HEALTH SAVINGS ACCOUNT (HSA)

Transcription

1 HEALTH SAVINGS ACCOUNT (HSA)

2 Plan Details Carrier: Healthcare Bank Local Phone: (866) Toll Free Phone: (866) Website: Policy or Anniversary Date: January 01 Employee Eligibility: Waiting Period for Enrollment: (Time employee must wait before being eligible to enroll) Initial Enrollment Period: (Time frame after the waiting period during which employee must enroll) Coverage Termination Date upon loss of Eligibility: Percent of Unused Balance that rolls over into the next plan year: Plan Year Employee HSA Contribution Maximum: If you qualify for and elect the HSA Group Value Network Health Insurance through The Archdiocese of Saint Paul and Minneapolis and are not also enrolled in another health plan that would disqualify an HSA contribution, you are eligible for the HSA. Once you qualify for and elect Health Insurance through The Archdiocese of Saint Paul and Minneapolis and are NOT also enrolled in another health plan that would disqualify an HSA contribution, participation can begin 30 days Contributions will cease the date you lose eligibility. You will continue to have access to any remaining funds in your HSA account. 100% The maximum that can be contributed to your account by any party is: $ 3,400 for single election for 2017 $ 6,750 for family election for 2017 If you are 55 or older you are eligible to make an additional catch-up contribution up to $1,000 Catch-Up Contributions (age 55 and older): The catch-up contribution is only available for the HSA owner. If a husband and wife both want to take advantage of the catch-up contribution, each would need to establish their own HSA.

3 Commonly Asked Questions Continued What is an HSA? Health Savings Accounts (HSAs) combine a high deductible health insurance plan (HDHP) with a tax-exempt trust or custodial account to pay for qualified medical expenses. The HSA is an individual health account that is owned by the employee and may be used for the payment of medical expenses that are not covered by their HDHP. Individuals or employers may contribute on a pretax basis. Funds used for qualifying healthcare expenses are tax-free to the account holder. An HSA is similar to an individual retirement arrangement (IRA) in that the participant owns it and directs the investments. Balances in the HSA continue to accumulate in the account. Employers and employees can make pre-tax contributions to an HSA via payroll deduction or by direct deposit into the account via check or electronic funds transfer. The HSA must be combined with an HDHP, which covers serious illness or injury, while the HSA can pay for medical expenses until the deductibles are met. Which health plans disqualify me from participating in an HSA? If you participate in a health plan that is not a high deductible health plan including a Health Flexible Spending Account that is not limited scope, you cannot participate in an HSA. What are the steps for employee participation in the plan? 1. If you elect to make a contribution to the HSA, pre-tax payroll deductions will be taken from your paycheck evenly divided by the number of payrolls remaining in the plan year and applied to your HSA account. 2. Your employer will begin to make contributions to your HSA account. 3. You incur an expense. 4. You request distribution from your HSA. 5. You may also use your HSA Benny card to pay for your medical expenses directly from your HSA. What is the Benny debit card? Your Benny Debit Card will definitely improve your cash flow. The Card eliminates the need for you to pay cash for eligible services by accessing funds from your account elections at the point of service. However, be aware that the IRS requires the Card be used only for eligible expenses. What expenses are eligible? Medical expenses as defined by Section 213(d) of the Internal Revenue Code. When must an expense be incurred in order to be eligible? Expenses must be incurred on or after the date you join the plan. How do I make withdrawals or take distributions from my HSA account? Simply swipe your Card each time you incur a qualified health care expense and the amount of your purchase will be deducted from your HSA automatically. You can also fill in your Card number on bills you receive from providers to pay the amount you owe. You ll have no claim forms to complete and you won t have to wait to get a check in the mail. You can check balances or account details anytime online or with a quick phone call. It s that easy! You can make tax-free withdrawals (also know as distributions) from your HSA to pay for qualified medical expenses at any time during the year. However, you do not have to make withdrawals for your HSA each year. Your contributions remain in your HSA from year to year until you use them. If you make withdrawals for non-qualified medical expenses or for other reasons, the amount withdrawn will be subject to income tax and may be subject to an excise tax as well. Please keep in mind you are required to track all of your withdrawals from your HSA so you can supply documentation for your expenditures, if/when needed. It is up to you to monitor the deposits and withdrawals made to your HSA. 1. Go to 2. Enter your login ID and password. For your 1 st time login see below: Login ID: SSN without dashes Password: changeme 3. Click Login. 4. To request distribution from your HSA, you may select the link in the I want to section, Make HSA Distribution. 5. Complete the fields and click Submit. You can also use your HSA debit card to pay for your medical expenses directly from your HSA. This summary is only an outline of general information. It is not a contract for coverage. Please refer to your summary plan description or certificate for detailed information.

