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Consumer Choice HSA Plan
This consumer-driven health plan offers the lowest premiums, includes in and out-of-network coverage and encourages
members to seek out the care that is right for them rather than pay for coverage they do not use.
How the plan works: Members will pay the full cost for services and prescriptions they receive until they reach the
annual deductible. Once the deductible is met, the plan will pay 100% of the costs for services received from providers
and facilities in-network and 80% of the costs for services received outside of the Cigna CareLink network. In-network
preventive services are always covered 100% regardless of where you are with your deductible. Generic preventive
medications are only $10 for a 90-day supply and are not subject to the deductible.
How the deductible works: If you enroll in this plan with one or more dependents, the family deductible of $3,000
applies; medical and prescription costs for employee and dependents work towards one family deductible. If you only
enroll yourself in coverage, the individual deductible of $1,500 applies.
To help protect you from an unexpectedly high cost, the plan features an out-of-pocket maximum. This is the most you
will need to pay in one year. Unlike the other two plans, your medical and prescription costs are put towards a combined
PHYSICAL WELL-BEING You may use a Health Savings Account (HSA) to help you pay for the deductible and other qualified medical,
out-of-pocket maximum.
prescription, dental and vision expenses on a tax-free basis.
To help you get started with your health savings,
Plymouth Rock will contribute up to $500 to your HSA!
What is a Health Savings Account (HSA)?
A Health Savings Account is a bank account for you to save pre-tax money through payroll deductions. It may be used
for you and qualified dependents for eligible medical, dental and vision expenses this year, or in the future. Your HSA
money can also be used as a vehicle to save for retirement.
What are the Benefits of an HSA?
Tax Advantage: Pre-tax money can be used to pay for out of pocket IRS-qualified medical, prescription, dental and
vision expenses. For a list of qualified expenses, visit Cigna.com.
Account Ownership: You own the account. You can use it, invest it, save it and move it as you see fit.
Portability: Accounts are completely portable. You can keep your HSA even if you change jobs, retire, change medical
coverage, become unemployed, move to another state or change marital status.
There are no “use it or lose it” rules for HSAs.
Who is eligible to contribute to the HSA?
You must be enrolled in the Consumer Choice HSA Medical Plan and you cannot be claimed as a dependent on someone
else’s tax return, be covered by another medical plan including a traditional health care FSA, be enrolled in Medicare or
be receiving Social Security benefits.
How do I contribute to an HSA?
You can choose how much you would like to contribute each pay period or choose an annual amount for the year. You
can change the amount you want to contribute or even choose to stop contributing throughout the year at anytime. You
can make HSA contribution elections directly through ADP.
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