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UnitedHealthcare Choice Plus
with Health Savings Account (HSA)
User Guide
Tips for Healthy Saving and Spending
CSAA Insurance Exchange
THINK HEALTHY.
SPEND WISELY.
We are committed to offering you a comprehensive
benefits program that supports your total well-being
— physically, financially and emotionally. To help
you make the most of your health care benefits,
we’ve developed this step-by-step guide to using
the UnitedHealthcare (UHC) Choice Plus with
Health Savings Account (HSA) plan.
What makes the UHC Choice Plus with HSA plan different?
This plan is considered a “consumer-driven health plan” (CDHP)
because it gives you more control over your spending decisions.
A CDHP is a health plan that allows participants to use a HSA to
pay health care expenses directly, while a high-deductible health
plan provides free preventive care services and protects the participant
from catastrophic medical expenses.
The CDHP encourages covered individuals to be informed and
thoughtful consumers of health care services, much like they would
be when purchasing other goods and services. In many ways, it works
just like the UHC Choice Plus Classic plan, where both plans share
in the cost of your covered services once you’ve met the annual
deductible. Both plans have a PPO design, but the CDHP is a PPO
plan with a higher deductible and lower premiums taken from your
paycheck. There are some key differences that reward you for
making consumer-minded health care decisions based on quality
and cost.
The UHC Choice Plus with HSA plan has lower premiums
and a higher annual deductible, which means:
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You keep more of your money each paycheck.
You decide when and where to spend your money toward
eligible health care expenses, because you own your HSA.
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The money in your HSA that you don’t spend is yours to keep.
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You can plan and save for future expenses with a tax-free HSA.
DID YOU
KNOW?
A recent study showed that
people who switched from a
traditional insurance plan (like
a PPO or HMO) to a CDHP
reduced their annual medical
costs by an average of 13% in
the first year, with sustainable
savings that continued year
over year. (7th Annual Cigna
Choice Fund Experience
Study, 2013)
INSIDE THIS GUIDE
This guide will help you make the most of the plan’s advantages. You’ll learn:
How the UHC Choice Plus with HSA plan works
2
What to do before you need health care services
6
What to do when you need health care services
7
What to do after you receive health care services
9
Resources
11
b
1
HOW THE UHC CHOICE PLUS
WITH HSA PLAN WORKS
This plan has two parts — low-premium, high-deductible health coverage and a tax-free Health Savings
Account (HSA).
Part 1: Low-premium, high-deductible health care coverage
For preventive care:
Your costs will be covered at 100% with no deductible when you see an in-network provider. This includes
annual physicals, well-child checkups, immunizations and more.
For nonpreventive care:
1. Nonpreventive services include medical services that are provided in order to diagnose, treat
or monitor disease, provide relief and/or improve the state of your health.
2. You pay for 100% of your costs until you meet the annual deductible.
3. You can use your HSA dollars — the amount provided by the company each year and your own
contributions, if you choose to make them—to help pay these expenses.
4. Once you meet your deductible, you and the plan share any further costs through coinsurance
until you meet your out-of-pocket maximum. You pay 20% and the plan pays 80%.
2
5. To protect you financially, the plan limits the amount you have to pay each year for medical care.
Once you meet the out-of-pocket maximum ($4,000 individual and $8,000 family), the plan pays 100%
of your eligible in-network expenses for the remainder of the year.
Part 2: Tax-free HSA
Setting up your account:
When you enroll in the UHC Choice Plus with HSA plan online, you’ll
be prompted to complete two steps to open an HSA that will work
alongside your medical plan. PayFlex is the HSA administrator and
will manage your account.
First, there are a series of questions that you must answer to determine
if you are eligible to open an HSA.
Next, you will need to complete a banking disclosure to authorize CSAA
to open an HSA on your behalf.
Details of the enrollment process can be found in the 2015 Open Enrollment
Guide on the Open Enrollment website: www.CSAAIE2015OE.com. For
new hires, you will receive an email telling you how to enroll. It’s a
good idea to confirm that your HSA has been properly established by
contacting PayFlex directly at www.healthhub.com or 800.284.4885.
You will receive a debit card to use for payments to providers, etc.
Company contributions:
The company will contribute $900 per year for employee only coverage
and $1,800 per year for employee +spouse/partner or family
members, with $250 contingent on the employee completing
his/her biometric screening by November 30, 2014. One fourth of
the company’s annual contribution will be deposited into your HSA
account at the beginning of each quarter. For employees who
don’t complete the screenings, you will receive $650 for employee
only coverage and $1,550 for employee + spouse/partner or family
coverage. If you are enrolling in this plan for the first time, you may
be eligible for an additional $300 or $500 lump-sum, salary-based
contribution if you make under $100,000 per year.
