HSA EMPLOYER TOOLKIT

Transcription

1 HSA EMPLOYER TOOLKIT Capital BlueCross has arranged for ACS BNY Mellon HSA Solution ( The HSA Solution SM ) to offer a host of financial solutions to complement your SimplySelect SM HSA products. This kit provides easy-to-use information that will enable you to quickly understand the attributes of The HSA Solution and share information with your clients. Just click on each document pictured below to retrieve a PDF of each communication: HSA Advantages A product summary describing key product features. HSA 101 Employee Flyer An example of the type of materials available to your employees. HSA Group Account Setup A summary of the employer experience and identifies the steps for employers to fund employees accounts. HSA Enrollment Steps A summary of the account holder experience and identifies the steps for account holders to open accounts. PowerPoint Presentation A summary of the key aspects of SimplySelect. Thank you for spending the time to review this information. For more information, agents can contact: 1. Capital BlueCross Account Executive 2. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Agent Support For more information, employers can contact: 1. Capital BlueCross Account Executive 2. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Employer Support Team HSAEmployerSetup@acs-inc.com ACS BNY Mellon HSA Solution ( The HSA Solution SM ) is an independent company whose products and services are not BlueCross products and services. The HSA Solution is solely responsible for these financial services. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. NF-805 (5/2013)

2 HSA ADVANTAGES Capital BlueCross has been dedicated to providing market appropriate, dependable, and quality health care plans to employers like you. In keeping with this trend, Capital BlueCross has arranged for ACS BNY Mellon HSA Solution ( The HSA Solution SM ) to offer a host of financial options to complement our SimplySelect SM Health Savings Account (HSA) products. Why offer your employees an HSA compatible health plan? Offering health care coverage is one more way you can retain the employees you have while attracting a pool of qualified new talent when you are hiring. By offering SimplySelect in combination with an HSA, your employees will have the unique opportunity to take advantage of: Pre-tax contributions: lowering their taxable income Tax-free growth: earning interest and building savings on a tax-free basis* Retirement savings vehicle: funds can be withdrawn for any purpose without penalty after reaching 65 (taxes may apply) Portability: their money stays with them Investment flexibility: access to a wide range of mutual funds available to help their money grow Roll over: unused funds carry over into the next year Your Support Team A variety of resources are offered to assist you in initial and ongoing activities, such as: Employer Support In addition to your Capital BlueCross Account Executive, you will have access to a Client Service Manager assigned by The HSA Solution, and an HSA-only dedicated Employer Support Team to assist with enrollment, funding, status updates, and more. Employer Website A website providing instant access to account status and funding information. In general, funding received by 4 p.m. each business day will post the same night. Many web reports are also available detailing account activity. Online Enrollment and Contributions You have the ability to set up and make reoccuring contributions to your employees HSA accounts online. Employees can activate their accounts online or by completing a signature card. *Tax advantages vary by state, check with your tax advisor regarding your specific circumstances.

3 What Your Employees Can Expect HSA ADVANTAGES As an employer you have the ability to contribute funds into your employees accounts. The Internal Revenue Service has set contribution, deductible, and out-of-pocket guidelines on HSAs and High Deductible Health Plans (HDHPs), as listed below. Individuals between 55 and 65 years of age can contribute extra amounts, up to $1,000 per year, as catch-up contributions. If your employees withdraw funds before age 65 for nonqualified medical expenses, regular income tax plus a penalty will apply. With a SimplySelect HSA, your employees have the ability to grow their savings by choosing to invest in a wide variety of mutual funds. To take advantage of this investment opportunity, employees must: Build up a balance of $1,000 in their HSA. Maintain at least $1,000 in the HSA to continue investing HDHP/HSA LIMITS INDIVIDUAL FAMILY Maximum HSA Contribution $3,250 $6,450 Minimum Deductible $1,250 $2,500 Out-of-Pocket Maximum $6,250 $12,500 Limits are adjusted annually. When a member s account reaches $1,000, they can set up automatic transfers into a Money Market account or into investment options they have selected. It s the employees choice to invest. HSA funds remain in an interest bearing transaction account until the employee chooses to invest it. The HSA Solution offers your employees highly competitive HSA fees and rates: Account set-up fee Monthly service charge for average monthly balance of $1,000 or more None No Charge Monthly service charge for monthly balance under $1,000 $3.50 Transaction fees for debit card and check transactions None Monthly service charge for an HSA investment account $2.90 Market-based interest rate Variable Fees and rates are subject to change. Getting Started Getting started is easy. Contact your Capital BlueCross Account Executive and tell them you want to offer your employees SimplySelect HSA! For more information, agents can contact: 1. Capital BlueCross Account Executive 2. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Agent Support For more information, employers can contact: 1. Capital BlueCross Account Executive 2. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Employer Support Team HSAEmployerSetup@acs-inc.com ACS BNY Mellon HSA Solution ( The HSA Solution SM ) is an independent company whose products and services are not BlueCross products and services. The HSA Solution is solely responsible for these financial services. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. NF-798 (3/2013)

