Page 7 - Aegion Value Plan SPDs
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After this amount has been met, You will receive coverage for Covered Services for the remainder of the
Plan year as specified elsewhere in this Benefit Booklet. The Traditional Health Coverage is governed by
the details contained elsewhere in this document.
NOTE: Words and phrases within this document that are denoted with initial capitalization have the
meaning ascribed to them within the document itself, or within the Definitions section.
The company reserves the right to amend or terminate the Plan at any time. You will be notified of
any changes that affect Your benefits, as required by Federal law.
Financial Tools
Each Plan offers online financial tools to help You keep track of Your health care dollars. Plus You can
track Your claims for covered services. You can review what you’ve spent on health care, view Your
balance, or look up the status of a particular claim any time of the day.
To receive maximum benefits at the lowest Out-of-Pocket expense, Covered Services must be
provided by a Network Provider. Benefits for Covered Services are based on the Maximum Allowed
Amount, which is the maximum amount the Plan will pay for a given service. When You use an Out-of-
Network Provider, You are responsible for any balance due between the Out-of-Network Provider’s charge
and the Maximum Allowed Amount in addition to any Coinsurance, Deductibles, and non-covered charges.
Coinsurance/Maximums are calculated based upon the Maximum Allowed Amount, not the Provider’s
charge.
Contributions to Your HSA
For 2019, contributions can be made to Your HSA up to the following:
Contributions to Your HSA
Individual Coverage $3,500
Family Coverage $7,000
NOTE: These limits apply to all combined contributions from any source, except rollover funds.
Your Employer will contribute to Your account up to these annual amounts:
Contributions to Your HSA
Employee / Individual Coverage $500
Employee + 1 Coverage $750
Family Coverage $1,000
Additional Protection:
For Your protection, the total amount You spend Out-of-Pocket is limited. Once You spend that amount,
the Plan pays 100% of the cost for Covered Services for the remainder of the Calendar Year.
7
Plan year as specified elsewhere in this Benefit Booklet. The Traditional Health Coverage is governed by
the details contained elsewhere in this document.
NOTE: Words and phrases within this document that are denoted with initial capitalization have the
meaning ascribed to them within the document itself, or within the Definitions section.
The company reserves the right to amend or terminate the Plan at any time. You will be notified of
any changes that affect Your benefits, as required by Federal law.
Financial Tools
Each Plan offers online financial tools to help You keep track of Your health care dollars. Plus You can
track Your claims for covered services. You can review what you’ve spent on health care, view Your
balance, or look up the status of a particular claim any time of the day.
To receive maximum benefits at the lowest Out-of-Pocket expense, Covered Services must be
provided by a Network Provider. Benefits for Covered Services are based on the Maximum Allowed
Amount, which is the maximum amount the Plan will pay for a given service. When You use an Out-of-
Network Provider, You are responsible for any balance due between the Out-of-Network Provider’s charge
and the Maximum Allowed Amount in addition to any Coinsurance, Deductibles, and non-covered charges.
Coinsurance/Maximums are calculated based upon the Maximum Allowed Amount, not the Provider’s
charge.
Contributions to Your HSA
For 2019, contributions can be made to Your HSA up to the following:
Contributions to Your HSA
Individual Coverage $3,500
Family Coverage $7,000
NOTE: These limits apply to all combined contributions from any source, except rollover funds.
Your Employer will contribute to Your account up to these annual amounts:
Contributions to Your HSA
Employee / Individual Coverage $500
Employee + 1 Coverage $750
Family Coverage $1,000
Additional Protection:
For Your protection, the total amount You spend Out-of-Pocket is limited. Once You spend that amount,
the Plan pays 100% of the cost for Covered Services for the remainder of the Calendar Year.
7