KEY
TERMS
Premiums —The amount
you pay for coverage out of
your paycheck.
Deductible —The amount
you pay for covered services
before the plan starts sharing
the cost through coinsurance.
Coinsurance — The percentage
of costs you and the plan each
pay for services after your
deductible is met.
Out-of-Pocket Maximum —
The total you will pay per
year out of your pocket.
3
Making your own HSA contributions:
You can contribute to your account with before-tax money from your paycheck, which lowers your taxable
income and saves on your annual federal (and some states’) income taxes. You can change your contribution
amount at any time during the year—either increasing or reducing it by going to MyLifeatAAA and selecting
My Benefits (if you are on the company network) or from your personal home computer by going to
https://csaa-insurance.aaa.com/mercer and logging in using your “g” ID and password. Once logged in, you’ll
need to go to the “MyHealth” section and select “Life Status Change.” You may also call the AAA Employee
Service Center at 800.216.4721. Note that you need not make contributions yourself in order to receive
the company contribution.
Using your account:
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Only expenses incurred after your HSA account is open are allowed. Any expenses incurred prior to your HSA
account being opened are not allowed per IRS regulations.
You can only spend HSA money that is already in your account. Check your account balance at
www.healthhub.com or contact PayFlex at 800.284.4885.
If you incur expenses that exceed the balance in your HSA, you can pay out-of-pocket and reimburse
yourself later when your HSA has accumulated more funds. This is a great time to increase your contributions.
You can pay your provider directly from your account using your PayFlex debit card or the online system.
Or, you can pay out-of-pocket using a credit card, personal check or cash and later reimburse yourself
for eligible expenses by submitting the receipts to PayFlex.
Be sure to keep all receipts in case of an IRS audit. You are responsible for proving that you used your HSA
only for qualified health care expenses. If you use your HSA funds for other expenses, you will owe taxes
on the withdrawal, as well as a 20% penalty tax.
Your unspent HSA dollars carry over year after year—you will never lose them, even if you change medical plans
or leave the company.
Consider investing your HSA money. Your HSA balance will earn interest, and any amount above a balance of
$1,000 can be invested through PayFlex. Any interest and investment gains you earn are tax-free, as long as the
money is used to pay for eligible health care expenses. For more information, contact PayFlex at 800.284.4885.
LIMITED PURPOSE REIMBURSEMENT
ACCOUNT (LPRA)
When you enroll in the UHC Choice Plus with HSA plan, you have the opportunity to also
enroll in a Limited Purpose Reimbursement Account (LPRA.) You can use this account to pay
for eligible dental and vision expenses and save your HSA for medical and prescription drug
expenses. To pay for your expenses, use your PayFlex debit card (Payflex is the administrator
for the HSA and the reimbursement accounts like the LPRA.) Or you can pay out-of-pocket
and submit your receipts to PayFlex for reimbursement. Unlike the HSA, the LPRA has a “use
it or lose it” limitation, although due to recent legislation, you can carry over up to $500 of unused
funds into the next year.
4
For more information about the LPRA and all of our reimbursement accounts, see your 2015
Open Enrollment Guide on the Open Enrollment site (www.CSAAIE2015OE.com). After Open
Enrollment this information can be found on our benefits site by going to MyLifeatAAA and
clicking on My Benefits, then Resources and Plan Information.
How Much Should You Contribute to Your HSA?
Deciding how much to contribute to your HSA is a personal decision. Consider the following:
The annual IRS limit. You can contribute a maximum of $3,350 for individual coverage or $6,650 for
employee + spouse/partner or family coverage (including any amount contributed by the company).
If you will be age 55 or older in 2015, you can make an additional contribution of $1,000.
Your annual deductible. You may want to have at least enough money in your HSA to meet your annual
deductible ($2,500 individual or $4,800 family). Keep in mind that the company contributes up to $900 for
employee only coverage and $1,800 per year for employee + spouse/partner or family coverage (with $250
contingent on the employee completing biometric screenings) to help you cover your initial out-of-pocket
expenses before reaching your deductible.
Your premium savings. If you compare how much you would have spent to enroll in the higher premium/
lower deductible UHC Choice Plus Classic plan to the UHC Choice Plus with HSA plan, you could
contribute the difference to your HSA.
