Westport Board of Education Effective High Deductible Health Plans with a Health Savings Account

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1 Your Cigna choices: Westport Board of Education Effective High Deductible Health Plans with a Health Savings Account

2 How is this different from a traditional plan? Same Wide choice of doctors/hospitals. SAME NETWORK AS CURRENT PLAN In-network Preventive care covered at 100% (Includes periodic well visits, routine immunizations and routine screenings for symptom-free or disease-free individuals. Examples-cholesterol screenings, preventive colonoscopy, preventive mammography) Covers routine, emergency and catastrophic care Plan pays percentage of bill for covered out-of-network care Plan pays higher percentage for covered in-network care Cigna receives bills, sends payment to doctors/hospitals Different Lower premium but higher deductible Plan begins to pay after deductible is met; however, funds in your HSA can be used to cover eligible health expenses Funds can be used to pay the deductible Limit on out-of-pocket expenses for in-network care Unused money rolls over to next year Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 2

3 What is a Health Savings Account (HSA) plan? Qualified Medical Plan Health Savings Account + = Tax-advantaged HSA Plan A tax-advantaged health plan that provides coverage for current medical/pharmacy expenses with the option to save for future health expenses Combines a Qualified Medical Plan (medical/pharmacy coverage) with a Health Savings Account (Bank account with JP Morgan Chase: JPMC) You, your employer or both can contribute to the Health Savings Account Money put in the Health Savings Account that is used for qualified medical expense is not taxable You have investment options (minimum balance of $2,000) Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 3

4 Deductible Out-of-pocket Max 100% Preventive Care (in-network) Out-of-pocket Max Deductible 100% Preventive Care (in-network) How does an HSA work In -Network? Individual Family 100% after $3, % after $5,000 Health Plan pays all medical 100% Health Plan pays all medical 100% RX $10/$30/$45 RX $10/$30/$45 Deductible $2,000 Deductible $4,000 Contribution $1,000 Employer + Employee $ Contribution $2,000 Employer + Employee $ Contributions can be used to pay for current year qualified health expenses or saved to pay for future health expenses Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 4

5 Deductible Out-of-pocket Max 100% Preventive Care (in-network) Out-of-pocket Max Deductible 100% Preventive Care (in-network) How does an HSA work Out of network Individual Family 100%* after $5, %* after $9,000 Health Plan pays all medical 80%* Health Plan pays all medical 80%* RX $10/$30/$45 RX $10/$30/$45 Deductible $2,000 Deductible $4,000 Contribution $1,000 Employer + Employee $ Contribution $2,000 Employer + Employee $ Contributions can be used to pay for current year qualified health expenses or saved to pay for future health expenses Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 5

6 Example of Cigna H.S.A. In-Network services: Coverage Type: Single Family Deductible: $2,000 $4,000 Westport BOE Contribution: $1,000 $2,000 Member Contribution:(to reach deductible) $1,000 $2,000 Plan pays for medical expenses (excludes RX) 100% Out-of-Pocket Maximum $3,000 $5,000 In-Network Preventive care: Covered at 100% (not subject to deductible) Rx Three Tier Copay (After Plan Deductible) $10/$30/$45 Retail -30 day supply; Mail Order 90 day supply (2.5 x retail copay) RX Copays apply to Out-of-Pocket Maximum Out-of-network services: Single Family Deductible $2,000 $4,000 Plan pays (Maximum reasonable charge: MCR) 80%* Out-of-Pocket Maximum $5,000 $9,000 Plan pays (Maximum reasonable charge: MCR) 100%* If elective not emergency and you are using out of network, I would suggest you submit a pre-determination to know your out of pocket cost. * = (Maximum Reasonable Charge / MCR) Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 6

7 What is the maximum I can contribute annually to the HSA? The IRS has set the following limits: Under age 55 and not enrolled in Medicare (based on a 12-month period): 2013 Up to $3,250 individual coverage* ($1,000 employer + $2,250 employee) Up to $6,450 family coverage* ($2,000 employer + $4,450 employee) Age 55 or older: Maximum contribution increases by $1,000 (considered a catch-up contribution) 2013 Up to $4,250 individual coverage* ($1,000 employer + $3,250 employee) Up to 7,450 family coverage* ($2,000 employer + $5,450 employee) To make the maximum contribution in a calendar year, you must: Meet all requirements to be eligible for HSA contributions on January 1 Remain qualified through December 1 If these criteria are not met, maximum contribution is prorated = if 1/12 maximum contribution for each month then individual is qualified *Contributions to your HSA that you receive from your employer and incentives count toward your maximum. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 7

