Page 6 - Ches User's Guide 2018 v1.4

Medical Plan Options (continued)

Health Investment Plan w/HSA

The Health Investment Plan gives you and your family an option for receiving
health care services and includes a valuable Health Savings Account (HSA). The

Health Investment Plan allows you to choose any physician or health care provider
you like, but as with our other plans you will receive discounted rates and higher
reimbursements when you select providers within the contracted network.

Who Pays? Your Amount Your Amount HIP w/HSA Coverage
employee only Family (In-Network)
The Plan Above $4,000 Above $8,000 n Plan Pays 100% After out-of-Pocket Maximum
The Plan $2,001 – $4,000 $4,001 – $8,000 Coinsurance Pharmacy
and You n Plan pays 70% n Plan pays 70% Preventive Care
n You pay 30% n You pay 30% (Plan Pays 100%)
You $0 – $2,000 $0 – $4,000 Annual Deductible
n You Pay 100%

If you select the Health Investment Plan, Chesapeake will make a contribution to your
Health Savings Account on your behalf.

4 2018 ToTAl ReWARdS GUIde