Example of employee only, salary at $55,000:
2015 Premium
Choice Plus Classic (PPO)
Choice Plus HSA (CDHP)
Savings
Biweekly
$100.34
$30.12
($70.22)
Annually
$2,608.84
$783.12
($1,825.72)
The deductible in the UHC Choice Plus with HSA plan for employee only is $2,500. The company contributes
$900 annually. If you also contribute $1,825 to your HSA, you would have a total of $2,725 in your account—
more than enough to cover your deductible. If you’d rather save the money in your HSA and pay your health
care expenses through other means, such as a checking account or credit card, you are well on the way to
building your account for future health care expenses.
How much you expect to spend during the year. UHC’s Cost Estimator tool provides information on the
cost of medical services and treatment based on your state. Before scheduling an appointment, find out the
cost of services. For example, the cost of an MRI can vary from $500 to $5,000. Visit www.myuhc.com or
call UHC at 877.835.9856.
Your future health care expenses. The money in your HSA is always yours to keep—even if you leave
the company or retire. So think about saving for future health care expenses, while taking advantage
of current income tax savings. Use the HSA calculator tools to estimate future expenses.
Double Savings Advantages:
■
Contributions to your HSA reduce your federal (and some states’) income tax liability (you pay less
on taxes!). HSA dollars used for eligible health care expenses are tax-free.
5
WHAT TO DO BEFORE
YOU NEED HEALTH
CARE SERVICES
The UHC Choice Plus with HSA plan helps you focus on your
physical and financial wellness by encouraging you to become
a more informed health care consumer. To make the plan work
the best for you, do a little homework before you go to the
doctor or use other health care services.
✓Check if your doctors are in-network providers. Using in-network
providers and services saves you money through lower rates that
UnitedHealthcare negotiates with providers. It’s also more convenient
because you don’t have to file claims. If you use out-of-network providers
who do not have contracts with UHC, you will pay more, and you may
be required to submit claim forms. UHC’s provider directory is available
at www.myuhc.com or by calling 877.835.9856.
✓Be informed about health care costs. Find out what typical charges
are for the medical services you need before you visit your doctor.
Information about the cost of medical services in your state is available
by using UHC’s Cost Estimator tool at www.myuhc.com or by calling
UHC at 877.835.9856. You can also download the free UHC Health4Me
app to your smartphone, available for iPhones and Android.
✓Practice preventive care. Remember, in-network preventive care
procedures are covered at 100% and Tier 1 preventive drugs for specific
conditions (high blood pressure, cardiovascular/heart disease, high
cholesterol and diabetes) are also covered at 100%. It’s important to
get your annual screenings, such as mammograms and prostate exams.
A list of recommended immunizations and screenings for women, men
and children is available at www.myuhc.com, or by calling 877.835.9856.
✓Manage chronic illness. If you or a family member has a chronic
condition, such as diabetes, asthma or lower back pain, then you
know it’s very important to follow through on the course of treatment.
Through our partnership with UnitedHealthcare, we offer a variety of
programs that can help you lead a healthier life, better manage any
chronic conditions or assist you if you or a family member becomes
seriously ill. You will have a personal nurse with specialized training
to help you through the program. You can also earn Vitality wellness
points for completing a care program and save on your monthly plan
premiums. You may have already been contacted by UnitedHealthcare
about these programs to help manage your chronic condition(s).
Participation in these health management programs is voluntary and
confidential. Save money while improving your health today! Call UHC
at 877.835.9856 to learn more.
6
DID YOU
KNOW?
Out-of-Network Care
If you visit a non-UHC provider, you
will probably be required to pay up
front for services. Then you’ll need
to submit a claim, along with your
receipt, to UnitedHealthcare for
any reimbursement.
WHAT TO DO WHEN YOU
NEED HEALTH CARE SERVICES
When it’s time to see the doctor, be a savvy shopper—not just a patient. Get informed before receiving services.
Follow these tips:
Compare quality and costs. Since your plan won’t start sharing the cost of your services until you meet your
deductible, it’s in your best interest to shop around before choosing a provider. Different medical practices,
hospitals and pharmacies may charge different fees and offer a different level of service. Call ahead to ask
questions before making your choice and access UHC’s Cost Estimator tool to see the estimated cost for
medical care. You can also turn to Health Advocate for assistance comparing providers’ costs. Call 866.799.2728
or visit www.healthadvocate.com.
Seek less costly options. You can save money by requesting a generic equivalent for a brand-name prescription.
Ask your doctor or pharmacist if there is a less expensive and appropriate generic available. You may want to fill
maintenance (long-term) prescriptions by mail order, instead of using a walk-in pharmacy. Also, be sure to get the
right care for your needs. Go to the doctor’s office or urgent care center—instead of a hospital emergency room—
when you feel sick, have symptoms or injuries that are not life-threatening. Access Teladoc, our telephonic advice
service, for guidance from a doctor or for a short term prescription refill.