4 The Easiest Way to Build Savings for Health-Related Expenses Why Capital BlueCross? Capital BlueCross is dedicated to providing dependable, quality health care programs. Capital BlueCross partners with ACS BNY Mellon HSA Solution (The HSA Solution SM ) for the administration of the HSA financial account. Introducing SimplySelect SM HSA As a SimplySelect HSA member, you enjoy the advantages of: Pre-tax Contributions: lowering your taxable income. Tax-free Growth: earn interest and build savings on a tax-free basis. 1 Tax-free Withdrawals: when used for qualified medical expenses. Retirement Savings Vehicle: funds can be withdrawn for any purpose without penalty after reaching age 65 (taxes may apply). Portability: the money stays with you if you change employers. Investment Flexibility: access to a wide range of mutual funds available to help your money grow. HSA 101 HSA Eligibility In order to participate in an HSA, individuals must meet the following requirements (applies to the subscriber, not spouse or dependents): Be covered by an IRS-qualified High Deductible Health Plan (HDHP) such as the SimplySelect HSA. Not be claimed as a dependent on another person s tax return. Not be covered under another health insurance plan or enrolled in Medicare.* (Individuals with limited benefit policies, including dental, vision, and workers compensation, may still be eligible for an HSA.) However, medical FSAs disqualify participation in the HSA. Note: Contributions to the account must stop once you are no longer enrolled in the HSA plan or if you are enrolled in Medicare. However, you can continue to use the money in your account to pay for qualified medical expenses tax-free. *If eligible for Medicare but have not filed an application for either Social Security retirement benefits or Medicare, members can continue to contribute to their HSA after age 65 and postpone applying for Social Security and Medicare until they stop working. There is no penalty for this delay. HSA Enrollment Process 1. Enroll in SimplySelect HSA, a qualilfied HDHP offered by your employer. 2. Activate your account via Advantage Direct link (if offered by employer), online at HSAmember.com or by returning the signature card included in the welcome kit that you receive in the mail. Debit cards are mailed four to seven days after account activation. Debit card PIN code is mailed three to five days following debit card mailing. 4. Mail in the beneficiary designation and signature card to receive your checkbook. Checkbooks are mailed four to seven days after the signature card is processed. Funding and Using Your HSA The Internal Revenue Service has set contribution, deductible, and out-of-pocket guidelines on HSAs and HDHPs, as listed below HDHP/HSA LIMITS INDIVIDUAL FAMILY Maximum HSA Contribution $3,250 $6,450 Minimum Deductible $1,250 $2,500 Out-of-Pocket Maximum $6,250 $12,500 Limits are adjusted annually. Individuals between 55 and 65 years of age can contribute extra amounts, up to $1,000 per year, as catch-up contributions. If HSA funds are withdrawn or used for a nonqualified expense before age 65, taxes and a 20 percent penalty will apply. 3. Activate your debit card (you will need your PIN code for activation).

5 HSA 101 Invest In The Future Of Your Health Care With a SimplySelect HSA, members can grow their savings by choosing to invest in a wide variety of mutual funds. To take advantage of this investment opportunity, members must: Build up a balance of $1,000 in their HSA. Maintain at least $1,000 in the HSA to continue investing. When your account reaches $1,000, you can set up automatic transfers into a Money Market account or into investment options you have selected. Administering Your Expenses Use your HSA to cover medical, dental, and vision services even copayments and deductibles. Your SimplySelect HSA gives you the option of paying for qualified medical expenses with debit card 2, manual request, or online bill pay. You may not use your HSA to pay for health insurance premiums, except under the following circumstances: For any health care coverage while receiving unemployment benefits from either the state or federal government. Continuing coverage under COBRA after leaving an employer that offered you health insurance. Qualified long-term care premiums. Premiums, copayments, coinsurance, and deductibles for Medicare Part A, Part B, Part C and/or Part D. You can obtain a list of qualified expenses at irs.gov. Search for Publication 502. HSA Account Fees and Rates Applicable fees associated with HSA account administration are as follows: Account set-up fee Monthly service charge for average monthly balance of $1,000 or more Monthly service charge for monthly balance under $1,000 Transaction fees for debit card and check transactions Monthly service charge for an HSA investment account None No Charge $3.50 None $2.90 Market-based interest rate Variable 1 Tax advantages vary by state, check with your tax advisor regarding your specific circumstances. Fees and rates are subject to change. 2 Personal spending account debit cards can only be used for qualified expenses and cannot be used at all merchants that accept debit cards or at any ATM. Please be reminded that Health Savings Accounts have tax and legal ramifications. Capital BlueCross and ACS BNY Mellon HSA Solution ( The HSA Solution SM ) do not provide legal or tax advice, and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on, for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax advisor regarding the tax consequences of specific health insurance plans or products. Capital BlueCross brings it all together. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) is an independent company whose products and services are not BlueCross products and services. The HSA Solution is solely responsible for these financial services. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. NF-790 (3/2013)

