Page 5 - C.J. Segerstrom 2022 Benefit Guide

HEALTH COVERAGE CARE

Your health care coverage includes medical, dental and vision plans. Detailed information about each
plan is in this section.

Your Medical Plan Health Savings Account (HSA)
You have four medical plan options: For employees enrolled in the Aetna CDHP HSA compatible plan,
you have the option to contribute to the savings account.
• Kaiser HMO
C.J. Segerstrom & Sons/South Coast Plaza will be providing
• Aetna Full California HMO
$1,250 if you elect employee only coverage or $2,500 if you
• Aetna PPO Open Access Managed Choice enroll dependents.
• Aetna CDHP, eligible for HSA
As a reminder, the amount you contribute added to the
amount the Company contributes can’t exceed the IRS
In/Out-of-Network Coverage maximum for 2022. Individual up to $3,650 and $7,300 for
Our PPO/CDHP medical plans feature in- and out-of-network family coverage.
coverage; individual and family deductibles; copays; • Your unused funds roll over from year to year.
coinsurance; and out-of-pocket maximums. Some offer a
• Your HSA always stays with you. It isn’t tied to an employer,
lower monthly cost, a higher deductible, and lower health plan or retirement.
coinsurance amounts, while others cost more each month
• If you have an HSA elsewhere, you can transfer the balance to
but offer a lower deductible and higher levels of coinsurance.
your new one. Plus, you’ll enjoy extra savings on eligible
You may use in- or out-of-network providers. You will always
over-the-counter health care items at CVS Pharmacy® stores as
pay less if you see a doctor or receive services within the well as online. This gives you more purchasing power.
provider network because the plan pays more “in-network.”
The HMO medical plans feature in-network coverage only. Your Medical Plan
In an HMO plan, your Primary Care Physician will direct your
• If you are 55 or older, you can contribute an additional
care as needed.
$1,000 per year
Deductible • You are not allowed to be enrolled in any other health
coverage and cannot have an HSA if you are enrolled in any
You must meet an annual deductible before the medical plan other coverage or Medicare, or claimed as a dependent on
begins to cover a portion of your costs; however, your HSA someone else’s tax return
may pay for some of those expenses on your behalf. Once the • You cannot participate in a Health Care FSA if you have an
deductible is met, the medical plan begins to pay for a HSA. Your spouse also cannot have a Health Care FSA
percentage of covered expenses (this is called coinsurance).
You decide which medical plan will work best for you and
With the HSA, prescriptions are subject to the deductible and
your family based on the monthly cost of coverage, the
out-of-pocket maximum.
annual deductible, and the out-of-pocket maximum, and the
Out-of-pocket maximums funding account you will use.

Out-of-pocket maximums apply to all of the plans. This is the
maximum amount you will pay for health care costs in a
calendar year. Once you have reached the out-of-pocket
maximum, the plan will fully cover eligible medical expenses
for the rest of the benefits plan year (except for any
copayments). If you see an out-of-network provider, you may
be responsible for out-of-pocket costs that are considered
above the “reasonable and customary” fees.

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