Page 14 - Franklin Madison 2021 Benefits Guide
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Health Savings Account


If you enroll in the Aetna Consumer Choice Plan, a Health Savings Account (HSA) through PayFlex will
be established at the time of enrollment. Franklin Madison will contribute $400 for individual coverage
or $1,000 for family coverage. If you complete a preventive health exam in 2021, Franklin Madison will
contribute an additional wellness incentive in the amount of $200.


The HSA is a bank account that you own and may HSA Contributions
take with you regardless of where you work. It You do not need to make HSA contributions yourself
enables you to set aside tax-free money to: to receive the Franklin Madison contribution. You

y Pay for your medical expenses incurred before may, however, choose to make pre-tax contributions
you meet your annual Plan deductible; to your HSA. The amount you are allowed

y Cover ongoing out-of-pocket costs for qualiied to contribute is governed by federal law. For
medical, prescription, dental and vision employees who elect individual coverage in 2021,
expenses; or the limit is $3,600; for family coverage, the limit is
$7,200. If you are age 55 or older, you may make
y Build savings to cover future medical expenses additional pre-tax catch-up contributions of up to
or even retirement. $1,000 a year. Contribution limits are generally

When you have an eligible health expense, you may indexed each year for inlation.
access your funds using your HSA debit card or
online banking and bill payment. You can start, stop or change the amount of your
HSA contributions prospectively anytime during the

Plan Eligibility year. If you are married and your spouse is also
enrolled in a separate high-deductible health plan
You must enroll in the Consumer Choice Plan to (like the Consumer Choice Plan), your combined
be eligible to participate in the HSA. In addition, in HSA contributions cannot exceed the federal
order to be eligible to participate in an HSA, you maximum for HSA contributions noted above.
must not:
Health Savings Account
y Be claimed as a dependent on someone else’s Franklin Madison
Up to $600 individual coverage
tax return; Contribution & Up to $1,200 for all other coverage
y Have other health plan coverage that provides Preventive Exam levels
Incentive
beneits covered under the Consumer Choice $3,600 (employee only coverage) or
Plan (for example, a Healthcare Flexible $7,200 (all other coverage levels), less
Spending Account, a separate prescription drug Contribution Limit any Franklin Madison contributions.
Employees age 55 or older may
per year
plan, or a spouse’s medical plan that covers contribute up to an additional $1,000
you); per year.

y Have a spouse with a Healthcare Flexible Eligible Expenses Out-of-pocket medical, prescription,
dental and vision costs.
Spending Account that could reimburse your
medical expenses; nor

y Be enrolled in a government health plan, such
as Medicare or Medicaid.

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