6 HSA GROUP ACCOUNT SETUP Health Savings Accounts (HSAs) are established for your employees upon their enrollment in a SimplySelect SM HSA. This document is intended to explain the necessary steps to fund accounts opened by your employees. Step 1: Discovery Complete the HSA Discovery Document with your Account Executive or Agent. Once you have decided to offer SimplySelect along with an HSA, complete the HSA Discovery Document with your Account Executive or Agent and it to the Employer Set-up Team at HSAEmployerSetup@acs-inc.com. Step 2: Employer Set-Up Team Review s from the ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Employer Set-Up Team. Within two to three business days of receipt of the HSA Discovery Document, the Employer Set-Up Team will send three s to the business contact listed on the form. The s will be labeled with the following subject titles: Welcome to the ACS BNY Mellon HSA Solution ACS BNY Mellon Funding Information ACS BNY Mellon Authentication and Security Your 14-digit employer sub-account number will be included in the Welcome . You will use this account number as your User ID to log in to the HSA Web site for funding purposes. The Payroll on the Web (POW) Guide embedded in the includes login instructions. Step 3: Log In Log in to The HSA Solution Web site. Go to hsamember.com and click the Login To Your Accounts button. Enter your 14-digit account number (included in your Welcome ) as your User ID. Your initial password is Once you have entered your User ID and password, you will be prompted to provide a valid address for security purposes. Upon completion press Submit. For more information, agents can contact: 1. Capital BlueCross Account Executive 2. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Agent Support Step 4: Employee Accounts Remind your employees to open their accounts. It s important that all employees in the plan open their account; you can only fund open HSA accounts. Employees can also open their accounts by either returning the Master Signature Card or online through e-signature. The Master Signature Card and e-signature instructions are included in the HSA Welcome Kit mailed to each employee. Advantage Direct is also available to help expedite the HSA account enrollment process during open enrollment. You can view your employees account status by selecting the Payroll on the Web tab on The HSA Solution s Web site (hsamember.com). Step 5: Funding Instructions Submit funding allocation instructions. Select the Payroll on the Web tab on The HSA Solution s Web site. You will see a list of your employees who have opened accounts. Allocate funds into your employees open accounts by entering a dollar amount into either the Employer, Employee, or both contribution boxes. Upon completion of your payroll allocation: Press Update to update the totals Press Submit to finalize the allocation Press OK to confirm dollar amounts are correct Press OK one final time to submit the allocation Step 6: Funding Fund your employer sub-account. Once you have submitted funding allocation instructions, submit a lump sum funding via wire, Automated Clearing House (ACH) Network, or check into your employer sub-account. Upon receipt of the lump sum funding, The HSA Solution will allocate those funds according to your request on POW. Large groups are encouraged to use alternative funding methods as defined in the ACS BNY Mellon Employer Guide. For more information, employers can contact: 1. Capital BlueCross Account Executive 2. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) Employer Support Team HSAEmployerSetup@acs-inc.com ACS BNY Mellon HSA Solution ( The HSA Solution SM ) is an independent company whose products and services are not BlueCross products and services. The HSA Solution is solely responsible for these financial services. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. NF-804 (11/2012)

