, or ankle sprains can be 2 to 3 times more expensive than urgent care centers.
Have typical blood tests performed at Independent Labs rather than hospitals
It possible to save up to 50% and most labs are quick and efficient and offer convenient hours, too.
Get X-rays and other imaging tests performed at an X-ray or Imaging Center rather than a hospital
On average, X-Rays, CT Scans and MRIs performed at most hospitals are up to 30 percent more expensive than those done at an imaging center.
When you have any medical tests performed, give the lab the contact information of your provider
You’ll be less likely to have tests repeated unnecessarily. On average, you can save between $83 to $105 on common lab tests and $ 1,100 and $1,800 on imaging tests.

25. Should You Choose the High Deductible Health Plan?
Determine the difference in your premium contribution for each health 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 Highmark website to estimate your costs

26. Questions??