welcome to chapter 4 – cdh plans please remember: all chapters provided in the 2016 employee...

•Welcome to Chapter 4 – CDH Plans•Please remember:

• All Chapters provided in the 2016 Employee Presentation are intended to be part of a module series

• There are 6 chapters• Follow along with and compile these into your own

presentation (see below) in the order they are presented• Text items in red are variable. Please modify them as

necessary in order to fit your customers’ needs• Please pick and choose from the slides provided to

create a custom presentation that is right for you and your customers. If your client is not offering a CDH plan, do not include any of the slides in this chapter.

Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.1

Delete this slide before distribution


Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Health Reimbursement Accounts

BENEFITS

Your Health Reimbursement Account (HRA) is a savings account funded by your employer.

Your employer funds it each year.

It will help you play for covered services.This includes paying for services that apply to your deductible, such as doctor visits, lab work, hospital stays, and more.

You won’t pay for services until it’s spent.The HRA will automatically pay for all covered services first. You won’t pay as long as you have money in your HRA. The money in the HRA may be enough to cover all of your health care costs for the year.

Remaining money will roll over to use next year.


Using your HRA

BENEFITS

It’s easy to use your HRA

Automatic payment1

If a service is covered by your health plan, we will automatically pay the bill (claim) from your HRA first, so you don’t have to.

Online claim formIf you need to submit a claim for reimbursement, you can easily do so online at myuhc.com. You can even sign up for emails to stay up to date on claim payments.

Health Care Spending Card MasterCard1

This handy debit card makes it easy to pay from your HRA. You can use it to pay by phone, online or at locations that accept MasterCard.

1. May not be available for some plans


Choice Plus Plan with HRA

With the Choice Plus plan with HRA, you can use any doctor, clinic, hospital or health care facility. You can save money when you use a health reimbursement account (HRA) and the network.

Save money by staying in our network. If you go out-of-network, you’ll have to pay for all of the costs.

There’s no need to choose a primary care provider (PCP) or get referrals to see a specialist.

Preventive care is covered 100% in our network.

BENEFITS

If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents.

Paying for network careCO-PAYMENT*

PCP <$XX>

Specialist <$XX>

DEDUCTIBLE*

[Self<$XXX

X>

[Family<$XXX

X>

CO-INSURANCE* <XX%>

OUT-OF-POCKET LIMIT

[Self<$XXX

X>

[Family<$XXX

X>


Navigate® Plan with HRA

With the Choice Plus plan with HRA, you can use any doctor, clinic, hospital or health care facility. You can save money when you use a health reimbursement account (HRA) and the network.


There’s no need to choose a primary care provider (PCP) or get referrals to see a specialist.


BENEFITS


Paying for network careCO-PAYMENT*

PCP <$XX>

Specialist <$XX>

DEDUCTIBLE*

[Self<$XXX

X>

[Family<$XXX

X>

CO-INSURANCE* <XX%>

OUT-OF-POCKET LIMIT

[Self<$XXX

X>

[Family<$XXX

X>


An HRA is an account funded by <your employer> to help you pay for covered health care services.

An HRA saves you money.When you have money in your HRA, that’s less you have to pay out of your pocket for covered services.

Your funds roll over each year.If you don’t spend all of your HRA during the plan year, it will roll over to the next year

BENEFITS

Ways to pay with

your HRA

Set up automatic payments.

[Use the Health Care Spending MasterCard.®]

[Submit claims on myuhc.com to get reimbursed.]

<Choice Plus> Plan with HRA


BENEFITS

How paying for network care works with an HRAYour deductible: Your HRA automatically pays for covered services first. If you spend all of your HRA, you’ll have to pay until you reach your deductible.

Your deductible

Your HRA pays first

You pay+

STEP

1

STEP

1



BENEFITS

How paying for network care works with an HRAYour deductible: You have to pay for covered services until you reach the HRA access point. Then your HRA will pay until you reach your deductible.

STEP

1

Your deductible

STEP

1

Your HRA pays first

You pay+



<Choice Plus> Plan w/ HRA: Step 1 Access Point + You Pay Again

BENEFITS

How paying for network care works with an HRAYour deductible: You have to pay for covered services until you reach the HRA access point. Then your HRA will pay. If HRA funds run out, you will pay again until you reach your deductible.

Your deductible

HRA pays

You pay first

You pay agai

n

++

STEP

1

STEP

1



<Choice Plus> Plan w/ HRA: Step 1 50% share before deductible

How paying for network care works with an HRAYour deductible: Your HRA will pay 50% of the cost of each covered service and you will pay the other 50% until the deductible is paid.

BENEFITS

STEP

1

Your deductible

STEP

1

Your HRA pays 50%

You pay50%

+



How paying for network care works with an HRAYour co-insurance: After you reach the deductible, you share the costs with the plan. You can use an HSA to help pay your share.

BENEFITS

STEP

2

Your co-insurance

STEP

2

Your plan

pays %

You pay %

+

Your deductible

STEP

1

Your HRA pays 50%

You pay50%

+



How paying for network care works with an HRAYour out-of-pocket limit: When you reach the limit, you are done paying. The plan pays 100% of covered services.

BENEFITS

STEP

3

Your out-of-pocket limit

Your co-insurance

Your plan

pays %

You pay %

+

Your deductible

You are done paying

Your HRA pays 50%

You pay50%

STEP

3

STEP

2

STEP

1

+



Health Savings Accounts

BENEFITS

Your Health Savings Account (HSA) is a savings plan for health care you’ll need today, tomorrow and into the future.

It’s a real bank account You don’t pay federal income tax on the money you deposit into it, and the money you use for qualified medical expenses. Your savings also grows tax free.

