YOUR CIGNA CHOICE FUND HEALTH SAVINGS ACCOUNT

Transcription

1 YOUR CIGNA CHOICE FUND HEALTH SAVINGS ACCOUNT Your health plan plus a health savings account JM Huber 2016 Offered by Cigna Health and Life Insurance Company or Connecticut General Life Insurance Company /15

2 We ve got your back. so you can achieve what matters most.. That s why we offer coverage tools resources that will work for you. Together, we can all live healthier lives. 2

3 Health savings plan and you Qualified high deductible medical plan Health + Savings = Account Taxadvantaged HSA plan A tax-advantaged Health Savings Account provides coverage for current health care expenses with the option to save for future health care expenses Combines a qualified high-deductible medical plan (medical/pharmacy coverage) with a Health Savings Account You, your employer, or both, can contribute to the Health Savings Account which is owned by you Money put in the Health Savings Account is generally not taxable* You have investment options with the Health Savings Account * HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state. 3

4 HSA UNDERSTANDING THE COMPONENTS $3,400 Out-of-Pocket $1,500 Ded Coinsurance 80% In Network Your Share $1,000* HSA provided by Employer $ % Preventive Care $6,8000 Out-of-Pocket $3,000 Ded Coinsurance 80% In Network Your Share $2,000* HSA provided by Employer $1, % Preventive Care EMPLOYEE ONLY FAMILY OF 2 OR MORE The out-of-pocket is off-set by the Huber funding in the HSA. * With no additional contribution from employee Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel Cigna 4

5 Are you eligible to participate? Because HSA plans have certain tax advantages, the IRS defines specific rules for participation. To be eligible, you: Must be enrolled in an IRS-qualified high-deductible medical plan (high-deductible medical plans offered with Cigna Choice Fund HSA meet IRS requirements) Cannot have any other health coverage which is not also a qualified high-deductible plan: Not covered by spouse s medical or pharmacy plan (unless it meets the IRS definition of a qualified high-deductible plan) Not covered through Medicare Part A or Part B or TRICARE 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 5

6 WHAT IS THE Cigna CHOICE FUND HSA? Qualified Medical Plan Employer HSA contribution + = Your HSA contribution HSA Tax-Advantaged Plan A health plan that provides coverage for qualified medical/pharmacy expenses and allows you the option to save HSA dollars on a tax advantaged basis. Your employer contributes and you can too! The total 2016 annual contribution limit for employee + employer is: - $3,350 Single Coverage - $6,750 Family Coverage Employee and employer money deposited into the HSA is generally not taxable 6

7 HOW ARE CONTRIBUTIONS MADE TO THE CHOICE FUND HSA? Employer Payroll withholding of Employee HSA contributions Employer Contributions to Employee HSA accounts Accountholder Account Holders Post-Tax Deposits or Transfers to the HSA Account Unscheduled Deposits to the HSA Account Transfers from other HSA Accounts Transfers from other HSA Accounts 7

8 TRIPLE TAX ADVANTAGES OF AN HSA Contributions Payroll deduction contributions are pre-tax* After-tax contributions can be deducted when you file your tax return HSA Account Growth Interest earned on your cash account is generally not taxable* Investment earnings on mutual funds are generally not taxable* Withdrawals to pay qualified health care expenses are tax-free Withdrawals Withdrawals for ineligible expenses are taxed and you pay a 20% penalty At age 65, withdraw funds for any reason with no penalty (taxes do apply) * HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings: Alabama, California, New Hampshire, New Jersey and Tennessee. 8

9 Your HSA maximum contribution The IRS has set the following limits for 2015/2016: Under age 55 and not enrolled in Medicare (based on a 12-month period): Up to $3,350 individual coverage* Up to $6,750 family coverage* Age 55 or older: Maximum contribution increases by $1,000 (considered a catch-up contribution) Up to $4,350 individual coverage* Up to $7,750 family coverage* 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. NOTE: These amounts are the maximum prior to the Huber contribution of $500 for single coverage and $1,000 for family coverage 9