7 HSA ENROLLMENT STEPS FOR MEMBERS Opening a Health Savings Account (HSA) is easy. These simple steps can get you started toward building a healthy and secure future for you and your family. Step 1: Medical Plan Enrollment Enroll in SimplySelect SM HSA. Enroll in SimplySelect HSA, a qualified High Deductible Health Plan (HDHP), offered by your employer. Step 2: Contribution Elect a pre-tax HSA contribution (not required). Determine how much you plan to contribute to your HSA account before taxes, and share this information with your employer. Your employer will withhold the designated amount during each payroll cycle, and will forward your contribution to your HSA. Funds will post within 24 hours of receipt. Step 3: Online Account Activation There are several options for account activation. Activate your account via Advantage Direct (if offered by your employer) or online at Sample Welcome Letter Envelope Step 4: Master Signature Card Request a checkbook and designate beneficiaries. A welcome letter from ACS BNY Mellon will be mailed to your home address within seven days of receiving your enrollment information. Do not throw the letter away. The welcome letter will include a Master Signature Card and reply envelope. Complete the Master Signature Card to designate account beneficiaries and sign up to receive a personalized checkbook. A checkbook is not sent automatically. Completing the card will also result in activating your account if you did not activate it online. Step 5: Debit Card, PIN, and Checkbook Watch for your debit card, PIN, and checkbook. Within ten business days of activating your account, The HSA Solution will mail you a debit card. Your Personal Identification Number (PIN) will be mailed shortly after your debit card. If you completed the Master Signature Card, then you will also receive a checkbook. Checkbooks are mailed four to seven days after the Signature Card is processed. Note: For security purposes, your debit card, checkbook, and PIN letters are mailed separately in plain envelopes. HSA Account Fees and Rates Applicable fees associated with HSA account administration are as follows: Sample Debit Card Envelope Account set-up fee Monthly service charge for average monthly balance of $1,000 or more Monthly service charge for monthly balance under $1,000 Transaction fees for debit card and check transactions None No Charge $3.50 None Monthly service charge for an HSA investment account $2.90 Market-based interest rate Variable Fees and rates are subject to change. Questions? Visit or call customer service at You can use The HSA Solution s Web site or the phone system to track the status of your Welcome Kit, debit card, and checkbook mailing. ACS BNY Mellon HSA Solution ( The HSA Solution SM ) is an independent company whose products and services are not BlueCross products and services. The HSA Solution is solely responsible for these financial services. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the BlueCross BlueShield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. NF-799 (12/2012)

8 Health Savings Accounts Group HSA

9 Concept of Consumer Directed Health The concept of consumer directed health (CDH) plans focuses on encouraging members to become active consumers of health care by taking more responsibility for their health care decisions and purchases. Be proactive Select an in-network physician who is dedicated to providing coordinated care. It increases the likelihood of receiving preventive screenings and appropriate and necessary care. It s easier and less expensive to prevent a health issue from occurring than it is to treat it. Be aware Understand your current health status. Have a plan and find the programs that support improving lifestyle choices. Awareness and understanding of your current health status aids in the development of a plan for change. 2

10 Concept of CDH (continued) Know your numbers Get tested and know basic biometric numbers, like blood glucose and cholesterol levels. Early detection may prevent serious illness or disease. Know the value Become a better consumer by knowing there is a cost difference and asking questions. Is an MRI really necessary or is an x-ray sufficient? Will the hospital be less expensive or a free-standing facility? How many procedures has each facility performed? Prices vary by hundreds of dollars for simple procedures like MRIs or CT scans. Cost differences have a direct impact on out-of pocket expenses through deductibles and/or coinsurance. Know your options when it comes to your health and your wallet. 3

11 Capital BlueCross CDH Strategy Consumer Engagement 4

12 Components of SimplySelect SM HSA The cornerstones of CDH incorporates all of these components. PPO Coverage The foundation of consumer-directed health plans Health Savings Account Employees retain control and make choices on how to spend their health care dollars Clinical Programs Clinical and wellness programs that provide access to both education and personal support Web Tools Interactive web-based tools, such as cost estimators, HSA calculators, and balance information 5

13 Member Engagement Our engagement strategy focuses on providing members with the necessary tools and information to support becoming a wiser, more adept consumer of health care. Providing benefit information to help members select a health plan that s right for them Offering health and wellness information to help members understand their treatment options and weigh those options against their lifestyle and needs Providing incentives to members through benefit designs and incentive initiatives to get the care they need to stay healthy and well Being a better consumer of health care means being informed and asking questions. 6

14 HSA Overview Health Savings Account 7

15 What is an HSA? Health Savings Accounts (HSAs) are like a medical 401(k)... a way to save for retirement. Savings account with money in it Allows employees to put money aside to pay for qualified expenses tax-free.* Unused dollars remain in the account year after year. Employer and/or employee contributions are permitted up to the established IRS maximum contribution limit each year. It s portable Employees own the account funds even after terminations, retirements, etc. Employees retain control and make choices about how to spend their health care dollars. Allows employees to pay for medical expenses that may not be covered under their health plan. *Tax references are for federal taxes only. State taxes vary. Consult your tax advisor. 8

16 HDHP + Account = SimplySelect HSA You must have a IRS-qualified High Deductible Health Plan (HDHP) in order to open an HSA. The two pieces work together to create the SimplySelect HSA product. Deductible Capital BlueCross Medical Plan Prescription Drug Plan HDHP Health Savings Account HSA Medical and prescription drug expenses accumulate to the same combined deductible. The PPO medical plan covers medical expenses after the deductible has been met. The prescription drug plan covers drug costs after the deductible has been met. Funds in the HSA can be used to pay for any eligible expenses as defined by Section 213(d). 9