Present your ID card. When you arrive at the doctor’s office, present your ID card. When you see an in-network
doctor, you won’t pay anything at the time of your visit. Your doctor will submit the claim to UHC before a bill is
sent to you. Your ID card ensures you’ll be billed at the reduced in-network rates. (Note: the provider must submit
the claim in order for the contracted discount to apply, so avoid paying for your office visit at the time of your
appointment and wait for the actual cost to be billed to you.)
Ask questions. Don’t be afraid to ask your doctor to explain his or her recommendations, such as why a
test is necessary or how a medication will help you. And be sure to tell your doctor everything that might be
helpful in determining the best course of treatment, such as your health history and any medications you
are currently taking. If you want a second opinion, reach out to Best Doctors, a company-paid program,
which can answer your questions and conduct a review of your diagnosis. Call Best Doctors at 866.904.0910
or visit www.bestdoctors.com/members.
PREVENTIVE AND DIAGNOSTIC
CARE–KNOW THE DIFFERENCE!
Preventive care focuses on evaluating your current health status to obtain early
diagnosis and treatment. This care is covered at 100% with no cost to you when
you use in-network providers.
Diagnostic care is medical treatment for specific health issues or conditions,
ongoing care, lab tests and health screenings necessary to manage or treat
an already identified medical issue or condition.
7
KNOW THE DIFFERENCE BETWEEN
EMERGENCY AND URGENT CARE
Avoid using emergency services for routine or urgent care. Emergency rooms have medical staff
and equipment for life and death situations, such as heart attacks or car accidents.
8
Emergency Situation
Urgent Care Situation
Non-Urgent Care Situation
Call 911 immediately
Call your doctor or UnitedHealthcare’s
24-Hour NurseLine; the phone number
is located on your plan member ID card
Call Teladoc (800.TELADOC) to resolve
many common medical issues, saving you
time, money and perhaps an unnecessary
trip to the ER or Urgent Care.
An accident or sudden illness that must
be treated right away to avoid loss of
life, serious medical complications or
permanent disability. Examples include:
A situation that requires prompt medical
attention, but is not considered an
emergency. Examples include:
Speak to a doctor about conditions
such as
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Common cold or cough
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Severe sore throat
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Ear infection
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Refill a short term prescription
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Uncontrollable bleeding
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Sprains and strains
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Seizure or loss of consciousness
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Ear or eye infection
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Shortness of breath
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Fever
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Chest pains
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Sudden paralysis
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Broken bones
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Severe pain
WHAT TO DO AFTER YOU RECEIVE
HEALTH CARE SERVICES
After receiving in-network health care services, here’s how your charges are processed.
You Visit a UHC
Provider
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You pay nothing
at the time
of service.
Your doctor will
send a bill to
UHC (and you
may receive
a copy but
you don't
need to do
anything yet).
UHC Will Send You
an Explanation of
Benefits (EOB)
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UHC will pay your
provider any amounts
it owes under the
plan and send you
an EOB.
Your EOB will tell
you how your claim
was processed.
Your EOB will tell you
the amount you are
responsible to pay.
Review your EOB
carefully for accuracy.
If Your Care Was Preventive …
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You will owe nothing.
■
Contact UHC Customer Service if you are
charged for any preventive care services.
If Your Care Was Nonpreventive …
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Your doctor will send you a final bill for any
balance you owe.
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You can pay in any of the following ways:
- Use your PayFlex debit card.
- Use the PayFlex online system
(www.healthhub.com) to pay provider
claims or reimburse yourself for eligible
out-of-pocket expenses.
- Pay out-of-pocket and submit a reimbursement
request to PayFlex to have funds withdrawn
from your HSA at a later date. You don’t have
to file for reimbursement during the same
year the expense was incurred.
- Pay out-of-pocket without requesting
reimbursement and save your HSA balance
for expenses you incur later this year or
in future years.
CHECK YOUR DEDUCTIBLE
See how much of your annual deductible you’ve met by logging on to www.myuhc.com
and viewing your medical and prescription drug claims history.
HEALTH ADVOCATE CAN HELP
Don’t forget that if you need help understanding your Explanation of Benefits (EOB),
using your HSA or navigating the medical claims process, you can call Health Advocate
at 866.799.2728 for assistance.
9
Focus on Wellness and Prevention
The best way to keep your health care costs down and enjoy a healthier life is to focus on wellness and
prevention every day.