10 WHAT ARE QUALIFIED MEDICAL EXPENSES? Qualified medical expenses are determined by the IRS Examples of qualified medical expenses* Examples of nonqualified medical expenses Deductibles and out-of-pocket costs for medical and dental care Prescriptions Vision care, including glasses and LASIK eye surgery Smoking cessation treatment and prescriptions Family planning procedures Chiropractic services Some insurance premiums, such as long-term care, COBRA and health care coverage premiums while receiving unemployment compensation Air purifiers Cosmetic surgery and related expenses Health club dues (unless prescribed by physician to treat illness) Illegal operations and treatments Massages for general well-being Premiums for health care coverage Transportation (unless specifically for and essential to medical care) Toothpaste, cosmetics and toiletries Vitamins and nutritional supplements Weight loss programs (unless for a specific illness) * This is not a complete list. For a detailed list, visit Cigna.com/expenses or the IRS website at and see Publications 502 and 969 for additional information. 10

11 PAYING FOR EXPENSES WITH THE HSA You can use HSA money only for expenses incurred after the account is established Use your Cigna HSA debit card, checks (if ordered) or online capabilities to access your HSA dollars You can only pay expenses from your HSA based on the balance in the account (similar to a checking account). If you don t have sufficient funds in your account to cover a payment, you may pay with after-tax money and later reimburse yourself with HSA money when additional HSA deposits have been made. Use of HSA funds for nonqualified medical expenses is subject to income tax and a 20% penalty. You must keep your own medical expense receipts for documentation, in the event you are audited. Any funds used for nonqualified expenses must be filed on your tax return. 11

12 USING HSA FUNDS Dependents to age 26 Dependents to age 26 may be enrolled in your medical plan. HSA funds may only be used for expenses of that dependent if the dependent is claimed on the employee s tax return. Domestic Partners HSA funds may not be used for Domestic Partner expenses. The IRS requires that HSA funds be used only for federally qualified tax dependents. Use the HSA for medical, prescription drugs, dental, vision and certain premium expenses Expenses for anyone you claim as a Federal tax dependent (other than Domestic Partners see above) Eligible Expenses Your HSA cannot pay for expenses of children to age 26 who are not claimed as a dependent (see above) You are responsible for making sure your expenses are eligible according to IRS Publication 502 If you use money from your HSA for ineligible expenses, you will pay taxes plus a 20% penalty (prior to age 65) 12

13 MORE ABOUT THE HSA AND HDHP What if I contribute more than I am allowed? Excess contributions are subject to income taxes and an additional penalty tax. You may withdraw any excess contributions within the tax year to avoid penalties. Can I rollover money from other accounts? Rollover contributions from medical savings accounts and other HSAs are allowed and do not count toward yearly maximum contributions. What if I change health plans? If you re no longer covered by the plan, you can still use HSA funds to pay for qualified medical expenses. You cannot contribute additional money to the HSA until you are enrolled in another qualified high-deductible health plan. 13

14 INVESTMENTS Planning for the future Comprehensive Investment Offering 36 mutual funds to choose from Minimum to invest: $2,000 No minimum deposit for any fund Once the investment account is open, no minimum balance applies No Monthly Fee Automatic Reinvestment features Investments can be allocated into one fund or multiple funds on a scheduled or unscheduled basis Convenient Online Experience & Reporting 14

15 HOW ARE MEDICAL CLAIMS PAID? Sick visit to an in-network doctor/hospital. Show your Cigna Choice Fund ID card. ID Card Health Care Professional files claim with Cigna directly. Cigna receives the claim and processes it based on the plan deductible, covered expenses and Cignanegotiated discounts. EOB Cigna provides an Explanation of Benefits or EOB ( receipt ) showing: Doctor s charge, Cigna discount, amount billed, (amount deducted from the HSA if elected), amount paid to doctor/facility and remaining HSA balance (if medical automatically claim forwarding elected). 15

