What are Health Savings Accounts (HSAs)?
Health Savings Accounts are a two-tiered system of benefits used to provide affordable low premium (40%-50%+ discount), high quality PPO, DA (Direct Access), POS (Point of Service) and HMO health insurance benefits for individuals, families and groups alike; there are no size limits, big or small.
Tier 1
HSA's provide PPO, POS and DA plan coverage with a range of deductibles, with 100% and 90% in-network and 80%, 70% and 60% out-of-network coverage.
They are also available as HMO and EPO plans with in-network benefits only.
- Minimum Deductible — Individual
- $1,300
with out-of-pocket maximum of $6,550
- Minimum Deductible — All Others
- $2,600
with out-of-pocket maximum of $13,100
Included are first-dollar charges for gynecological exams, pap smears, routine mammograms, PSA’s and child immunizations with no deductible and no coinsurance, and 100% prescription coverage after deductible.
Tier 2
HSA’s — Health (IRA) Savings Accounts allow yearly tax deductible contributions for both individuals and families:
- up to $3,400 for individuals
- (100% of the deductible, per year!)
- up to $6,750 for families
- (100% of the deductible, per year!)
Catch-up of $1,000 applies to all participants age 55+ AND an additional $1,000 for Spousal Accounts age 55+.
HSA contributions may be withdrawn tax-free to reimburse plan participant’s for a medically-related expenses, including, but not limited to, dental, optical and orthodontia, medicare premiums and long term care premiums. Please refer to IRS Publication 502, Medical and Dental Expenses for further details.
HSA contributions can be accumulated for retirement purposes, in addition to current retirement plan contributions.
This is truly one of the only “Use It” or “Keep It” programs in the country!
Note: Over-the Counter Rx - due to the Patient Protection and Affordable Act, these charges may only be reimbursed if they have a prescription. Refer to our Coverage and Benefits and/or Resources pages for more details.
Case Study
This is an actual case of about 50 employees with dramatic savings, where we saved enough premiums to FULLY FUND everyone’s HSA account, with a tremendous savings to the practice, amounting to providing everyone with 100% coverage, since the HSA fund is sufficient to cover the deductible and if they don’t use the monies, they get to keep it. Note that in addition to what the practice saves, there is nearly $100,000 invested in the HSA/IRA account.
Cost Benefit Analysis
Employees |
Coverage |
Current Horizon DA Premium |
Proposed AmeriHealth HSA/PPO Premium | Monthly Premium Savings |
Combined Annual Premium Savings | HSA Deductible |
Savings in Excess of Total Exposure | Employee Share |
Savings in Excess of Employee Share |
|---|---|---|---|---|---|---|---|---|---|
| 5 | P&C | $4,376.38 | $2,637.45 | $1,738.93 | $20,867.12 | $12,700.00 | $8,367.12 | $27,004.33 | $35,371.45 |
| 12 | Family | $19,029.83 | $10,567.80 | $8,462.03 | $101,544.39 | $30,000.00 | $71,544.39 | $146,665.07 | $218,209.46 |
| 29 | Single | $12,090.49 | $8,642.58 | $3,447.91 | $41,374.94 | $36,350.00 | $5,124.94 | $29,017.18 | $34,142.12 |
| 3 | H/W | $3,520.52 | $1,877.52 | $1,643.00 | $19,715.94 | $7,500.00 | $12,215.94 | $24,791.61 | $37,007.55 |
| Cobra | |||||||||
| 1 | Family | $1,585.82 | $880.65 | $705.17 | $8,462.03 | $2,500.00 | $5,962.03 | $12,222.11 | $18,184.15 |
| 1 | H/W | $1,173.51 | $625.84 | $547.67 | $6,571.98 | $2,500.00 | $4,071.98 | $8,263.87 | $12,335.85 |
| Tefra | |||||||||
| 2 | H/W | $2,347.01 | $1,251.68 | $1,095.33 | $13,143.96 | $5,000.00 | $8,143.96 | $16,527.74 | $24,671.70 |
| 1 | Single | $416.91 | $298.02 | $118.89 | $1,426.72 | $1,250.00 | -$176.72 | $1,000.62 | $823.90 |
| 54 | Total | $44,540.46 | $26,781.54 | $17,758.92 | $213,107.09 | $97,500.00 | $115,253.65 | $265,492.53 | $380,746.18 |
| Savings in Excess of Maximum Claims | 218.57% | 390.51% | |||||||