17 Design Differences HSA vs. PPO The IRS requires design differences in qualified high deductible health plans compared to standard PPO plans. Deductible Out-of-Pocket (OOP) HSA Medical and Rx are combined. The deductible applies to ALL services (except preventive). Qualified plans only have two tiers of deductible coverage single or family (contracts of two or more). The deductible amount must be met before any family member is eligible for covered benefits. Medical and Rx are combined The OOP max includes the deductible, coinsurance, and copayments. Once the in-network OOP max is met, member is covered in full. Coinsurance is 100 percent and all copayments are waived (in-network) through the end of that calendar year. PPO Medial and Rx are not combined. The deductible does not apply to services that take a copayment (such as OV, ER, etc.). Plans can have various tier structures, including two party. The family deductible amount may not need to be met to be eligible for benefits if the individual met the single deductible amount. Medical and Rx are not combined The OOP max includes coinsurance only (does not include deductible or copayments). Once in-network OOP max is met, coinsurance no longer applies but copayments are still applicable. 10

18 HSA Plan Designs IRS qualified HDHP plan designs range in deductible from $1,200 $3,500. Product Name HSA 1200-Q/100 HSA 1500-Q/100 HSA 1500-Q/80 HSA 2000-Q Deductible Out-of-Pocket Maximum Coinsurance (network/non-network) Physician of Choice Office Visit (network) $1,200 single; $2,400 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) Member Pays $1,500 single; $3,000 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) $1,500 single; $3,000 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) $2,000 single; $4,000 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) 0/20% 0/20% 20/40% 0/20% $20 copayment (services are subject to deductible) Covered in full 20% coinsurance $20 copayment (services are subject to deductible) 11

19 HSA Plan Designs IRS qualified HDHP plan designs range in deductible from $1200 $3500. Product Name HSA 2500-Q/100 HSA 2500-Q/80 HSA 3500-Q/100 Deductible Out-of-Pocket Maximum Coinsurance (network/non-network) Physician of Choice Office Visit (network) $2,500 single; $5,000 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) Member Pays $2,500 single; $5,000 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) $3,500 single; $7,000 family (combined in- and out-of-network) $5,000 single; $10,000 family (combined in- and out-of-network) ebasics SM HSA 3000-Q/70 $3,000 single; $6,000 family (combined in- and out-of-network) $5,800 single; $11,600 family (combined in- and out-of-network) 0/20% 20/40% 0/20% 30/50% Covered in full 20% coinsurance Covered in full 30% coinsurance 12

20 HSA Plan Designs IRS qualified HDHP plan designs range in deductible from $1200 $3500. Product Name HSA 1200-Q/100 HSA 1500-Q/100 HSA 1500-Q/80 HSA 2000-Q Specialist Office Visit (network) Urgent Care Emergency Care Inpatient Services (network) Outpatient Services (network) $20 copayment (services are subject to deductible) $45 copayment (services are subject to deductible) $75 copayment (services are subject to deductible) Member Pays Covered in full Covered in full Covered in full 20% coinsurance Covered in full Covered in full $20 copayment (services are subject to deductible) $45 copayment (services are subject to deductible) $75 copayment (services are subject to deductible) Covered in full Covered in full 20% coinsurance Covered in full Covered in full Covered in full 20% coinsurance Covered in full 13

21 HSA Plan Designs IRS qualified HDHP plan designs range in deductible from $1200 $3500. Product Name HSA 2500-Q/100 HSA 2500-Q/80 HSA 3500-Q/100 Specialist Office Visit (network) Member Pays ebasics HSA 3000-Q/70 Covered in full 20% coinsurance Covered in full 30% coinsurance Urgent Care Covered in full Covered in full Covered in full Covered in full Emergency Care Covered in full Covered in full Covered in full Covered in full Inpatient Services (network) Outpatient Services (network) Covered in full 20% coinsurance Covered in full 30% coinsurance Covered in full 20% coinsurance Covered in full 30% coinsurance 14

22 Who is eligible for an HSA? HSAs are available to any individual who: Is covered by an IRS-qualified high deductible health plan (HDHP). Is not covered by other health insurance. Some examples of permitted/nonpermitted coverage are: Permitted Limited FSAs and HRAs Auto, life, workers compensation, or disability coverage Dental care, vision care, or long-term care Specific disease insurance and per-diem hospitalization insurance Nonpermitted General Purpose FSA or HRA Other Rx coverage Medical coverage under spouse plan 15