16 meet Karen Single, in her 50s Heart disease; controlling health through medication Looking to save money for future health expenses TOTAL EXPENSES IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100% Preventive care $ ER visit PCP visits Generic Rx Brand Rx TOTAL 3, % covered Karen s deductible HSA EMPLOYER $500 + KAREN $2,550 PLAN 80% + KAREN 20% PLAN 100% 80% plan % Karen BALANCE DUE 0.00 $3, Deductible: % Karen: $1, % plan: $1, % Karen: $1, HSA BALANCE This is an example used for illustrative purposes only. 16

17 meet the Coopers Active family of six Daughter has diabetes Looking to save money for future health expenses TOTAL EXPENSES IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100% Preventive care $1, Spec Visits $4, PCP visits $ Generic Rx $ Brand Rx $ TOTAL $8, % covered $1, Coopers deductible $3, % plan $3, % Coopers $ BALANCE DUE $0.00 HSA EMPLOYER $1,000 + COOPERS $4,500 $5, Deductible: $3, % Coopers: $ $1, PLAN 80% + COOPERS 20% 80% plan: $3, % Coopers: $ $4, PLAN 100% HSA BALANCE This is an example used for illustrative purposes only. 17

18 Help, when and where you need it Find a doctor, hospital or other health facility whenever you need one, online, by phone or on the go with the mycigna Mobile App* Access to emergency care 24 hours a day, inside or out of the network Talk with a health advocate who can help you make decisions about your treatment Avoid the emergency room for minor injuries your plan s network includes urgent care facilities and retail clinics Keep your doctor during transitions (for example, if you re new to Cigna or your doctor leaves our network) when you are in the middle of treatment for certain health conditions (subject to prior approval) *The downloading and use of the mycigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply. 18

19 Planning for your medical expenses Core Cigna Choice Fund with HSA Single Employee +1 Family Single Employee +1 Family Payroll deduction $102 * Qualifier Monthly Rates $220 * Qualifier Monthly Rates $338 * Qualifier Monthly Rates $70* Qualifier Monthly Rates $156 * Qualifier Monthly Rates $242 * Qualifier Monthly Rates Deductible $300 In-network $750 Out-of-network $600 In-network $1,500 Out-of-network $900 In-network $2,250 Out-of-network $1,500 In-network $3,000 Out-of-network $3,000 In-network $6,000 Out-of-network $3,000 In-network $6,000 Out-of-network Out-of-pocket maximum $2,500 In-network $5,000 Out-of-network $5,000 In-network $10,000 Out-of-network $5,000 In-network $10,000 Out-of-network $3,400 In-network $6,800 Out-of-network $6,800 In-network $13,600 Out-of-network $6,800 In-network $13,600 Out-of-network HSA contribution from employer [n/a] [n/a] [n/a] $500 $1,000 $1,000 Coinsurance 80% In-network/ 60% Out-ofnetwork 80% In-network/ 60% Out-ofnetwork 80% In-network/ 60% Out-ofnetwork 80% In-network/ 60% Out-ofnetwork 80% In-network/ 60% Out-ofnetwork 80% In-network/ 60% Out-ofnetwork Lifetime maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited *If you choose to receive care outside of your plan s network, only covered expenses will be applied to your deductible subject to your plan s Maximum Reimbursable Charge provisions. See your enrollment materials for more information about costs and details about covered and non-covered services, including plan exclusions and limitations. 19

20 Planning for your prescription expenses Cigna Choice Fund with HSA In-network Retail (30-day supply) Home delivery (90-day supply) Generic You pay 20% You pay 20% Preferred brand You pay 20% You pay 20% Non-preferred brand You pay 20% You pay 20% Self-injectable medications You pay 20% You pay 20% Out-of-network Retail not covered Home delivery not covered This chart shows the amounts you ll pay for covered services after your plan deductible has been met. NOTE: Certain preventative medications will be covered at 100% in-network and there are other preventative medications that bypass the deductible, coinsurance will still apply. 20

