Page 6 - 2020 NextCare Enrollment
P. 6
Qualified Example HEALTH SAVINGS ACCOUNT
Expenses (HSA)
Payments toward your deductible If you elect the BCBS High Deductible Health Plan, you may
Prescriptions open and contribute to a health savings account (HSA) through
Medicare premiums Health Equity Bank. This account is not an option with the
Orthodontia BCBS PPO plan.
Glasses/contacts
You elect a certain amount to contribute tax-free from your
Non-Qualified Example paycheck and the money is deposited into your account through
Expenses Health Equity Bank. You receive a debit card from Health Equity
Food Bank which can be used to pay for eligible health, dental, and
vision care.
Clothing
Household items For non-provider employees, NextCare matches 10 cents on
Visit irs.gov to view a complete list of the dollar to what you contribute to the health savings account
eligible and ineligible expenses . for the employee portion of the deductible. The chart below
highlights the maximum you can contribute per paycheck to your
HSA Eligibility health savings account without exceeding the IRS maximum. You
You may open and contribute pretax to an may elect to contribute less than the employee portion listed.
HSA under the following circumstances: If you are eligible to contribute more than the per pay period
maximum noted below or would like to change your contribution
Enrolled in an IRS qualiied high amount, send an email to Michelle Geeve.
deductible health plan (HDHP)
Not enrolled in a traditional PPO Employee HSA Per Pay Period Maximum
plan through your spouse or other Contributions
employer sponsored plan options Plan Type
Not enrolled in a Government Non-Providers: Individual Deductible $0 .00–$124 .13
sponsored program (Medicare, Non-Providers: Family Deductible $0 .00–$260 .66
Medicaid, Tricare, etc.) Providers: Individual Deductible $0 .00–$136 .54
Have not received VA beneits within Providers: Family Deductible $0 .00–$273 .08
the last three months (unless receiving
beneits for a service related disability) The IRS allows a maximum contribution in 2020 for individual
Not claimed as a dependent on coverage of $3,550 and $7,100 for family coverage.
someone else’s tax return
Do not have an HSA and healthcare
FSA; your spouse also cannot have a
healthcare FSA through his/her own
employer
6
Expenses (HSA)
Payments toward your deductible If you elect the BCBS High Deductible Health Plan, you may
Prescriptions open and contribute to a health savings account (HSA) through
Medicare premiums Health Equity Bank. This account is not an option with the
Orthodontia BCBS PPO plan.
Glasses/contacts
You elect a certain amount to contribute tax-free from your
Non-Qualified Example paycheck and the money is deposited into your account through
Expenses Health Equity Bank. You receive a debit card from Health Equity
Food Bank which can be used to pay for eligible health, dental, and
vision care.
Clothing
Household items For non-provider employees, NextCare matches 10 cents on
Visit irs.gov to view a complete list of the dollar to what you contribute to the health savings account
eligible and ineligible expenses . for the employee portion of the deductible. The chart below
highlights the maximum you can contribute per paycheck to your
HSA Eligibility health savings account without exceeding the IRS maximum. You
You may open and contribute pretax to an may elect to contribute less than the employee portion listed.
HSA under the following circumstances: If you are eligible to contribute more than the per pay period
maximum noted below or would like to change your contribution
Enrolled in an IRS qualiied high amount, send an email to Michelle Geeve.
deductible health plan (HDHP)
Not enrolled in a traditional PPO Employee HSA Per Pay Period Maximum
plan through your spouse or other Contributions
employer sponsored plan options Plan Type
Not enrolled in a Government Non-Providers: Individual Deductible $0 .00–$124 .13
sponsored program (Medicare, Non-Providers: Family Deductible $0 .00–$260 .66
Medicaid, Tricare, etc.) Providers: Individual Deductible $0 .00–$136 .54
Have not received VA beneits within Providers: Family Deductible $0 .00–$273 .08
the last three months (unless receiving
beneits for a service related disability) The IRS allows a maximum contribution in 2020 for individual
Not claimed as a dependent on coverage of $3,550 and $7,100 for family coverage.
someone else’s tax return
Do not have an HSA and healthcare
FSA; your spouse also cannot have a
healthcare FSA through his/her own
employer
6
