Page 33 - 2022 DPR Construction Benefit Guide_Administrative Employees

Explanation of Benefits care, prescription drugs, dental care, and vision care. You
can use the money in your HSA to pay for qualified medical
A statement sent by your insurance carrier that explains expenses now, or in the future. Your HSA can be used for
which procedures and services were provided, how much your expenses and those of your spouse/domestic partner
they cost, what portion of the claim was paid by the plan, and dependents, even if they are not covered by the HDHP.
and what portion is your liability, in addition to how you can
appeal the insurer’s decision. These statements are also Health Maintenance Organization (HMO)
posted on the carrier’s website for your review.
An HMO is a managed care plan that requires you to receive
Generic Drugs your medical care from hospitals and doctors in the HMO
network. Your Primary Care Physician (PCP) coordinates
Generic drugs are less expensive versions of brand name your medical care and refers you to specialists (within their
drugs that have the same intended use, dosage, effects, medical group) and hospitals as necessary.
risks, safety and strength. The strength and purity of
generic medications are strictly regulated by the Federal High Deductible Health Plan (HDHP)
Food and Drug Administration.
A qualified High Deductible Health Plan (HDHP) is defined
Guaranteed Issue by the Internal Revenue Service (IRS) as a plan with a
minimum annual deductible and a maximum out-of-pocket
The amount of coverage pre-approved by the insurance limit. These minimums and maximums are determined
carrier regardless of health status. annually and are subject to change.

Flexible Spending Accounts (FSAs) Imputed Income

FSAs allow you to pay for eligible health care and day The IRS requires that the value of any paid Life insurance
care expenses using tax-free dollars. The Health Care premiums for coverage above $50,000 be included in
Account can be used to pay for services not covered by your taxable income. This taxable income is known as
your medical, dental or vision plan such as copayments, “imputed income” and will be reflected in your paycheck
coinsurance deductibles, prescription expenses, lab exams and year-end W-2 form. Imputed income also applies to
and tests, contact lenses, and eyeglasses. covering domestic partners as well. The employer portion

Limited Purpose Account is used to pay for qualified vision of the monthly premium attributed to domestic partners
and dental expenses when you are enrolled in a qualified is subject to taxation.
High Deductible Health Plan with a Health Savings Account. In-Network

The Day Care account is used to pay for day care expenses A designated list of health care providers (doctors,
associated with caring for elder or child dependents that dentists, etc.) with whom the health insurance provider
are necessary for you or your spouse/domestic partner to has negotiated special rates.
work or attend school full-time. The money in the account
is subject to the “use it or lose it” rule which means you Using in-network providers lowers the cost of services for
must spend the money in the account before the end of you and DPR Construction.
the plan year.
Life Insurance
Health Savings Account (HSA)
A specific amount of money paid to designated
An HSA is a personal health care account for those enrolled beneficiaries in the event of the insured person’s death.
in an HDHP. You may use your HSA to pay for qualified
medical expenses such as doctor’s office visits, hospital

33