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Weber State University. STAR Plan 2014. The STAR Plan. S elf-Directed T ax A dvantaged R esource. The STAR Plan Intent. How does it benefit you…. The STAR PLAN. PEHP. Star Plan Health Benefits (A qualified HDHP) Medical and Pharmacy. Health Savings Account (HSA)

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Weber State University

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Weber state university

Weber State University

STAR Plan 2014


Weber state university

The STAR Plan

Self-Directed Tax Advantaged Resource


Weber state university

The STAR Plan Intent

How does it benefit you…


Weber state university

The STAR PLAN

PEHP

Star Plan Health Benefits

(A qualified HDHP)

Medical and Pharmacy

Health Savings Account (HSA)

Interest-bearing account

Two Components

HealthEquity

Financial Institution


Weber state university

HSA ELIGIBILITY

To qualify for an HSA, an individual:

Must be covered by PEHP’s STAR Plan (a HDHP)

  • Must be 18 years or older

  • Can’t be enrolled in Medicare A, B, C, D

  • Can’t be claimed as a dependent on someone else's tax return

  • Can’t have other health coverage, unless permitted by the IRS. (TRICARE)

  • Cannot participate or be covered by a FSA or HRA, or the balance will be $0 by June 30th


Weber state university

HEALTHCARE REFORM

Preventive Health Benefits

Routine Services

Contracted Provider

Some are age specific

Deductible does not apply

Women’s Health

Removal of waiting periods for adults


Weber state university

ADVANTAGE/SUMMIT STAR

When Using Contracted Providers

Deductible You pay for all pharmacy, doctor and hospital

visits before PEHP begins paying for coverage.

Payment based on PEHP’s Allowed Amount (AA)

  • Individual: $1,500

  • Two- Party, Family: $3,000

    After Deductible is met you pay:

    20% coinsurance for inpatient and out patient services

    20% coinsurance for physician office visits

    Applicable pharmacy copays


Weber state university

Advantage and Summit STAR

When Using Non - Contracted Providers

You pay for all pharmacy, doctor and hospital visits before PEHP

begins paying for coverage.

Payment based on PEHP’s Allowed Amount

Deductible Combined with Contracted Provider

  • Individual: $1,500

  • Two- Party, Family: $3,000

    After Deductible is met you pay:

    40% coinsurance for inpatient and out patient services

    40% coinsurance for physician office visits

    Applicable pharmacy copays.

    Excess fees above AA

    NO out-of-Pocket Maximum


Weber state university

Star vs. Traditional

Deductibles and Plan Maximums


Weber state university

Star vs. Traditional

Out-of-pocket Maximum Comparison


Weber state university

STAR Plan Key Concepts

PEHP pays eligible Medical/Pharmacy benefits after Deductible is met

Payment is based on Allowed Amount

One Deductible

- Includes pharmacy/medical

One out-of-pocket maximum

- Includes pharmacy/medical

Medical Benefits – July 1 to June 30th each year


Individual star plan example

Individual STAR Plan Example


Double star plan example

Double STAR Plan Example


Family star plan example

Family STAR Plan Example


Weber state university

Health Savings Account

Administered by HealthEquity

Savings account combined with qualified health plans to offset cost of higher deductibles

Can be used to offset retiree coverage costs

Both the employer and employee can contribute

  • Like a Flex Plan …… But Better!


Weber state university

HSA Facts

Interest-bearing account

Account money rolls over to the next plan year

Account is portable

Employee & Employer contributions are made tax-free

Money grows tax-free

Money used on eligible expenses is tax-free


Weber state university

Who can use HSA Funds?

Based on IRS guidelines.

Yourself

Spouse and dependents you

claim on your tax return or

could be claimed on your tax return.


Weber state university

LIMITED PURPOSE FLEX

This option is only available on the STAR plans

You may elect a Limited Purpose Flex Account

  • Dental and Vision expenses

  • Medical Expenses after the deductible is met

  • Up to $2,500

  • This is in addition to your H.S.A contributions

    FLEX RULES APPLY…USE OR LOSE


Weber state university

STAR PLAN

WSU will help you fund the account with

Semi-monthly contributions.

  • $33.09 for Individual coverage

  • $66.18 for Double Family coverage

  • Employer and employee contributions made through payroll will be in deposited in your account.

  • Change your contribution each pay period

WSU Contribution


Weber state university

HSA – Contributions

Must be enrolled in the STAR plan (HDHP)

Contribution limits are based on a Calendar year!

Catch-up contribution 55 years and above

Includes Employer and Employee contributions


Weber state university

How Can HSA Funds be Used?

Deductibles

Copayments

Dental

Vision

Prescription Costs *

Eligible services not covered by the medical plan.

*1/1/11 OTC medications

require a prescription.


Weber state university

HSA Common Uses

Reminders

Just because you can use your HSA money for a service does not guarantee that the service will accrue towards your deductible or

out-of-pocket maximum


Health care account comparison

Health Care Account Comparison


Health care account comparison1

Health Care Account Comparison


Weber state university

STAR Plan Key Concepts

It is your account, you never lose funds

Employer and Employee contributions are made tax free.

Must be enrolled in a qualified HDHP to make contributions

Contributions based on calendar year

Allows you to save for future costs.

You can’t have a Flex account

You can have Dependent Day Care account

HSA


Weber state university

HSA How To:

Doctors Visit

Show ID card

No payment at

time of service

PEHP adjusts

price based on

discounts (see your EOB).

Pay provider from your HSA funds, if they are available. Pay out of pocket if funds aren’t available and reimburse yourself later.

1

2

3


Weber state university

HSA How To:

Pharmacy Prescriptions

1

Show your

pharmacy card

Pay with your

HSA Card

PEHP applies amount to your deductible, no paperwork necessary.

2

3


Weber state university

Questions for Medical

HealthEquity 24/7

  • 866-346-5800

PEHP Customer Service

  • 801.366.7555

  • 800.765.7347


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