Page 8 - Evisions Benefit Guide 2020 - Effective 1.1.2020

Benefits

How the Health Savings Account (HSA) Works

The opportunity to establish and contribute to a Health Savings Account is available when you
elect the HDHP/HSA medical plan option. It’s like a personal, tax-free savings account for health HSA
care expenses that earns interest. Any unused money rolls over from year to year.

Evisions will contribute $1,500 into your HSA account for the 2020 plan year. You must open an
account through Fidelity prior to receiving the employer contribution of $1,500.

In addition to Evisions’ contribution, you may elect to make Examples of
contributions into your account up to IRS maximums. IRS
maximums for 2020 are: Eligible HSA Expenses
• Employee: $3,550
• Family: $7,100 • Providers (Doctors, Specialists,
• Catch-up if you are 55 years of age or older: $1,000 Nurses)
• Prescription Drugs
The portion of your paycheck that you contribute to your • Inpatient Hospital Services
HSA will be taken out before you pay federal income taxes, • Laboratory & X-Ray
Social Security taxes and most state taxes (excluding state MEDICAL • Emergency Services
taxes in AL, CA and NJ). Any contributions you make can be • Acupuncture / Chiropractic
increased or decreased over the course of the year.

You can decide how to manage your money. The money in
your HSA is yours to save and spend on eligible health care • Providers (Dentists,
expenses whenever you need it, whether in this plan year • Specialists, Orthodontists)
or in future plan years. You can use the funds in your • Teeth Cleaning
account to pay tax-free for qualifying out-of-pocket DENTAL • Dental Treatment
Medical, Dental and Vision expenses such as deductibles, Orthodontia
coinsurance and copays. Your account balance earns
interest and the unused balance rolls-over from year to
year. The money is yours to keep even if you leave Evisions, • Providers (Optometrists,
no longer participate in a high deductible health plan (like
Ophthalmologists)
the HDHP/HSA), or retire. You may continue to make • Exams
contributions to your HSA if you enroll in another qualified • Glasses
high deductible health plan, or elect COBRA continuation VISION • Contact Lenses
coverage of your HDHP/HSA coverage if your employment • Lasik Surgery
terminates.

HSA Tax Savings Without With
Comparison the HSA the HSA
• COBRA
• Long-Term Care

Gross Annual Pay $45,000 $45,000 PREMIUMS • Medicare
Employee pre-tax HSA Not Elected $2,500
contributions

Taxable Gross Income $45,000 $42,500 Examples of
Payroll Taxes (at 30%) $13,500 $12,750 Ineligible HSA Expenses
Net Pay $31,500 $32,250
Ineligible HSA expenses include expenses that are not
Annual Tax Savings $0 $750 medical or health related as well as cosmetic surgery.

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