23 Who is eligible for an HSA? (continued) HSAs are available to any individual who: Is not enrolled in Medicare. If eligible for Medicare but have not filed an application for either Social Security retirement benefits or Medicare, members can continue to contribute to their HSA after age 65 and postpone applying for Social Security and Medicare until they stop working. There is no penalty for this delay. Can t be claimed as a dependent on someone else s tax return. 16

24 HSA Contributions The IRS annually adjusts minimum deductible amounts and maximum contribution amounts based on Cost of Living. Minimum Deductible Maximum Contribution Maximum Out-of-Pocket Amount $1,200 single $2,400 family $3,100 single $6,250 family $6,050 single $12,100 family 55+ Catch-up Contributions $1,000 17

25 HSA Eligible Expenses In addition to HSA funds to pay for eligible deductible, coinsurance, and copayments under the health plan, funds can also be used for any IRS-qualified medical expenses. Listed are just a few examples of covered and noncovered services. Covered Expenses Noncovered Expenses Hearing aids LASIK surgery In vitro fertilization Long-term care premiums Eyeglasses/ contacts Copayments Coinsurance and deductibles COBRA premiums Wheelchairs Life insurance premiums Health club fees Special food and beverages Cosmetic surgery Burial expenses Maternity clothes Cosmetics Medigap premiums Spa treatments For a complete listing of IRS qualified expenses, go to irs.gov/pub/irs-pdf/p502.pdf 18

26 HSA Advantages From the EMPLOYER's perspective: Lower premium costs than traditional health plans Funds contributed to the HSA are tax deductible by the employer Educates employees on the true cost of health care services Minimizes cost shifting to employees 19

27 HSA Advantages From the EMPLOYEE's perspective: Funds belong to the employee and unused balances remain in the account year-to-year regardless of job changes or retirement. Ability to save for future health care expenses and retiree health care coverage Ability to pay for services not covered under the medical plan LASIK, dental care, vision care, etc. Triple tax advantage contributions are made pretax, plus any interest earned is earned tax-free and payment (distributions) for eligible expenses are tax-free After age 65, funds can be used for anything without penalty (only taxes apply). Can continue to use HSA funds even if no longer covered by an IRS qualified HDHP (cannot continue to make contributions) 20

28 Potential Savings of HSA The chart below shows possible savings for individuals with an HSA. Health Savings Account Balances (Assumes a $2,000 deductible and deposit each year) Account Balance after X Years Age of Head of Household starting at 25 After Family Medical Expenses of $1,000 each year After Family Medical Expenses of $500 each year $0 Family Medical Expenses 5 Years 30 $5,802 $8,703 $11, Years 35 $13,207 $19,810 $26, Years 40 $22,657 $33,986 $45, Years 45 $34,719 $52,079 $69, Years 50 $50,113 $75,170 $100, Years 55 $69,761 $104,641 $139, Years 60 $94,836 $142,254 $189, Years 65 $126,840 $190,260 $253,680 Source: The HSA Coalition; HSAInsider.com Assumes 5% interest per year, and 100% of a $2,000 deductible is deposited each year. 21

29 Member Responsibilities HSAs are an IRS program, and as such, require tax filing every year. If funds are withdrawn, or used for a nonqualified expense before age 65, taxes and a 20 percent penalty will apply. Save receipts in the event of an audit. Do not exceed contribution limits with personal and employer contributions. Keep account in an open status to receive all applicable contributions. Reconcile account regularly to ensure adequate funds are available to cover qualified expenses. Employers and employees should contact their tax professional for more information on tax implications and filings. 22

30 HSA Mechanics How does it work? 23

31 HSA Process Flow Member goes to the doctor s office for service and pays copayment at time of service Provider submits claim to Capital BlueCross Capital BlueCross processes claim Yes Capital BlueCross determines if deductible met No Claim is processed and applied to deductible Capital BlueCross mails EOB to member, SOR to provider Provider bills member for outstanding liability amount Capital BlueCross mails check to provider and EOB to member Option 1 Member pays provider with debit card, HSA check, or Direct Pay HSA Option 2 Option 3 Member pays provider with own OOP funds Member chooses to pay OOP and saves HSA funds for future use EOB = Explanation of Benefits HDHP = High Deductible Health Plan SOR = Statement of Remittance OOP = Out of Pocket Member writes check from HSA account or uses Direct Pay HSA to reimburse themselves 24

32 How the Plan Works Scenario 1 Single contract with PPO 1500Q... Single with minimal needs... HSA YEAR ONE HSA YEAR TWO Your employer contribution $750 HSA account Roll-over from year one $787 Your contribution $1,000 balance $1,750 Your employer contribution +$750 You see your doctor for a sick visit -$25 copayment $1,725 Your contribution starting balance +$500 HSA account balance $2,037 A minor hiking accident sends you to the emergency room -$638 $1,087 See your doctor for a cold -$85 $1,952 Monthly prescription filled at $25/month HSA balance at the end of year one -$300 $787 $787 You fill a prescription for antibiotics and purchase some OTC cold medicine Monthly prescription filled at $25/month -$76 $1,876 -$300 $1,576 HSA balance at the end of year two $1,576 Costs and expenses are for example purposes only. 25

