All About HSAs.ppt
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1、All About HSAs,U.S. Treasury Department Washington, DCAugust 18, 2004,Revised August 18, 2004,2,HSA Overview,A Health Savings Account (HSA) is a special account owned by an individual where contributions to the account are to pay for current and future medical expenses HSAs are used in conjunction w
2、ith a “High Deductible Health Plan” (HDHP) Insurance that does not cover first dollar medical expenses (except for preventive care) Can be an HMO, PPO or indemnity plan, as long as it meets the requirements,Revised August 18, 2004,3,HSA Overview,HSAs were created in Medicare legislation signed into
3、law by President Bush on December 8, 2003 HSAs modeled after Archer MSAs,Revised August 18, 2004,4,Who Is Eligible for HSAs?,Any individual that: Is covered by an HDHP Is not covered by other health insurance Is not enrolled in Medicare Cant be claimed as a dependent on someone elses tax return Chil
4、dren cannot establish their own HSAs No income limits on who may contribute to an HSA No requirement of having earned income to contribute to an HSA,Revised August 18, 2004,5,Who Is Eligible for HSAs?,What other health coverage is allowed for you to still be eligible for an HSA? specific disease or
5、illness insurance and accident, disability, dental care, vision care and long-term care insurance Employee Assistance Programs, disease management program or wellness program These programs must not provide significant benefits in the nature of medical care or treatment Drug discount cards Eligibili
6、ty for VA Benefits Unless you have actually received VA health benefits in the last 3 months,Revised August 18, 2004,6,Who Is Eligible for HSAs?,What “1st dollar” medical benefits make someone ineligible for an HSA? Medicare Tricare Coverage Flexible Spending Arrangements Health Reimbursement Arrang
7、ementsThere are permitted HSA/HRA/FSA combinations,Revised August 18, 2004,7,Who Is Eligible for HSAs?,Permitted HSA/HRA/FSA combinations: “Limited purpose” FSAs and HRAs that restrict reimbursements to certain permitted benefits such as vision, dental, or preventive care benefits “Post-deductible”
8、FSAs or HRAs that only provide reimbursement after the minimum annual deductible has been satisfied under the HDHP “Retirement” HRAs that only provide reimbursement after an employee retires “Suspended” HRAs where the employee has elected to forgo health reimbursements for the coverage period,Revise
9、d August 18, 2004,8,What Is a “High Deductible Health Plan” (HDHP)?,Health insurance plan with minimum deductible of: $1,000 (self-only coverage) $2,000 (family coverage) These amounts are indexed for inflation Annual out-of-pocket (including deductibles and co-pays) cannot exceed: $5,000 (self-only
10、 coverage) $10,000 (family coverage) These amounts are indexed for inflation,Revised August 18, 2004,9,What is a “High Deductible Health Plan” (HDHP)?,Reasonable benefit designs not counted toward the out of pocket maximum include: Lifetime limits on benefits Limits to usual, customary and reasonabl
11、e (UCR) amounts Limits on specific benefits Maximum number of days or visits covered Maximum dollar reimbursements Pre-certification requirements,Revised August 18, 2004,10,What is a “High Deductible Health Plan” (HDHP)?,HDHPs can have: first dollar coverage (no deductible) for preventive care highe
12、r out-of-pocket (copays & coinsurance) for non-network services,Revised August 18, 2004,11,What is a “High Deductible Health Plan” (HDHP)?,Conflicts with state benefit mandates State mandated first dollar coverage will result in plan losing status as HDHP NJ requires first dollar coverage of any tre
13、atment of lead poisoning Transition relief for state mandates in place on January 1, 2004 Plans containing such mandates will not lose status as HDHP prior to January 1, 2006 After that date, plan will lose status as HDHP if such mandates remain in place,Revised August 18, 2004,12,What is a “High De
14、ductible Health Plan” (HDHP)?,Prescription Drugs HDHPs must apply costs of prescription drugs to the annual deductible or the individual may not contribute to an HSA Transition relief provided until January 1, 2006 if the individual is covered by a prescription drug benefit provided by a separate pl
15、an or rider from the HDHP,Revised August 18, 2004,13,What is a “High Deductible Health Plan” (HDHP)?,Preventive Care Safe harbor list of preventive care that HDHP can provide as first-dollar coverage before minimum deductible is satisfied: Periodic health evaluations (e.g., annual physicals) Screeni
16、ng services (e.g., mammograms) Routine pre-natal and well-child care Child and adult immunizations Tobacco cessation programs Obesity weight loss programs Can apply co-pays to preventive care services,Revised August 18, 2004,14,What is a “High Deductible Health Plan” (HDHP)?,Preventive Care Preventi
17、ve care generally does not include any service or benefit intended to treat an existing illness, injury or condition Certain drugs and medications can be considered preventive care. Drugs taken by a person who has developed risk factors for a disease that has not yet manifested itself or to prevent
18、reoccurrence of a disease Example: Cholesterol-lowering medication for those with high cholesterol,Revised August 18, 2004,15,HSA Contribution Rules,Contribution to HSA can be made by the employer or the individual, or both If made by the employer, it is not taxable to the employee (excluded from in
19、come and wages) If made by the individual, it is an “above-the-line” deduction Can be made by others on behalf of individual and deducted by the individual,Revised August 18, 2004,16,HSA Contribution Rules,Maximum amount that can be contributed (and deducted) to an HSA from all sources lesser of: Am
20、ount of HDHP Deductible or Maximum specified in law (indexed annually) $2,600 (self-only coverage) - 2004 $5,150 (family coverage) 2004,Revised August 18, 2004,17,HSA Contribution Rules,Revised August 18, 2004,18,HSA Contribution Rules,Special deduction rules for family coverage where there is a sep
21、arate individual embedded deductible amount for each family member of at least the minimum contribution limit for family coverage ($2,000 in 2004) and an overall umbrella deductible amount for the whole family. Maximum contribution is the lower of: Maximum contribution limit for family coverage ($5,
22、150 in 2004) The umbrella deductible amount The embedded individual deductible multiplied by the number of family members covered by the plan If the embedded individual deductible is less than the minimum contribution limit for family coverage, then the insurance is not a qualifying HDHP,Revised Aug
23、ust 18, 2004,19,HSA Contribution Rules,For individuals age 55 and older, additional “catch-up” contributions to HSA allowed 2004 - $500 2005 - $600 2006 - $700 2007 - $800 2008 - $900 2009 and after - $1,000 Contributions must stop once an individual is enrolled in Medicare,Revised August 18, 2004,2
24、0,HSA Contribution Rules,The total amount of contributions to an HSA are based on the number of months that the individual is covered by an HDHP as of the first day of the month. 3 months of HDHP coverage with an annual high deductible amount of $1,200 will mean that the maximum contribution will be
25、 3/12ths of $1,200 or $300. Also applies to “catch-up” contributions Age 55 for 6 months in 2004 will mean a $250 catch-up contribution permitted,Revised August 18, 2004,21,HSA Contribution Rules,Contributions to the HSA in excess of the contribution limits must be withdrawn by the individual or be
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