FAMILY COVERAGE

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HIGH DEDUCTIBLE HEALTH PLAN

With the High Deductible Health Plan (HDHP), no money is deducted from your paycheck (if you are a full-time employee) for medical plan premiums. When you and/or your covered family member need healthcare, you are covered just like a traditional plan including access to the same doctors and hospitals.

Having a deductible means that you’ll pay out-of-pocket up to a certain point when you need care. The deductible is a combined deductible, meaning that you and/or your covered family members expenses count towards the deductible, there are no separate deductibles. After you meet the deductible, you pay a copay or coinsurance up to what’s called the out-of-pocket maximum. Once that maximum is reached, the health plan pays all the in-network costs. Plus you receive money from the County, and you can save money in a Health Savings Account (HSA) that helps you pay for expenses when you and/or your covered family member need care.

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SEE HOW THE PLAN WORKS IF YOU HAVE A HEALTHY FAMILY

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If you and your covered family members only receive preventative care (covered at 100%) and have no prescriptions, you will have no medical expenses for the year and receive up to $1,750 into your HSA from the County; it’s like getting paid to participate.

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SEE HOW THE PLAN WORKS IF YOU AND/OR A FAMILY MEMBER MANAGES A CHRONIC DISEASE

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If you and/or your covered family member(s) are managing a chronic disease or care for an injury, you will pay for the full cost of care until you meet your deductible. The County will deposit $1,200 (for new hires, this amount is prorated based on the number of pay periods remaining in the benefit plan year) into your HSA to help you pay for your deductible, plus you can earn an additional $550 for you and your spouse-adult designee by completing wellness activities. Typically you do not pay anything at the time of service for doctor visits or hospitalizations and will receive a bill several weeks later. When you receive a bill, you can use the money from the County and money you contribute to your HSA to pay for the services.

For prescriptions, you pay the full cost of the drug until you meet your deductible. Once you meet your deductible, you typically pay a copay or coinsurance. For prescription drugs that treat chronic diseases, the deductible is waived for certain drugs. Check with your medical plan for a list of specific drugs.

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SEE HOW THE PLAN WORKS IF YOU AND/OR A FAMILY MEMEBER HAS A CATASTROPHIC EVENT

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In the event that the unexpected happens, the most you will pay for in-network services is $7,000. You will receive $1,200 (for new hires, this amount is prorated based on the number of pay periods remaining in the benefit plan year) plus up to an additional $550 for wellness incentives from the County in your HSA to help you pay for expenses. You will have no premium (for full-time employees), which keeps your total cost lower than the Traditional PPO Plan.. When you take into consideration the County contribution to your Health Savings Account, your out-of-pocket maximum cost is less than the Traditional PPO Plan.

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