8 Am I eligible to participate in an HSA plan? Because HSA plans have special tax advantages, the IRS defines specific rules for participation. To be eligible, you: Must be enrolled in an IRS-qualified high-deductible medical plan (highdeductible medical plans sold with Cigna s Choice Fund HSA meet IRS requirements) Cannot have any other health coverage Not covered by spouse s medical or pharmacy plan unless it is highdeductible medical plan Not covered through Medicare Part A or Part B * Not covered through a general-purpose Flexible Spending Account (FSA) plan (either employer s or spouse s) Cannot be claimed as a dependent on another person s tax return *Member can be enrolled in Medicare; however, cannot contribute to the H.S.A. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 8

9 How are my medical claims paid? Medical claim payment process Sick visit to an in-network doctor/hospital/facility. Cigna updates quarterly Health Statement; sends alert or mails to your home, based on preference setting. Show Cigna Choice Fund ID card to obtain Cigna discounted rates. Cigna provides an Explanation of Benefits or EOB ( receipt ) showing: Doctor s fee, Cigna discount, amount billed, amount deducted from the HSA, amount paid to doctor, remaining HSA balance, and what you saved. Doctor bills Cigna. Cigna receives the claim and processes it based on the HSAqualified plan deductible, covered expenses and Cigna-negotiated discounts. If Auto Claim Forwarding was elected, Cigna automatically subtracts the amount owed to the doctor from your HSA and pays the doctor. If no Auto Claim Forwarding in place, you have the option to pay the doctor bill using your HSA (debit card/ checkbook) or pay out of pocket Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 9

10 How are my prescription claims paid? Prescription claim payment process Prescriptions drug in-network Show Cigna Choice Fund ID card to obtain Cigna discounted rates. Pharmacy processes immediately You pay what pharmacy says you owe with your debit card at the time of service. Could be the full amount of prescription if you didn t meet deductible. If you met deductible it could be a copay or if you met you out of pocket expense it will be paid at 100%. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 10

11 How can I access my H.S.A. funds to pay for qualified medical expenses? There are several ways to access the $ in your H.S.A. to pay for qualified medical expenses. Use your debit card to pay for a purchase or doctor's visit Use the Chase HSA Online Bill Pay to make payments Reimburse yourself for purchases by getting cash at an ATM at a JPMC bank (press CHECKING not savings) Write a check with your HSA checkbook (fees associated) *Contributions to your HSA that you receive from your employer and incentives count toward your maximum. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 11

12 Can Cigna help me understand and track my health care expenses? Explanation of Benefits (EOB) Available in print or online at mycigna.com Choose if you would like EOBs mailed to your home, or go paperless and receive alerts after each claim is processed and posted to mycigna.com Clearly shows how and when claims were paid, and by which plan and/or account(s) Quarterly Health Statement Available online at mycigna.com You will be alerted by after each statement is posted to mycigna.com Shows year-to-date deductibles, all claim activity and out-of-pocket expenses for that quarter Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 12

13 How can I reach you when I need help? Prior to plan being effective you can call the pre-enrollment line: /7 online health account management After effective call us anytime day or night live, 24/7 customer service Cigna24 ( ) Cigna Home Delivery Find information when you need it at mycigna.com Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 13

14 How do I obtain a health savings account with JP Morgan Chase? You will complete an on-line enrollment process. Before opening the account, JPMC will verify your identity (required by the Federal government) using information provided in the HSA application and enrollment form. You will receive notification from JPMC if additional documentation is needed for verification (name, social security number or address). JPMC will send your H.S.A. information and a debit card within 7-10 days of the start of the plan year or the verification of identity (whichever is later). You will need to activate your H.S.A. before $ can be deposited into your account. ID cards are mailed from Cigna Debit cards are mailed separately from JPMC Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 14

15 Questions? Cigna is a registered service mark and the "Tree of Life" logo is a service mark of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided exclusively by such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, (CGLIC), Cigna Health and Life Insurance Company (CHLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C.,and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc. In Arizona, HMO and Network plans are offered by Cigna HealthCare of Arizona, Inc. In California, HMO plans are offered by Cigna HealthCare of California, Inc. In Connecticut, HMO plans are offered by Cigna HealthCare of Connecticut, Inc. In North Carolina, HMO plans are offered by Cigna HealthCare of North Carolina, Inc. All other medical plans in these states are insured or administered by CGLIC or CHLIC. "Cigna Home Delivery Pharmacy" refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. In Texas, Open Access Plus plans are considered Preferred Provider plans with certain managed care features. All models are used for illustrative purposes only b 09/ Cigna. Some content provided under license.