Page 6 - Hitachi Benefit Guide February 2018
P. 6

Medical Plans


      HMO Medical Plan | Aetna  (Available to California Residents Only)
      With the Aetna Health Maintenance Organization (HMO) plan, you must choose a primary care physician (PCP) or medical group
      within the HMO network. All of your care must be directed through your PCP or medical group. Any specialty care you need will
      be coordinated through your PCP and will generally require a referral or authorization. You will receive benefits only if you use the
      doctors, clinics and hospitals that belong to the medical group in which you are enrolled, except in the case of an emergency.

      HMO Medical Plan | Kaiser Permanente  (Available to California Residents Only)
      With the Kaiser Permanente Health Maintenance Organization (HMO) plan, services must be obtained at a Kaiser Permanente
      facility, except in the case of emergency. All of your care must be directed through your selected doctor, but you can choose and
      change your doctor at any time, for any reason. Kaiser Permanente integrates all elements of healthcare such as physicians,
      medical centers, pharmacy, and administration in one convenient facility. In addition, Kaiser Permanente offers online tools so
      you can email your doctor’s office, make appointments, refill prescriptions, and more.

      HSA Medical Plan | Aetna
      The Health Savings Account (HSA) plan through Aetna combines a high deductible health plan (HDHP) with a special, tax-qualified
      savings account. Important - you have to meet your plan deductible before health care and prescription drug benefits are paid by
      the plan. You may use your HSA funds to pay for current medical expenses or save toward future medical expenses. Similar to the
      PPO plan, you have the freedom to choose your doctor without the requirement of selecting a PCP and you may self-refer to
      specialists. You may use a network provider whose negotiated rates provide richer levels of benefits with claim forms filed by the
      providers. You may also obtain services using a non-network provider; however, you will be responsible for the difference
      between the covered amount and the actual charges and you may be responsible for filing claims. You may elect to make
      contributions into the bank account up to the IRS maximums:

        HSA Contributions                                2018 Annual IRS Team Member Contribution Maximum
        Team Member                                                          $3,450
        Team Member + Family                                                 $6,900
        Catch-Up for Team Members Ages 55+                              Additional $1,000

      Additional information on how the HSA plan option works is located on pages 6-7 of this guide.

      PPO Medical Plans | Aetna
      The Aetna Preferred Provider Organization (PPO) plans allow you to direct your own care. You are not limited to the physicians
                             ®
      within the Managed Choice  (Open Access) network and you may self-refer to specialists. If you receive care from a physician who
      is a member of the PPO network, a greater percentage of the entire cost will be paid by the insurance plan. You may also obtain
      services using a non-network provider; however, you will be responsible for the difference between the covered amount and the
      actual charges and you may be responsible for filing claims.



        Health Advocate | Cigna

        With Cigna, you have access to Health care support and answers. Your Health Advocate is there to help you, your family,
        parents and parents-in-law get answers needed to navigate through the health care landscape.

        They are here to assist with the following:
         •  Find the right healthcare professional                       •  Medical bill questions or concerns
         •  Schedule appointments, arrange for medical tests or special treatments   •  Find eldercare or special needs services
         •  Questions about diagnosis, test results, treatments, and medications   •  Help in applying for Medicare supplement
         •  Help obtain estimated fees in your service areas             •  Coordinate care among multiple providers
         •  Find options for non-covered services or alternate health services   •  Arrange transportation for appointments


          Accessing the Health Advocate
          Contact (866) 799-2725 or www.HealthAdvocate.com/members | (Company name: Hitachi Solutions)




         6                                                                Hitachi Solutions America Employee Benefits Guide | 2018
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