To our MSA/HSA Clients, Present and Future: MAJOR CHANGES TO THE 2005 HSA

Written by Michael G. Kirwan, ChFC, CLU
Published Spring 2005 in the Union and Morris County Newsletters

 

We have reviewed Benefit Highlight sheets for Horizon’s “new HSA 2005” plans and would like you to understand the comparison to the MSA Plan that you have and/or which is still available to new enrollees. Note that the deductibles being offered of $3000 Family ($1500 Single) and $5000 Family ($2500 single) are similar, however, the product is vastly different than the MSA currently being offered.

The following represents the most notable changes with the HSA Plan Only:

  • The Low Deductible In Network cap/Maximum Out–of–Pocket Expense, will be nearly doubled from the present maximum of $3500 Family ($1750 Single) to potentially $7000 Family ($3500 Single).
  • The High Deductible In Network cap/Maximum Out–of–Pocket Expense, will be nearly doubled from the present maximum of $5250 Family ($2650 Single) to potentially $9000 Family ($4500 Single).

    Current Plan: Most all Benefits would be paid at 100%, after satisfaction of the deductible shown above, with the exception of Rx, which has always been treated as an Out–of–Network Benefit and paid 80%/20%, to the max Out–of–Network cap for the Low Deductible of $5500 Family ($3000 Single) High Deductible of $6450 Family ($3500 Single), as described below.

    New Plan (2005): 100% Practitioner Services, 80% Hospital and other settings, 60% Rx after deductible.

  • The Low Deductible Out–of– Network cap/Maximum Out–of–Pocket Expense, will be nearly doubled from the present maximum of $5500 Family ($3000 Single) to potentially $10500 Family ($5250 Single).
  • The High Deductible Out–of– Network cap/Maximum Out–of–Pocket Expense, will be nearly doubled from the present maximum of $6450 Family ($3500 Single) to potentially $13500 Family ($6750 Single).

    Current Plan: 80%/20% to max cap shown above of potentially $6450 Family ($3500 Single)

    New Plan (2005): 60%/40% to max cap shown above of potentially $13500 Family ($6750 Single)

The Current MSA Plan is offered on a PPO platform, a Network of approx 25,000+ physicians.

The New Plan is offered on both a PPO and a Direct Access Platform, a Network of approx 23,000 physicians, which will provide for a significantly decreased premium structure, when selecting the Direct Access Platform, and a corresponding Managed Care payment to the provider, and therefore towards your chosen deductible.

However, the premiums are commensurate with the reduced Benefits, and should be considered accordingly.

Recently, effective 4/1/05, Oxford/United has entered the HSA playing field and we will be analyzing their Plan Benefits and Cost Structure and providing you with a comparative quote prior to your plan anniversary or enrollment.

 

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