Page 7 - Apricity Benefits Guide
P. 7
2020
Apricity Benefits Overview
COMPARING MEDICAL PLAN OPTIONS
How They Are the Same
All three plans have many basic features in common:
Same network. All three plans provide access to the same network of providers and are
administered by Anthem.
Cost sharing. You have to meet a deductible before the plans begin to pay beneits. After you
meet the deductible, you pay a portion of eligible charges.
Protection. All of the plans have an annual out-of-pocket maximum that protects you in case
you and your family have unusually large health care expenses in a single year. If you meet
the out-of-pocket maximum, the plans will cover all eligible expenses at 100% for the rest of the
year.
Preventive care coverage. Most preventive care services are covered at 100% (in-network).
How They are Different
If you enroll in the HSA Plan:
You have no medical copays. The irst dollar will go toward your deductible and once your
deductible has been met the plan will pay 80% (in-network).
You will have to meet the family deductible. If you have anything other than Employee Only
coverage, then you must satisfy the family deductible before the plan will pay, with the
exception of preventive care.
You have access to a Health Savings Account (HSA). An HSA is a special tax-advantaged
account you can use to pay for eligible health care expenses. You have the ability to
contribute money to your HSA on a pre-tax basis through payroll deductions, up to IRS limits.
You can contribute to a Limited Purpose Flexible Spending Account (FSA). Since the HSA Plan
offers an HSA, the IRS allows limited use of FSA funds for eligible dental and vision expenses
only. As a result, you may only participate in the Limited Purpose FSA and not the traditional
Health Care FSA.
You are rewarded for smart health care decisions. When you make decisions that save
money, you get to keep those savings. Money left in your HSA account at the end of the year
rolls over into the next year, which lets you save for future health care expenses.
You pay lower premiums. The premiums per paycheck are lower so you can use that savings
to pay for your expenses.
Table of Contents Your Quick Guide to Savings and Group Auto and Home Insurance .33
About Your Beneits Program. . . . . . .2 Spending Accounts .............16 Group Legal Services ............33
Beneits Basics ...................3 Dental Beneits .................18 Employee Assistance Program ....34
Medical/Prescription Drugs Beneits . 6 Dental Plan Summary ............20 Medicare Part D Creditable
Comparing Medical Plan Options ..7 Vision Beneits ..................21 Coverage Notice ...............35
First Stop Health ................11 Voluntary Disability Insurance .....22 Premium Assistance Under Medicaid
Medical Plan Summary ..........12 Life and AD&D Insurance ........25 and the Children’s Health Insurance
Program (CHIP) .................42
Pharmacy Plan Summary .........13 Voluntary Accident Insurance ....29 Contact Information .............46 7
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
Apricity Benefits Overview
COMPARING MEDICAL PLAN OPTIONS
How They Are the Same
All three plans have many basic features in common:
Same network. All three plans provide access to the same network of providers and are
administered by Anthem.
Cost sharing. You have to meet a deductible before the plans begin to pay beneits. After you
meet the deductible, you pay a portion of eligible charges.
Protection. All of the plans have an annual out-of-pocket maximum that protects you in case
you and your family have unusually large health care expenses in a single year. If you meet
the out-of-pocket maximum, the plans will cover all eligible expenses at 100% for the rest of the
year.
Preventive care coverage. Most preventive care services are covered at 100% (in-network).
How They are Different
If you enroll in the HSA Plan:
You have no medical copays. The irst dollar will go toward your deductible and once your
deductible has been met the plan will pay 80% (in-network).
You will have to meet the family deductible. If you have anything other than Employee Only
coverage, then you must satisfy the family deductible before the plan will pay, with the
exception of preventive care.
You have access to a Health Savings Account (HSA). An HSA is a special tax-advantaged
account you can use to pay for eligible health care expenses. You have the ability to
contribute money to your HSA on a pre-tax basis through payroll deductions, up to IRS limits.
You can contribute to a Limited Purpose Flexible Spending Account (FSA). Since the HSA Plan
offers an HSA, the IRS allows limited use of FSA funds for eligible dental and vision expenses
only. As a result, you may only participate in the Limited Purpose FSA and not the traditional
Health Care FSA.
You are rewarded for smart health care decisions. When you make decisions that save
money, you get to keep those savings. Money left in your HSA account at the end of the year
rolls over into the next year, which lets you save for future health care expenses.
You pay lower premiums. The premiums per paycheck are lower so you can use that savings
to pay for your expenses.
Table of Contents Your Quick Guide to Savings and Group Auto and Home Insurance .33
About Your Beneits Program. . . . . . .2 Spending Accounts .............16 Group Legal Services ............33
Beneits Basics ...................3 Dental Beneits .................18 Employee Assistance Program ....34
Medical/Prescription Drugs Beneits . 6 Dental Plan Summary ............20 Medicare Part D Creditable
Comparing Medical Plan Options ..7 Vision Beneits ..................21 Coverage Notice ...............35
First Stop Health ................11 Voluntary Disability Insurance .....22 Premium Assistance Under Medicaid
Medical Plan Summary ..........12 Life and AD&D Insurance ........25 and the Children’s Health Insurance
Program (CHIP) .................42
Pharmacy Plan Summary .........13 Voluntary Accident Insurance ....29 Contact Information .............46 7
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
