There are three different medical plans for you to choose from. The County and you share on the cost of premiums.
High Deductible Health Plan (HDHP)
- Employer contribution into an HSA or FSA for qualified employees meeting specific criteria.
- Annual deductible of: $1,200 for employee only and $2,400 for employee with dependents.
- Annual out of pocket max of: $2,400 for employee only and $4,800 for employees with dependents.
- Preventive care covered 100% even prior to deductible.
- Preventive medications covered prior to the deductible.
- Prior to deductible, you pay the negotiated rate for all non-preventive care.
- After you meet the deductible, you pay 20% coinsurance for all non-preventive care until you meet the annual out of pocket maximum.
- After you meet the out of pocket maximum, all covered services and pharmacy is paid 100% by the plan for the rest of the calendar year.
Low Deductible Health Plan (LDHP)
- Hybrid plan: Combines elements of a traditional copay plan with elements of a deductible plan.
- Certain medical services like doctor visits and urgent care will have a flat copay year round (ranging from $20 to $100 depending on service type) while other services have a deductible, coinsurance, and out of pocket max.
- Annual deductible of: $500 for employee only and $1,000 for employee with dependents (only applies to “non copay” services).
- Annual out of pocket max of: $1,500 for employee only and $3,000 for employees with dependents (only applies to “non copay” services).
- Preventive care covered 100% even prior to deductible.
- All medications covered with a 3-tier copay schedule, without deductible or out of pocket max.
The Fine Print
Deductibles and out-of-pocket maximums are yearly.
- You pay the negotiated rate for all non-preventive care until you meet the deductible.
- You pay year-round copayments ranging from $20 to $100. Copayments do not count towards the annual deductible or out-of-pocket maximums.
- Only for services that do not require a copayment.
- Pharmacy coverage without a separate deductible.
- Pharmacy coverage with a copayment and/or coinsurance with no deductible.
TRICARE Supplemental Plan
- Supplemental plan for eligible members of the armed forces and their families.
- Available to employees who are enrolled/entitled to the TRICARE Retiree health benefits due to their military affiliation.
Health Savings Account
A Health Savings Account (HSA) is a personal savings account that you can use to pay for qualified medical expenses. The money in an HSA account comes from contributions made by the County, you, or any other individual provided that they do not exceed the maximum amount set by the law. Check the Benefits Handbook for contribution details.
Key Benefits:
- Contributions made to your HSA are exempt from federal income tax.
- The County offers payroll deductions to help you deposit money into your HSA.
- Your deposits may earn interest and continue to grow over time.
- The money in your HSA belongs to you, no matter who deposited it, even if you change jobs or switch health plans.
- HSA funds can be used to pay for current and future qualified medical expenses – there's no "use it or lose it" rule.
- You can use your HSA to pay for qualified medical expenses for your spouse or dependents, even if they are not covered under your high-deductible health plan.
Eligibility:
To qualify for an HSA, you must meet the following requirements:
- You must be covered under a high deductible health plan (HDHP)
- You have no other health coverage that is not a high deductible health plan including TRICARE, TRICARE for Life, Medical Flexible Spending Account (yours or your spouse’s).
- You are not enrolled in Medicare.
- You cannot receive VA medical benefits within the 3 months prior to making a contribution.
- You cannot be claimed as a dependent on someone else's tax return.
How do I contribute to my HSA?
If you elect and open an HSA through OptumHealth Bank, you will be able to contribute pre-tax dollars to your account through payroll deduction. Payroll deduction amounts can be started, changed, or stopped at any time during the year without reason. Simply complete the HSA Deduction Change Form and send it to the Payroll Department for processing.