Page 5 - Union COBRA Guide
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5
Glossary
Premium: The amount you contribute
UHC Account-based Plans each month from your paycheck for
insurance coverage.
Let’s take a look at the key features of each plan. Deductible: A set dollar amount
you have to pay for your healthcare
Health Reimbursement
Arrangement Health Savings Account expenses before the company starts
to share costs with you. Deductibles
Out-of-
Out-of-
In-Network Network In-Network Network vary by plan and by coverage levels.
Calendar Year Deductible Coinsurance: Once you’ve satisied
Individual $1,750 $3,500 $3,000 $6,000 the deductible, this is a set percentage
Family $3,500 $7,000 $6,000 $12,000 of the remaining costs which are your
Coinsurance 80% 60% 80% 60%
Out-of-Pocket responsibility, until you reach your out-
Maximum Includes Deductible Includes Deductible of-pocket max.
Preventive care 100% Not available 100% Not available Copay: A set dollar amount you pay
Individual $2,800 $5,600 $6,000 $12,000 for services every time you use them.
Family $5,600 $11,200 $12,000 $24,000
Ofice Visit Copay Out of pocket max: Generally, the
Primary care $30 copay Ded/60% Ded/80% Ded/60% most you can spend on healthcare for
physician the year, not including your monthly
Specialist $60 copay Ded/60% Ded/80% Ded/60% premiums.
Emergency room $200 copay; $200 copay; Ded/80% Ded/80%
Ded/80% Ded/80% HRA: A Health Reimbursement
Urgent Care $60 copay Ded/60% Ded/80% Ded/60% Arrangement includes an account
Virtual Visits $20 copay N/A Ded/80% N/A that the company establishes for
Prescription Drugs you. HRAs do not accept employee
Pharmacy Out-of-Pocket Maximum contributions.
Individual $3,100 N/A Pharmacy expenses are HSA: A Health Savings Account is
included in your medical out a personal bank account you own
Family $6,200 N/A of pocket maximum and is used to pay for qualiied
Retail medical expenses. Whatever money
Tier 1 $10 copay $10 copay Ded/80% Ded/60% you contribute or accumulate is
Tier 2 $30 copay $30 copay Ded/80% Ded/60% yours for life. Employees can make
Tier 3 $60 copay $60 copay Ded/80% Ded/60%
Tier 4 $90 copay $90 copay Ded/80% Ded/60% contributions to the account up to the
Mail Order allowed maximum contribution limits.
Tier 1 $20 copay Ded/80% The IRS contribution limits for 2016
Tier 2 $60 copay Ded/80% are $3,350 for individuals and $6,750
Tier 3 $120 copay Not available Ded/80% Not available for families. The maximum contribution
Tier 4 Not available Not available limit includes wellness credits and
company seeding. These funds can
be withdrawn at any time to cover
qualiied medical expenses as deined
by the IRS.
2016 Open Enrollment
Glossary
Premium: The amount you contribute
UHC Account-based Plans each month from your paycheck for
insurance coverage.
Let’s take a look at the key features of each plan. Deductible: A set dollar amount
you have to pay for your healthcare
Health Reimbursement
Arrangement Health Savings Account expenses before the company starts
to share costs with you. Deductibles
Out-of-
Out-of-
In-Network Network In-Network Network vary by plan and by coverage levels.
Calendar Year Deductible Coinsurance: Once you’ve satisied
Individual $1,750 $3,500 $3,000 $6,000 the deductible, this is a set percentage
Family $3,500 $7,000 $6,000 $12,000 of the remaining costs which are your
Coinsurance 80% 60% 80% 60%
Out-of-Pocket responsibility, until you reach your out-
Maximum Includes Deductible Includes Deductible of-pocket max.
Preventive care 100% Not available 100% Not available Copay: A set dollar amount you pay
Individual $2,800 $5,600 $6,000 $12,000 for services every time you use them.
Family $5,600 $11,200 $12,000 $24,000
Ofice Visit Copay Out of pocket max: Generally, the
Primary care $30 copay Ded/60% Ded/80% Ded/60% most you can spend on healthcare for
physician the year, not including your monthly
Specialist $60 copay Ded/60% Ded/80% Ded/60% premiums.
Emergency room $200 copay; $200 copay; Ded/80% Ded/80%
Ded/80% Ded/80% HRA: A Health Reimbursement
Urgent Care $60 copay Ded/60% Ded/80% Ded/60% Arrangement includes an account
Virtual Visits $20 copay N/A Ded/80% N/A that the company establishes for
Prescription Drugs you. HRAs do not accept employee
Pharmacy Out-of-Pocket Maximum contributions.
Individual $3,100 N/A Pharmacy expenses are HSA: A Health Savings Account is
included in your medical out a personal bank account you own
Family $6,200 N/A of pocket maximum and is used to pay for qualiied
Retail medical expenses. Whatever money
Tier 1 $10 copay $10 copay Ded/80% Ded/60% you contribute or accumulate is
Tier 2 $30 copay $30 copay Ded/80% Ded/60% yours for life. Employees can make
Tier 3 $60 copay $60 copay Ded/80% Ded/60%
Tier 4 $90 copay $90 copay Ded/80% Ded/60% contributions to the account up to the
Mail Order allowed maximum contribution limits.
Tier 1 $20 copay Ded/80% The IRS contribution limits for 2016
Tier 2 $60 copay Ded/80% are $3,350 for individuals and $6,750
Tier 3 $120 copay Not available Ded/80% Not available for families. The maximum contribution
Tier 4 Not available Not available limit includes wellness credits and
company seeding. These funds can
be withdrawn at any time to cover
qualiied medical expenses as deined
by the IRS.
2016 Open Enrollment