4 Commonly Asked Questions Continued What is an itemized receipt? An itemized receipt must include: merchant or provider name, services received or item purchased, date of service, and amount of the expense. Cancelled checks, handwritten receipts, card transaction receipts or previous balance receipts cannot be used to verify an expense. We suggest that you keep their itemized receipts in one place (perhaps using the Save the Receipt envelopes provided) so they re readily available if/when you need to produce them during an IRS audit. What happens to money I do not use by the end of the plan year? If you do not have claims that equal or exceed the balance of your HSA account at the end of the plan year, the remaining funds will roll forward into the next plan year. How do I check my HSA balance? Go to: 1. Enter your login ID and password (both provided by CHS). Login ID: SSN without dashes Password: changeme 2. Click Login. The Home Page is easy to navigate: The top section shows messages from your employer and links to employee information. To assist in getting you to the most common tasks, the I Want To section contains the most frequently used options within the consumer portal. On the far right, Available Balance links to the Account Summary page, where you can see and manage your account. The Message Center section displays alerts and relevant links that enable you to keep current on your account. The Quick View section graphically displays some of your key account information. How do I report distribution on my tax return? How you report your distributions depends on whether or not you used the distribution for qualified medical expenses. When you use a distribution from your HSA for qualified medical expenses, you do not pay tax on the distribution but you have to report the distribution on IRS Form Follow the instructions for the form and attach it to your IRS Form When you do not use a distribution from your HSA for qualified medical expenses, you must pay tax on the distribution and report the amount on IRS Form Follow the instruction for the form and attach it to your IRS Form You must also report and pay an additional tax on your IRS Form 1040, unless you meet one of the exceptions established by the IRS. You will need to contact the IRS or your accountant for more information on the exceptions. Reporting and paying the additional tax: There is a 10 percent additional tax on the part of your distribution that was not used for a qualified medical expense. The account owner is required to report the additional tax in the Other Taxes section of your IRS Form1040. Exceptions to the additional tax: There is no additional tax if you are disabled, age 65 or older or die during the year. Are health insurance premiums qualified medical expenses? In most cases, health insurance premiums are not qualified medical expenses. However, the following are exceptions: Premiums for qualified long-term care insurance Premiums for COBRA health care continuation coverage Premiums for health coverage while an individual is receiving unemployment compensation For individuals over age 65, premiums for Medicare Part A or B, a Medicare HMO and the employee share of premiums for employer-sponsored health insurance, including premiums for employer-sponsored retiree health insurance. Premiums for Medigap policies are not qualified medical expenses This summary is only an outline of general information. It is not a contract for coverage. Please refer to your summary plan description or certificate for detailed information.