You can build savings for retirementAnyone can contribute.No “use it or lose it” rule.You can invest savings.

The money is there when you need itUse your UnitedHealthcare HSA MasterCard debit card to pay at the pharmacy, doctor’s office or at locations that accept MasterCard. Or save it, the money in your Health Savings Account is yours, so it stays with you if you change health plans, employers, or retire.


HSA Eligibility

2016 contribution limitsThe IRS limits how much you can put into your HSA each year. The 2016 limits are:•$3,350 for individual coverage•$6,750 for family coverageAre you 55 or older?You can put in an extra $1,000 this year.

BENEFITS

You must be eligible to open or fund a Heath Savings Account (HSA)

You must be enrolled in a high-deductible health plan (HDHP).

You cannot be covered by any other health coverage Unless it is permissible coverage like vision or dental.

You cannot be enrolled in Medicare

You cannot be claimed as a dependent on someone else’s tax return.

Some other restrictions apply. Please consult a tax, benefits, or financial advisor.


Optum BankSM

BENEFITS

• UnitedHealthcare’s preferred health care bank

• Is dedicated to helping people save for health care

• The national leader in HSA banking with more than a million account holders

• Offers the convenience of banking through myuhc.com

Open your HSA with Optum BankSM, Member FDIC

Only Optum Bank lets you do your banking through your plan website, myuhc.com® or optumbank.com

Easy online bill payment and reimbursement

An HSA MasterCard® debit card to make it easy to pay

Investment options to grow your retirement savings.

Start by setting a savings goalThere are several ways to contribute to your account. Payroll deduction: Pre-tax dollars are taken out of your paycheck and deposited into your HSA. It’s the easiest way to build your savings.Electronic deposits: Transfer money to the HSA from another bank account.


With the Choice Plus plan with HSA, you can use any doctor, clinic, hospital or health care facility. You can save money when you use a health savings account (HSA) and the network.


There’s no need to choose a primary care provider (PCP) or get referrals to see a specialist.Consider a PCP; they can be helpful in managing your care.


BENEFITS

Paying for network care


CO-PAYMENT*

PCP <$XX>

Specialist <$XX>

DEDUCTIBLE*

[Self<$XXX

X>

[Family<$XXX

X>

CO-INSURANCE* <XX%>

OUT-OF-POCKET LIMIT

[Self<$XXX

X>

[Family<$XXX

X>

Choice Plus Plan with HSA


This plan requires you to select a PCP to help guide you through the health care system. Plus, you can save money when you use a health savings account (HSA).

You need to select your personal PCP from the network.

You need to get referrals to see a specialist.

There’s no coverage if you go out-of-network or if you see a network specialist without a referral.You will be responsible for the entire cost of the service.


BENEFITS

Paying for network care


CO-PAYMENT*

PCP <$XX>

Specialist <$XX>

DEDUCTIBLE*

[Self<$XXX

X>

[Family<$XXX

X>

CO-INSURANCE* <XX%>

OUT-OF-POCKET LIMIT

[Self<$XXX

X>

[Family<$XXX

X>

Navigate® Advanced Plan with HSA


An HSA is a personal bank account to help you save and pay for your health care.

It’s your money.There’s no “use it or lose it” rule and you get to keep it even if you change plans, change employers or retire.

Set a goal, even a small one.Check with your employer to see if you can set up regular, pretax deposits through payroll deduction.

[Open your account.Don’t leave money on the table. Open an account to make sure you get the money [your employer] is giving you.]

BENEFITS

Qualified expenses:

Doctor office visits

Prescriptions

Eyeglasses and contacts

Dental care and braces

Chiropractic services and more

<Choice Plus> Plan with HSA


Save on taxes.You don’t have to pay federal or, in most instances, state income taxes on your HSA deposits, qualified expenses and interest earned. The 2016 IRS HSA limits are:

BENEFITS

Open an account

with Optum Bank.

Individual $3,350

Family $6,650

LEARN MORE and see if you’re eligible at welcometouhc.com</xxxxxxxxx>. VISIT optumbank.com.



How paying for network care works with an HSAYour deductible: You pay for all services, including prescriptions, until you meet your deductible. You can use an HSA to help pay it.

BENEFITS

STEP

1

Your deductible

Pay with your HSA or pay another way

STEP

1



How paying for network care works with an HSAYour co-insurance: After you reach the deductible, you share the costs with the plan. You can use an HSA to help pay your share.

BENEFITS

STEP

2

Your co-insurance

STEP

2

Your plan

pays %

You pay %

+

Your deductible


STEP

1



How paying for network care works with an HSAYour out-of-pocket limit: When you reach the limit, you are done paying. The plan pays 100% of covered services.

BENEFITS

STEP

3

Your out-of-pocket limit

STEP

3

You are done paying

Your co-insurance

STEP

2

Your plan

pays %

You pay %

+

Your deductible


STEP

1


•This ends Chapter 4- CDH Plans•Please open Chapter 5- Pharmacy•Copy and paste slides from Chapter 5 to

your Master1. Click on the first slide and then press shift while you click

on the last slide2. Right click on the first slide and select copy3. Go to your Master (Chapter 1)4. Click below the thumbnail of the last slide in that section5. Right click there and select Copy—Use Source

Formatting•Whichever slides from Chapter 5 that do

not apply to your customer’s needs, delete

Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.23



welcome to chapter 4 – cdh plans please remember: all chapters provided in the 2016 employee...

Documents

health plan

health care costs

health care facility

hra benefitsits easy

covered services

preventive care

remaining money

online claim form