CIGNA HDHP/HSA Plan

High Deductible Health Plan (HDHP)

  • An HDHP is an example of a consumer-driven health plan that is designed to empower employees to take control of their health decisions and the dollars they spend on care. The plan offers in-network only coverage (CIGNA Open Access Plus network) and requires satisfaction of a sizeable calendar year deductible.

  • Per the IRS, the plan is available to active employees who are not enrolled in any other health plan, which includes enrollment in Medicare Part A and/or Part B.

  • Selection of a Primary Care Physician is not required, although it is recommended for coordination of care.

  • Preventive care exams are covered at 100%.

  • The calendar year deductible is $1,250 for individual coverage and $2,500 (cumulative) for employee +1 or family coverage.

  • The calendar year Out-of-Pocket Maximum is $2,500 for individual coverage and $5,000 (cumulative) for employee +1 or family coverage.

  • With the HDHP/HSA plan, the deduction from each paycheck is lower than the other medical plan options. The lower premium provides the opportunity to open and contribute to a Health Savings Account (HSA). This is especially important because instead of a co-payment, the participant pays the full cost of a doctor’s visit or service until he/she satisfies the calendar year deductible. Once the deductible is met, the participant pays 10% coinsurance  for medical (or 20%, 30% or 40% coinsurance for prescriptions) until  the calendar year Out-of-Pocket Maximum is reached - then he/she pays 0% and the plan pays 100% of covered services and/or prescriptions for the remainder of the calendar year.


CIGNA HDHP/HSA Plan Summary


HDHP/HSA FAQs


HDHP Per Paycheck Premiums (July 1, 2013 through June 30, 2014)

CIGNA HDHP/HSA Plan Certificate of Coverage


 

 

A Health Savings Account (HSA) is a tax-advantaged account for participants enrolled in a HDHP. J P Morgan Chase is the administrator for CIGNA’s HDHP/HSA account (CIGNA Choice Fund).

  • Only qualified expenses, as allowed by the IRS, are eligible for reimbursement from an HSA on a tax-free basis.
     
  • Unlike the Flexible Spending Account, unused HSA funds rollover from plan year to plan year.
     
  • To be eligible, the employee must be enrolled in the University's CIGNA HDHP.
  • The maximum contribution for the 2013-2014 plan year is $3,250 if an employee elects individual HDHP coverage and $6,450 if he/she elects employee + 1 or family HDHP coverage.

  • Employees aged 55+ during the July 1, 2013 – June 30, 2014 plan year may elect to contribute an additional $1,000 to the HSA.

  • The funds in the HSA are owned and controlled by the employee/account owner. It is his/her responsibility to keep track of all deposits and expenditures and to retain all receipts. The employee is responsible for determining whether or not a particular expense is considered to be a qualified medical expense.

  • The funds can be used for any person treated as a qualified dependent on the employee’s federal tax form, even if the dependent is not enrolled in the CIGNA HDHP.

  • In addition to pre-tax contributions via payroll deduction, contributions can also be made to an employee’s HSA by others (e.g., relatives). However, the employee receives the benefit of the tax deduction.

  • The HSA earns interest, much like a regular interest-bearing bank account. Interest is calculated daily and posted to the account monthly.

  • Once the HSA balance reaches $2,000, the employee may elect to invest the additional amount (in excess of $2,000) in options available through J P Morgan Chase (fees and charges may apply).

  • Withdrawals forineligible expenses are taxed and assessed a 20% tax penalty.

  • HSA account owners must file IRS Form 8889 (updated for 2013 and 2014) with their federal tax returns.


Once the participant has enrolled in the HDHP, the University Benefits office will send an e-mail which includes a link for opening an HSA with J P Morgan Chase. The HSA can only be used to pay for eligible expenses incurred after the HSA bank account has been opened.

An interested employee should consult his/her tax advisor to determine the tax advantages and potential consequences associated with an HSA.

Employees who enroll in the HDHP/HSA and separate as a qualified retiree during the plan year will be required to elect a different plan option (with a higher monthly premium) in retirement. The HDHP/HSA plan is not offered to qualified retirees.

 

JPMC HSA Customer Fees

IRS Publication 969 – HSA and Other Tax-Favored Health Plans

IRS Publication 502 – Medical and Dental Expenses