33 How the Plan Works Scenario 2 Family contract with PPO 1500Q (a $3,000 family deductible)... HSA Year One Family of seven with many needs... HSA Year Two Your employer contribution $1,500 HSA account Roll-over from year one $1,583 Your contribution $1,000 balance $2,500 Your employer contribution $1,500 Three kids have strep throat $25 copayment for each person you decide to pay OOP (do not use HSA) Three kids visit doctor for a case of pink eye ($75) Antibiotics for pink eye -$53 $2,222 Youngest sees a speech therapist -$125 $2,097 You visit the doctor for the flu -$75 $2,022 OTC cold medicine -$18 $2,004 Youngest sprains a wrist and visits the ER $75 $2,500 Your contribution $1,000 HSA account balance $4,083 -$225 $2,275 Youngest sees a speech therapist -$175 $3,908 -$421 $1,583 Fourth child goes to emergency room after bike accident Your husband/wife has their gall bladder removed (total bill is $4,100) You pay out of your HSA to meet your remaining family deductible You pay out of your own pocket for coinsurance (0%) Remaining cost of surgery plan pays 100% -$850 $3,058 -$1,975 $1,083 $0 $1,083 $2,125 $1,083 HSA balance end of year one $1,583 HSA balance end of year two $1,083 Costs and expenses are for example purposes only. 26

34 Web Tools 27

35 Website and Tools Members have access to benefit and claim information, EOBs, and account balances. Capital BlueCross members with an ACS BNY Mellon HSA can view their HSA account balance on mycapbluecross.com and use the More Details link to Single Sign-on to their secure HSA information and features on hsamember.com. It s that easy! 28

36 MyCare Advisor SM MyCare Advisor can help estimate out-of-pocket expenses related to a procedure or service, which is especially helpful for those members who have an HSA. MyCare Advisor provides valuable insight when selecting where a procedure is performed, since all providers are not priced equally. 29

37 ACS BNY Mellon Where do they fit in? 30

38 Who is ACS BNY Mellon? Capital BlueCross partners with ACS BNY Mellon to provide best-in-class administration for our HSA clients. Both ACS (Affiliated Computer Services) and BNY (Bank of New York) Mellon are Fortune 500 companies. Largest HSA administrator in the country with 800,000+ total accounts Dedicated customer service that specializes in HSAs Simple, easy-to-use online tools for groups and members Access to account information 24/7 ACS BNY Mellon HSA Solution ( The HSA Solution SM ) is an independent company whose products and services are not BlueCross products and services. The HSA Solution is solely responsible for these financial services. 31

39 Key Features ACS BNY Mellon offers many convenient capabilities, features, and dedicated support. Funding Simple online funding tool Fully automated processes Unmatched reporting No minimum deposit Unlimited funding frequency Spending Free checkbook Free check writing Free online bill pay No claim forms No minimum withdrawal No minimum balance Investing 22 highly-rated mutual funds Multiple fund families Automatic investing Integrated investing Support HSA-dedicated customer service HSA-dedicated employer service HSA-dedicated broker service ACS BNY Mellon does not cross-sell any other banking products. 32

40 Distribution and Reimbursement How do accountholders get money out? Debit Card A signature based card or pin based Cannot use card at ATM s to withdraw funds Card is automatically issued when the account is opened First card is free, additional cards are $5 each Checkbook Write a check! No manual claim forms or receipts need to be submitted Signature card in the welcome kit must be signed and returned for checkbooks to be issued First 40 checks are free, additional checkbooks are $5 each Direct Pay HSA Generate payments online 24/7 Create one-time or recurring payments No postage or transaction fees 33