Take advantage of no-cost preventive care. Yearly checkups are a great way to prevent serious health
problems down the road. If you haven’t already, scheduled an annual wellness visit with your primary doctor–
it’s free! In addition to annual checkups, all in-network preventive services and Tier 1 preventive medications
for specific chronic conditions, (diabetes, heart disease, high blood pressure and high cholesterol) are covered
at no cost to you.
Make your health a priority. Our Living Healthy at AAA wellness program (in partnership with Vitality) is
the foundation of our commitment to a culture of health. From health screenings and personal coaches
to an online health assessment, our wellness program offers many ways to help you adopt a healthier
lifestyle. We strive to create an experience that’s personal and meaningful to you, no matter where you
are on your path to well-being. Learn more by visiting MyLifeatAAA and clicking on Vitality or log on
to www.powerofvitality.com/vitalityportal/csaa.
MAKING TIME FOR EXERCISE
10
We’re all busy—but did you know that simply adding movement into your daily routine
can increase your fitness level? For example, if you park on the top of the parking
structure and walk down the stairs, walk up and down the building stairs for 10 minutes
during your lunch break and take a 10-minute walk when you get home, you’ve racked
up 30 minutes of exercise for the day. Need help getting started? Contact your AAA
wellness coordinator today at [email protected]!
RESOURCES
For More Information About ...
UnitedHealthcare (UHC) Choice Plus with HSA plan
(also known as a consumer-driven health plan)
UnitedHealthcare
877.835.9856
www.myuhc.com
Group Number # 708571
Health Savings Account (HSA)
PayFlex
800.284.4885
www.healthhub.com
How to get help from a Benefits Advisor to do
the following:
■ Understand your health plan options.
■ Understand the HSA and other reimbursement
accounts.
■ Resolve a claims/billing issue.
Health Advocate
866.799.2728
www.healthadvocate.com
For questions and second opinions
Best Doctors
866.904.0910
Consult with a doctor by phone about common
health situations
Teladoc
800.835.2362
Your benefits service center
AAA Employee Service Center
800.216.4721
MyLifeatAAA, click on “My Benefits” (when in the office)
or https://csaa-insurance.aaa.com/mercer (using your “g” ID and
password from your personal home computer)
Living Healthy at AAA wellness program
Vitality
Call 877.224.7117.
■ From work: Go to MyLifeatAAA and click on the “Vitality” link.
■ From home: Go to www.powerofvitality.com/vitalityportal/csaa
(use your network credentials, e.g., “G” ID and password).
■ Spouses/domestic partners: Go to www.powerofvitality.com
or send an email to [email protected].
■
11
CDHP Reference Guide—Tips to Know
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A CDHP is a health plan that allows you to use an HSA to pay health care expenses directly, while
a high-deductible health plan provides free preventive care services and protects you from catastrophic
medical expenses. The CDHP structure motivates you to take a more active role in selecting your health
care providers, managing your health care expenses and improving your overall health through good
nutrition, exercise and other factors that you can control.
The company contributes $900 for individual coverage or $1,800 for family coverage (with $250 contingent on the
employee completing biometric screenings) into the HSA each year you are enrolled in the UHC Choice Plus with
HSA plan (also known as the CDHP). If you are a new plan participant, you may qualify for an additional one-time
lump-sum contribution of $300 or $500, depending on your salary.
The HSA is similar to a traditional savings account, but is designated specifically for paying for eligible healthrelated expenses, such as deductibles, coinsurance, prescription medications and medical expenses that are
not covered by your health plan.
Like most health plans, the CDHP includes an annual deductible. A deductible is a fixed amount you
must pay before the plan begins to share in expenses (coinsurance).
Most preventive medical services—such as routine physical exams and age-based screenings and
immunizations—are covered at 100% under the CDHP when you receive care from in-network
providers, so you will not pay for these services. Preventive and wellness services are not subject
to the annual deductible or coinsurance.
You have the option to pay for health care expenses out-of-pocket (on your own), instead of using your
available HSA funds. You can save now and spend later because your HSA balance rolls over from
year to year.
At the end of the plan year, unused HSA funds remain in your HSA for the next plan year.
There is no maximum balance for accumulated HSA funds. However, there are annual limits on
contributions that can be deposited into your HSA. The 2015 HSA contribution maximum limit is
$3,350 for Individual and $6,650 for family, and the amount includes both your contributions and
the company’s contributions. If you are over age 55, the limit increases by $1,000.
The HSA accrues interest similar to a traditional savings account. Any interest and investment gains
you earn are tax-free, as long as the money is spent on eligible health care expenses.
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