Health Savings Account Plan

The Health Savings Account (“HSA”) Plan combines a high-deductible medical benefit administered by Premera Blue Cross with a tax-advantaged Fidelity savings account. You may use your HSA to pay for out-of-pocket medical expenses or you can save these dollars as part of a long-term strategy to pay your medical bills in retirement (for example).

The University makes monthly HSA contributions on your behalf and you may also make paycheck contributions to your account up to the annual IRS limit. Unlike a Flexible Spending Account, unused HSA dollars rollover each year and can be invested to build a nest egg for future health expenses.

Because HSAs have special tax benefits, they are also subject to certain restrictions. For example, you can sign up for the Premera HSA Plan if you’re not enrolled in Medicare, can’t be claimed as a dependent on someone else’s tax return, and you aren’t already covered under a spouse’s medical plan (unless that plan is also a high deductible plan.)

> Health Savings Account Plan Questions and Answers
> Fidelity HSA overview (15-minute video presentation)

Premera HSA Plan Benefit
 In-Network
 Out-of-Network
Deductible
$2,000 individual/$4,000 family
$4,000 individual/$8,000 family
Annual Out of Pocket Max
$4,000 individual/$8,000 family
(includes deductible)
Lifetime maximum benefit Unlimited
Office Visits 90% after deductible 50% after deductible
 Preventive Care
Immunizations
100%
50% after deductible
Routine physicals
100%
50% after deductible
Well-woman exams/screenings
100%
50% after deductible
Well-baby exams
100%
50% after deductible
Other Services  In-Network Out-of-Network
Emergency Room
(copay waived if admitted)
90% after deductible
50% after deductible
Inpatient hospital services
90% after deductible
50% after deductible
Outpatient hospital services
90% after deductible
50% after deductible
Outpatient surgical center
90% after deductible
50% after deductible
Prescription drugs (retail/pharmacy)
30-day supply
Generic
90% after deductible
Brand formulary
90% after deductible
Nonformulary
90% after deductible
Prescription drugs
(mail order)
90-day supply  
Generic
90% after deductible
Brand formulary
90% after deductible
Nonformulary
90% after deductible

 This is a brief outline of the benefits provided. Refer to the Premera High Deductible Health Plan plan summary for a comprehensive description of plan benefits. Under all circumstances, the plan summary will take precedence over information contained on this website. > 2013 plan summary

 

Last modified on Wednesday, January 29, 2014