Page 6 - 2019 NextCare
P. 6
Qualified Example Expenses Health Savings Account
X Payments toward your deductible
X Prescriptions (HSA)
X Medicare premiums If you elect the BCBS High Deductible Health Plan, you may open
and contribute to a Health Savings Account (HSA) through Health
X Orthodontia
Equity Bank. This account is not an option with the BCBS PPO
X Glasses/contacts plan.
Non-Qualified Example You elect a certain amount to contribute tax-free from your
Expenses paycheck and the money is deposited into your account through
X Food Health Equity Bank. You receive a debit card from Health Equity
X Clothing Bank which can be used to pay for eligible health, dental, and
vision care.
X Household items
For non-provider employees, NextCare matches 10 cents on the
Visit irs.gov to view a complete list of
eligible and ineligible expenses . dollar to what you contribute to the health savings account for the
employee portion of the deductible. The chart below highlights the
HSA Eligibility maximum you can contribute per paycheck to your health savings
You may open and contribute pretax to an account without exceeding the IRS maximum. You may elect to
HSA under the following circumstances: contribute less than the employee portion listed. If you are eligible
to contribute more than the per pay period maximum noted below
X Enrolled in an IRS qualiied high or would like to change your contribution amount, send an email
deductible health plan (HDHP) to Michelle Geeve.
X Not enrolled in a traditional PPO
plan through your spouse or other Employee HSA Per Pay Period Maximum
employer sponsored plan options Contributions
X Not enrolled in a Government Plan Type
sponsored program (Medicare, Non-Providers: Individual Deductible $0 .00–$ 122 .38
Medicaid, Tricare, etc.) Non-Providers: Family Deductible $0 .00–$256 .99
X Have not received VA beneits within Providers: Individual Deductible $0 .00–$134 .62
the last three months (unless receiving Providers: Family Deductible $0 .00–$269 .23
beneits for a service related disability)
X Not claimed as a dependent on The IRS allows a maximum contribution in 2019 for individual
someone else’s tax return coverage of $3,500 and $7,000 for family coverage.
X Do not have an HSA and healthcare
FSA; your spouse also cannot have a
healthcare FSA through his/her own
employer
6 2019 Benefits Guide
X Payments toward your deductible
X Prescriptions (HSA)
X Medicare premiums If you elect the BCBS High Deductible Health Plan, you may open
and contribute to a Health Savings Account (HSA) through Health
X Orthodontia
Equity Bank. This account is not an option with the BCBS PPO
X Glasses/contacts plan.
Non-Qualified Example You elect a certain amount to contribute tax-free from your
Expenses paycheck and the money is deposited into your account through
X Food Health Equity Bank. You receive a debit card from Health Equity
X Clothing Bank which can be used to pay for eligible health, dental, and
vision care.
X Household items
For non-provider employees, NextCare matches 10 cents on the
Visit irs.gov to view a complete list of
eligible and ineligible expenses . dollar to what you contribute to the health savings account for the
employee portion of the deductible. The chart below highlights the
HSA Eligibility maximum you can contribute per paycheck to your health savings
You may open and contribute pretax to an account without exceeding the IRS maximum. You may elect to
HSA under the following circumstances: contribute less than the employee portion listed. If you are eligible
to contribute more than the per pay period maximum noted below
X Enrolled in an IRS qualiied high or would like to change your contribution amount, send an email
deductible health plan (HDHP) to Michelle Geeve.
X Not enrolled in a traditional PPO
plan through your spouse or other Employee HSA Per Pay Period Maximum
employer sponsored plan options Contributions
X Not enrolled in a Government Plan Type
sponsored program (Medicare, Non-Providers: Individual Deductible $0 .00–$ 122 .38
Medicaid, Tricare, etc.) Non-Providers: Family Deductible $0 .00–$256 .99
X Have not received VA beneits within Providers: Individual Deductible $0 .00–$134 .62
the last three months (unless receiving Providers: Family Deductible $0 .00–$269 .23
beneits for a service related disability)
X Not claimed as a dependent on The IRS allows a maximum contribution in 2019 for individual
someone else’s tax return coverage of $3,500 and $7,000 for family coverage.
X Do not have an HSA and healthcare
FSA; your spouse also cannot have a
healthcare FSA through his/her own
employer
6 2019 Benefits Guide