41 Investment Options ACS BNY Mellon offer a large investment portfolio with online access 24/7. Fund Category The HSA Solution Investment Fund Ticker Money Market DREYFUS CASH MGMT PLUS INVESTOR SHS DVCXX Integrated investments via HSA website $1,500 balance to start investing Twenty-two highly-rated funds from multiple fund families Automatic investing No minimum investment No transaction fees All options are no-load or load-waived mutual funds Ready access to funds via checkbook or debit card Balances and transaction info available via IVR Transaction Account Investment Account Intermediate-Term Bond CALVERT INCOME FUND CLASS A CFICX.LW Short-Term Bond CALVERT SHORT DURATION INC CLASS A CSDAX.LW High Yield Bond FIDELITY ADV HIGH INC ADVANTAGE CLASS T FAHYX Short Government GOLDMAN SACHS SHORT DURATION GOVT CL A GSSDX.LW World Bond TEMPLETON GLOBAL BOND CLASS A TPINX.LW Mid-Cap Growth AMERICAN CENTURY HERITAGE CLASS A ATHAX.LW Large Blend DREYFUS APPRECIATION FUND DGAGX Large Blend Index VANGUARD TOTAL STOCK MARKET INDEX VTSMX Large Value DREYFUS PREMIER STRATEGIC VALUE CLASS A DAGVX.LW Diversified Emerging Markets FIDELITY ADVISOR EMERGING MKTS CLASS A FAMKX.LW Mid-Cap Blend GABELLI ASSET FUND CLASS AAA GABAX Large Growth MFS AGGRESSIVE GWTH ALLOCATION CLASS A MAAGX.LW Foreign Large Growth MARSICO INTERNAT'L OPPORTUNITIES MIOFX Foreign Large Blend MFS RESEARCH INTL CLASS A MRSAX.LW Small Growth FIDELITY ADVISOR SMALL CAP CLASS A FSCDX.LW Small Blend KEELEY SMALL CAP VALUE FUND KSCVX.LW Small Blend Index VANGUARD SMALL CAP INDEX NAESX World Stock MUTUAL SERIES MUTUAL DISCOVERY CLASS A TEDIX.LW Moderate Allocation AMERICAN CENTURY STRAT ALLOC CLASS A ACVAX.LW World Allocation IVY ASSET STRATEGY CLASS A WASAX.LW Real Estate T ROWE PRICE REAL ESTATE FUND ADV CL PAREX 34

42 Website and Tools Members have access to estimator tools, educational materials, and account information through ACS BNY Mellon 24/7. 35

43 Account Fees Competitive fees in today s market... Description Fee Account set-up fee (one-time) $15.00 Monthly service charge Paid by member with account balance <$1000 Paid by employer regardless of account balance Transaction fees for debit card and checks $3.50 $2.25 None Monthly service charge for HSA investment account $2.90 Market-based interest rate Variable 36

44 Steps to Account Setup HSA employer account set-up process. Setup: Employer details provided via Employer Discovery Document. Employer code and web logon credentials assigned. Enrollment: Integrated enrollment from Capital BlueCross to ACS BNY Mellon. Capital BlueCross interface passes enrollment data to ACS BNY Mellon daily. Account Opening: Account Opening is accomplished by providing individual signature in acknowledgement of receipt and acceptance of account terms and conditions. It is accomplished electronically and/or through hard copy signature card. Employer Payroll Processing: Using one of the numerous supported methods, employer processes payroll (employee and/or employer contributions). Employer Reporting: Reporting suite verifies status of payroll, identifies errors and provides YTD summary and detail information. 37

45 Advantage Direct HSA Advantage Direct allows Capital BlueCross members who are enrolling in an HSA to open their account online without having to wait for a welcome kit. What s Next? A personalized HSA debit card will be mailed 5-10 days after The ACS BNY Mellon HSA Solution receives an enrollment file from Capital BlueCross and the data match is successful. (NOTE: for the protection of the account holder, a separate mailing containing the PIN will be mailed to activate the HSA debit card.) An abbreviated welcome kit will be mailed to the address received on the enrollment file including a personalized Master Signature Card. The account holder must complete and return the Master Signature Card found in the welcome kit to obtain an HSA checkbook or designate beneficiaries. Once ACS BNY Mellon HSA Solution processes the Master Signature Card, an HSA checkbook will be mailed. 38

46 Payroll on the Web (POW) Employers can easily make HSA contributions online. All funding received by 4 p.m. each business day, posts the same night. Checks may need one additional day to clear. 1. Employer sends employer and employee HSA contributions via lump sum ACH, wire, or check. 2. Employer provides accompanying funding instructions that can be done using POW. 3. POW accommodates groups with less than 150 HSA accounts (other options available for larger groups). 4. Deposits can be accepted at any time (typically follow payroll cycles). 39

47 Customer Service One phone call does it all... Members All medical or Rx questions on the QHDHP are directed to the Capital BlueCross customer service number on the back of the ID card. For Specific HSA questions, Capital BlueCross customer service will transfer members to ACS BNY Mellon or members can also call ACS BNY Mellon directly at ACS BNY Mellon Customer Service available Monday thru Friday 8:00 a.m. to 11:00 p.m. Groups/Agents Capital BlueCross Account Executive ACS BNY Mellon HSA Solution Employer Support Team Mailing dates of welcome kits, debit cards, and checkbooks Account activation status Training classes Password issues Funding verification Payroll reconciliation Phone:

48 Thank You 41