21 Help, to keep you healthy Online coaching programs help you maintain a healthy lifestyle 100% coverage for in-network wellness checkups, immunizations and preventive screenings* Use Cigna Healthy Rewards ** to save money on health and wellness products and services like fitness clubs, alternative medicine, vision and hearing care, and more A personal health advocate can help you prepare for office visits, improve your lifestyle and reduce your health risks, explore and choose treatment options, and answer questions about health and coverage Healthy pregnancy education programs with the March of Dimes helps every baby get a healthy start Programs to help you better manage stress, quit tobacco or lose weight Earn gift cards and merchandise for taking steps to stay healthy * Some preventive services may not be covered under your plan. For example, immunizations for travel are generally not covered. Other non-covered preventive services/supplies may include any service or device that is not medically necessary or services/supplies that are unproven (experimental or investigational). See your enrollment materials for details. **Healthy Rewards is a discount program and is separate from your medical benefits. If your plan includes coverage for any of the services offered through Healthy Rewards, this program is in addition to, not instead of, your plan benefits. Some Healthy Rewards programs are not available in all states and may be discontinued at any time. A discount program is NOT insurance, and you must pay the entire discounted charge. 21

22 Make mycigna your personal health place Once registered on mycigna.com you can log in anytime, anywhere to: View ID card information and print temporary cards Check your coverage and explanation of benefits Manage and track claims Sign up for online coaching programs Keep track of your health history and records with an online personal health record Find in-network doctors, specialists, hospitals and labs Learn about common health problems and treatment options Find cost and quality ratings for doctors and hospitals Talk with a health specialist when you can t reach your doctor day or night No claim forms needed in-network Download the mycigna Mobile App* for easy access on the go! *The downloading and use of the mycigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply. 22

23 Enrolling. How we can help you.. Call Cigna Pre-Enrollment Line at to ask questions prior to the effective date of the plan. Available 24 hours a day/7 days a week Visit mycignaplans.com to review benefit details and choose the best plan for you. User ID: Jmhuber2016 Password: cigna (lower case) Call Express Scripts (ESI) at to ask questions regarding the prescription drug coverage under the H.S.A. Open enrollment November 2 nd -13 th 23

24 Enrolling. How we can help you. Plan and cost comparison tool on mycignaplans.com Compare potential out-of-pocket costs of various Cigna health plans offered. Supports your decisions and helps you learn about the plan. 24

25 Enrollment checklist. This is one of the most important decisions you ll make this year. This checklist will help you choose wisely: Think about your health history and health care needs. How much do you spend, on average, for health care? How might that change in the upcoming year? Check the online directory on Cigna.com to see if your doctor participates in the plan s network. Review your Summary of Benefits for specific plan details. Look to see if you can save money by earning incentives for taking certain actions to improve your health. Take a health assessment on mycignaplans.com. 25

26 Rates will vary by plan design including the amount of plan deductibles, coinsurance, and out-of-pocket and lifetime maximums. All health insurance policies and health benefit plans have exclusions and limitations. For costs and details of coverage, see your enrollment materials. The information in this presentation summarizes the highlights of your plan. For a complete list of both covered and not covered services, including benefits required by your state, see your employer s group insurance certificate, summary plan description or group service agreement the official plan documents. If there are any differences between the information in this presentation and the plan documents, the information in the plan documents takes precedence. Health care professionals who participate in Cigna s network are independent contractors solely responsible for the treatment provided and are not agents of Cigna. The HSA provider and/or trustee/custodian is responsible for all HSA services, transactions and related activities. Cigna and your employer are not responsible for any aspects of the HSA services, administration or operation. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company (CHLIC), Connecticut General Life Insurance Company (CGLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite Health, LLC, Cigna Behavioral Health, Inc., and Cigna Health Management, Inc. 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 and Open Access Plus IN plans are considered Exclusive Provider plans with certain managed care features. OK Policy Forms: HP-APP-1 et al (CHLIC); GM6000 C1 et al (CGLIC). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All models are used for illustrative purposes only / Cigna. Some content provided under license.