5 Eligible Health HSA Expenses Medical expenses covered under the HSA can include expenses that are not covered under the high deductible health plan such as chiropractic, dental, orthodontia or vision expenses. HEALTH HSA EXPENSES ALLOWED: Dental and Orthodontic Care: Hearing Expenses: Artificial teeth or dentures Hearing aids and batteries Braces, orthodontic devices Telephone equipment to assist hard Dental x-rays of hearing Oral surgery Therapy and Treatments: X-ray treatments Speech therapy Alcoholism treatment Drug therapy treatment Acupuncture Physical therapy treatment Vaccinations Hair transplant (if medically necessary) Electrolysis (if medically necessary) The cost of weight loss program (only to treat obesity as prescribed by a physician) Fees and services: Ambulance Physicians fees Hospital service fees Service of chiropractors Services connected with donating an organ Eye Care: Eyeglasses Contact lenses Contact Solution Lasik surgery Medical Expenses: Wheelchair or autoette (cost of operating/maintaining) Excess cost of orthopedic shoes over cost of ordinary shoes Crutches (purchased or rented) Excess cost of special mattress prescribed to alleviate arthritis Prescribed oxygen equipment and oxygen used to relieve breathing problems Support hose (if medically necessary) Artificial limbs Insurance Premiums: Health insurance (including individual and non-employer sponsored coverage and including continuation premiums) Long Term Care Insurance Co-payments (not premiums): Health insurance out-of-pocket Dental insurance out-of-pocket Prescription medication co-payments Assistance for individuals with disabilities: Cost of guide for visually impaired Special devices, such as tape recorder and typewriter, for the visually impaired Costs of equipping automobile Cost of Braille books and of regular editions Seeing Eye Dog Psychiatric Care: Services of psychotherapists, psychiatrists and psychologists Physical Exams Prescription & Over-the-counter medications: Prescription co-payments Over-the-counter medications used to treat a medical condition (with doctor s prescription) HEALTH HSA EXPENSES NOT ALLOWED: Illegal medication Mechanical exercise devices not prescribed Vacuum cleaner purchased by individual dust allergy Expenses of divorce when doctor or psychiatrist recommends divorce Athletic Club memberships Boarding school fees Diaper service Domestic help Funeral, cremation or burial expenses Contributions to state disability funds Maternity clothes Insurance against loss of income, life, limb or eyesight Distilled water purchased to avoid drinking fluoridated city water supply Mobile telephone used for personal calls as well as calls to a physician Swimming pool Treatments unrelated to a specific problem (for example, massage for general well-being) Marriage counseling Nursemaids or practical nurses in charge of healthy infants Cosmetic surgery and procedures Over -the-counter supplements/vitamins or other substance related to general good health THE IRS WILL CHANGE THIS LIST FROM TIME TO TIME. FOR A COMPLETE AND CURRENT LISTING OF HEALTH EXPENSES SEE IRS PUBLICATION 502.

6 Eligible Over-the-Counter Medications OVER-THE-COUNTER EXPENSES ALLOWED: Band-Aids, bandages, gauze Catheters Cold pack Contact lens supplies & solution Denture adhesives Diagnostic test & monitors Elastic bandages & wraps First aid kits Hot pack Incontinence supplies Insulin & diabetic supplies Ostomy supplies Pedialyte for dehydration Reading glasses Rubbing alcohol Wheelchairs, walkers & canes OVER-THE-COUNTER EXPENSES ALLOWED ONLY WITH A DOCTOR S PRESCRIPTION: Acne treatments Allergy & sinus medicine Antacids Antibiotic products Anti diarrhea medicine Anti-gas Anti-itch & insect bite Anti-parasitic treatments Aspirin Baby rash ointments & creams Bactine Bee sting kits Bug bite ointments Calamine lotion Carmex/Blistex/Medicated lip balms Cold medicine Cough drops, lozenges Diaper rash ointments Digestive aids Feminine anti-fungal / anti-itch First aid cream Hemorrhodial preps Lactaid for lactose intolerance Laxatives Menstrual cycle products for pain Motion sickness pills Muscle pain creams Nasal strips medicated/vapor only Nicotine gum and patches Pain reliever Respiratory treatments Sinus sprays Sleeping aids & sedatives Sunburn ointment Suppositories Visine Wart remover OVER-THE-COUNTER EXPENSES ALLOWED ONLY WITH A DOCTORS NOTE: These items would not normally be eligible for reimbursement under your HSA plan, but, could be if used to treat a specific medical condition. The IRS requires a letter from your attending physician stating your medical condition and also stating that the following item is being prescribed for treatment of that condition. Acne treatments Feminine hygiene products St. John s Wart for depression Weight loss medication Fiber supplements for constipation Glucosamine / Chondroitin for arthritis Hormone therapy for menopause Lactaid for lactose intolerance Orthopedic shoes Sunscreen for cancer Prenatal vitamins OVER-THE-COUNTER EXPENSES NOT ALLOWED: Chapstick Face creams and moisturizers Vitamins* Cosmetics Food, food replacement Toiletries Dietary supplements Medicated shampoos and soaps Toothbrush / toothpaste * Vitamins would not normally be eligible for reimbursement under your HSA plan, but, could be if used to treat a specific medical condition. The IRS requires a letter from your attending physician stating your medical condition and also stating that the vitamin is being prescribed for treatment of that condition. THE IRS WILL CHANGE THIS LIST FROM TIME TO TIME. FOR A COMPLETE AND CURRENT LISTING OF HEALTH EXPENSES SEE IRS PUBLICATION 502