Pulling it All Together ....We recognize the changing landscape of healthcare, health insurance and tax free plans can be confusing to some plan participants. We've created this page to assist participants to better understand, plan and execute in order to ensure plan participants maximize the plan benefits seamlessly. Know Your Plans
Execute Your Plan Online Presentation - Independent Health, HRA & FSA OverviewPlease view this presentation http://www.brainshark.com/HRTechnologies/STEL2014-2015 Health Insurance TermsHere are definitions* for some health insurance terms we use all the time. Knowing what they mean will help you understand our plans—and your coverage—better. allowed amount—the maximum amount your health plan will pay for a specific service. In-network providers agree to accept the allowed amount as payment in full. coinsurance—a cost-sharing method that requires you to pay a portion of the allowed amount for certain medical services. consumer driven health care (CDHC)—an approach to health insurance intended to significantly reduce costs throughout the healthcare field by enabling people to allocate more funds toward ordinary medical expenses, such as prescriptions or procedures. copay—a dollar amount due at the time you receive certain services. A typical example would be an office visit copay due when visiting your physician’s office for treatment. deductible—a set dollar amount you pay for covered services you receive before your insurer will make a payment. flexible spending account (FSA) - is a tax-advantaged account that covers your out-of-pocket medical expenses. You set aside pre-tax dollars out of your paycheck. By setting these dollars aside, you decrease your taxable income FSAs save you money by reducing FICA and Federal unemployment taxes. health maintenance organization (HMO) - a health insurance plan that coordinates the care of members and negotiates costs on their behalf through physician, hospital, and pharmacy networks. health reimbursement account (HRA) - offered by your employer is health fund to help pay for covered health care expenses. health savings account (HSA)—a personal account that holds funds you have deducted from your wages pretax to pay for medical expenses such as deductibles, coinsurance, and prescriptions. That money accumulates from year to year and is yours even if you leave your job. in-network coverage—the coverage available when you receive services from a provider who participates in your health plan. out-of-area—describes when you receive services while outside the geographic service area of your health plan. Your plan benefits may differ if you live or work beyond the geographic service area. out-of-network coverage—the coverage available when you receive services from a provider who does not participate in your health plan. Some plans may not include out-of-network coverage. out-of-pocket maximum—the maximum amount of deductible and coinsurance payments that you will pay for health services each calendar year. preferred provider organization (PPO)—a cooperative effort among doctors and hospitals who agreed to provide your medical services at a discount through your health insurer, without the need for a PCP or referrals. primary care physician (PCP)—a doctor who serves as your health care manager and coordinates virtually all of the healthcare services you routinely receive. Some plans do not require you to choose a PCP. referral—instructions provided by your PCP for specialty care. Some plans do not require referrals. |
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