BETTER INFORMED. BETTER TOGETHER. Open Enrollment presentation for Englewood Schools

easy to get appointments

I can choose my doctor

I’m part of the decision

free to focus on my patients

test results onlineexcellent prenatal care

great specialists

BETTER INFORMED. BETTER TOGETHER.Open Enrollment presentation forEnglewood Schools

2 | © Kaiser Permanente. All Rights Reserved.

Kaiser Permanente HDHP-HSA

Understanding the Kaiser Permanente High Deductible Plan with a Health Savings Account (HSA)

| © Kaiser Permanente. All Rights Reserved.3

A different way to pay for your care

Same great doctorsSame personalized attentionSame convenient locationsSame health resources

Your Kaiser Permanente High Deductible Plan with HSA


A deductible is the set amount you’ll need to reach each calendar year before services are covered by your plan.

You’ll pay full charges for all services (except prevention) until you reach your deductible.

If you have Employee +1 or family coverage (2 or more people on your plan), you must meet the full family deductible before you’ll be covered by the plan

What’s a deductible?


For 2014, you will have a choice of two different HDHP- HSA plans:

Option 1 (current plan offered) Your individual deductible is $4,000 Your family deductible is $8,000

Option 2 (new plan with lower deductibles) Your individual deductible is $2,000 Your family deductible is $4,000

What are the deductibles?


How does this work? Option 1 ($4,000/$8000)

You payKaiser Permanente pays

After you reach your deductible

0% for any additional covered services during the calendar year

The full cost of covered services

Before you reach your deductible


Full charges for all covered services (except prevention), up to your deductible amount $4,000 (Indiv) $8,000 (Family)

$0

No charge only for preventive care services

Full cost of covered preventative services


How does this work? Option 2 ($2,000/$4,000)



0% for any additional covered services during the calendar year

The full cost of covered services



Full charges for all covered services (except prevention), up to your deductible amount $2,000 (Indiv) $4,000 (Family)

$0

No charge only for preventive care services

Full cost of covered preventative services


How does this work? CONTINUED

Note: These are estimated costs only.

Before you reachyour deductible

Office visit $195

You pay $195

Kaiser Permanente pays $0


$195

$0.00

$195.00


Examples of services that count toward my calendar year deductible?

Emergency room visitsHospital care through Kaiser network facilities Imaging, laboratory, and special procedures through KaiserOffice visits, including primary care, specialty care, dialysis and therapy

obtained at Kaiser clinicsOutpatient therapy through Kaiser facilitiesPrescriptions obtained at Kaiser


Preventive care services

Preventive care is about staying healthy and preventing illness. Preventive services are covered at little or no cost to you, even before you reach your deductible. Examples include:

preventive annual exams well-child visits well-woman exam preventive lab tests and

X-rays

breast cancer mammography screening (every one to two years for women over 40)

colorectal cancer screenings for adults over 50 cervical cancer screening for women 21 to 65


Out-of-pocket maximum

Your out-of-pocket maximum offers peace of mind by limiting the total amount you’ll pay for most covered services each year.

All your deductible payments count towards your out-of-pocket maximum.

After you reach your out-of-pocket maximum, Kaiser Permanente will pay the full amount for covered services for the rest of the calendar year.

Individual FamilyAnnual out-of-pocket maximum

Option 1: $4,000Option 2: $2,000

Option 1: $8,000Option 2: $4,000


What’s a Health Savings Account (HSA)?You can use HSA funds to cover your out-of-pocket costs for

deductibles, and other qualified medical expenses

Your HSA belongs to you, so whatever you don’t spend rolls over to the next plan year. And if you change jobs or health plans, you can take your money with you.

Englewood Schools contributes $136.23/month (Option 1) or $65.97/month (Option 2) to your HSA. You can contribute more to your HAS on a tax-free basis up to the annual IRS limits.

The funds in your HSA are not considered part of your wages, so they’re not subject to federal income taxes.


More About Health Savings Accounts (HSAs)Your contributions to the HSA do NOT negatively impact your PERA

Highest Average Salary

The 2014 annual contribution limits (set by the IRS) are:

–Single: $3,300

–Family: $6,550

Note: this is the TOTAL amount that both you and Englewood Schools together can contribute in calendar year 2014

If you are age 55 or older, you may contribute an additional $1,000 to your Health Savings Account


Paying for careWhen you check in for your visit, you will be asked to make a payment or you can ask to be billed for any services rendered. You can use funds in your HSA to make this payment for yourself or your dependents.

You will get a bill after your visit if: Your payment at check-in didn’t cover the full amount you owe for the services you

received during your visit. You received additional services during your visit.


Payment is based on full charges and will count toward your deductible and out-of-pocket maximum.


Kaiser Permanente will pay for all covered services under the plan for the remainder of the calendar year.


Tools and resources to help you plan and budgetAt Kaiser Permanente, we think you should be in charge of your health and your budget. You’ll find helpful information, tools, and resources at kp.org/deductibleplans.

Some resources are:

Financial Counselors to provide cost estimates for services

Preventive care services list

Estimates and Out-of-Pocket Summary tools

Sample fee list

BETTER INFORMED. BETTER TOGETHER. Open Enrollment presentation for Englewood Schools

Documents

Transcript of BETTER INFORMED. BETTER TOGETHER. Open Enrollment presentation for Englewood Schools