BENEFITS PORTAL

FAQ’S

What is and H.S.A. (Health Savings Account) : An H.S.A. Plan Is a special combination of a health plan, Kaiser or Health Net with a high deductible somtimes coupled to an H.S.A. Account. The H.S.A. Account  is similar to a bank account in which its contributions can come from an employer or employee. Employees may receive a Federal Tax deduction for any of their own money that they contribute to this account as long as it does not exceed the maximum limit.

What happens to my H.S.A. money at the end each year?   The money in the H.S.A. Account does not get reduced to zero if you fail to spend it by the end of the year. In fact it continues to rollover from year to year and some H.S.A. providers may choose to allow you to invest  your savings depending on the amount in the account.

What will happen if I use my H.S.A. Account for something other than eligible medical expenses?  Similar to an IRA in which you would receive a penalty for money that was taken out before retirement, you will receive a penalty for all monies taken out for other purposes than medical expenses. Additionally, you may be required to show proof of what you did with these funds if you get audited. Therefore keep all of your receipts organized, so that in the event of an audit you are prepared.

Qualifying events?: A qualifying event is a special circumstance where an employee has the opportunity to enroll his/her dependents in his/her coverage off of Open Enrollment, due to loss of coverage, marriage or birth of a newborn. In order to add any dependents to the employer plan, the employee typically needs a certificate of coverage from the prior carrier, a marriage certificate or the date of birth of any newborn children. Please keep in mind that all dependents have to be added to the Employee’s coverage within 30 days of the event .

HMO? An HMO (Health Maintenance Organization) is a specific network of doctor’s where an employee would choose their own Primary Care Physician, however this Primary Care Physician would control and manage all of the member’s care, including seeing specialists.

PPO ? A PPO(Preferred Provider Organization) is a large network of doctors, however you are not required to choose a Primary Care Physician, nor does the Primary Care control or manage your care. A PPO gives you complete freedom to go In or Out Of Network

H.S.A. Plan is a high deductible plan, where an employees has to reach a much higher deductible until benefits are paid out by the insurance carrier.

Health Net providers: You can find Health Net doctors online at www.Healthnetca.com

Kaiser provider: Kaiser providers are assigned by your proximity to a Kaiser facility.

Delta: You can locate a Delta Dental Provider online at www.deltadental.com

Open Enrollment? This is the one time every year in which employees can change their coverage, add or drop dependents. Employee’s can not make any changes to their coverage throughout the rest of the year unless they have a qualifying event.

Deductible vs Out of Pocket Maximum: The deductible on a plan is the amount that needs to be met before certain benefits are paid by the insurance carrier for that specific plan. When the Annual Out of Pocket on a policy is met, the insurance carrier assumes the remainder of the liability of the insurance policy for the rest of that calendar year for most medical services, but not typically prescriptions.

H.S.A. deductibles work differently from other insurance plans: Once you have more than one person on the Medical plan, your plan utilizes the family deductible rather than the individual. However, while this may seem like a downside for most participants, it is actually an upside because now one family member can satisfy the deductible for the rest of the family.