2015 Medical Benefit Change

2015 Medical Plan Change

Starting for the 2015 plan year (January 2015), Carleton College will have a new medical benefit provider--HealthPartners.  Under HealthPartners, there will be two plans available: Maize and Blue.  The Maize plan has the same plan design as our current Blue Cross/Blue Shield Aware Preferred Provider (PPO) Plan.  The Blue plan will link a Healthcare Spending Account (HSA) to a high deductible health plan (HDHP) with Carleton providing dollars toward the HSA.

Here are some links to the new plans and other information from HealthPartners:

PowerPoint Presentation of General Information Session for 2015 medical plans

PowerPoint Presentation of Health Savings Account (HSA) Information

Maize Plan (National ONE 500-35)

HealthPartners Summary of Benefit & Coverage (SBC) Maize Plan

Summary Plan Description (SPD) Maize Plan

Blue Plan (National ONE HSA 1300-80 w/ Rx Plus)

HealthPartners Summary of Benefit & Coverage (SBC) Blue Plan

Summary Plan Description (SPD) Blue Plan

Employee Costs for Plans -2015 

Prescription discount list for the Blue Plan

HealthPartners Company Information

HealthPartners Add on Feature of Plans

HealthPartners Travel Assist Information

FSA, HRA, HSA comparison guide

 

Frequently Asked Questions:

What is the difference between our current Health Reimbursement Accounts (HRA) and the new HSA?

HRA and HSA's are similar as they are able to pay for costs associated with your healthcare--deductibles, co-pays, medicines, etc.  However, HRA plan dollars are owned by the college while HSA funds are owned by the employee.  Your HSA money will be in an interest-bearing account that will roll-over from year to year and can be used after an employee is not longer employed with Carleton College. Both the employer and the employee can set aside money in the HSA and the money is tax-deferred as long as it is used for authorized medical expenses.  The HSA has to be linked with a HDHP while a HRA does not.   Please see the comparison guide above for more detailed information on differences.

With the HRA plans going away in 2015, what happens to my HRA money if I have any left over for 2014?

If you currently have a plan with an HRA account (currently BC/BS Accord or Options Blue plans) and select the Maize plan for 2015, your HRA balance will carry over for the year.  No new money will be added to the HRA and you have one year to spend down your HRA account balance. HRA funds for 2015 will not have the auto pay feature available with the HealthPartners plan, you will need to submit for reimbursement for any HRA funds used in 2015.

If you have a balance and you select the Blue plan for 2015, you will not be able to convert your HRA funds to HSA funds and your HRA funds will be lost. Due to IRS regulations we are not able to convert HRA funds to HSA funds.

Any HRA funds left at the end of the calendar year 2015 will revert back to the college.

How can I spend down the HRA dollars?

Carleton has expanded the reimbursement types allowed under the HRA accounts to include all uninsured medical expenses including  deductibles, co-pays, coinsurance, dental, vision, prescriptions and other out-of-pocket medical expenses allowed under IRC 213(d).  This change is effective for any 2014 and 2015 expenses.  A separate form will need to be submitted to Select Account for reimbursement of expenses outside of the Blue Cross/Blue Shield deductibles and coinsurance amounts.  That form can be found here.

How are prescription coverages different under the Blue Plan?

IRS guidelines do not allow for co-payments by the insurer on prescriptions until the full deductible on the plan is met.  Under the Blue plan, you pay the cost of the drug and that cost is applied to your overall deductible for the Blue plan.  Given the cost of some drugs can be expensive, HealthPartners has designed a prescription plan under the Blue plan that has low cost options on commonly used drugs to help save you money for prescription coverage.  Please see the "Prescription discount list for the Blue Plan" link above to access the list of commonly used drugs discounted by HealthPartners.

I currently use the FSA to help pay for my health care costs.  How will that work under each plan?

If you choose the Maize plan, your FSA will work as it always has. 

If you choose the Blue plan, you will not be able to carry over a FSA balance into 2015. You must spend down your FSA plan to zero by December 31, 2014.  In 2015, all medical reimbursements will come from your HSA under the Blue plan. You will have access to use a limited scope FSA for costs associated with vision and dental costs, however those costs are also covered under a HSA plan.

Are there any changes to the Dependent Care Reimbursement Accounts (DCRA)?

No, the DCRA plan works the same for 2015.

Are my current providers covered?

Most providers are covered under the HealthPartners plan that are covered under your BC/BS plan.  You can verify coverage of your physician by going to: https://www.healthpartners.com/public/find-a-provider/group-medical/  Select the Open Access Network "Find a doctor/dentist" link.

Are my current prescriptions covered?

You are able to check to see if your prescriptions are currently in the HealthPartners formulary by going to: https://www.healthpartners.com/public/pharmacy/formularies/preferredrx/  to look up your drug information.  HealthPartners formulary list is subject to change by HealthPartners.

Will I need to sign up for this change in benefits? What if I currently don't take the medical benefit?

All benefit eligible employees will need to participate in the 2015 Open Enrollment process this Fall even if they currently do not take Carleton's medical insurance and plan on not taking medical insurance for 2015.  We will need documentation from all benefit eligible employees through our benefit enrollment system to accept or waive the coverage under HealthPartners. Notices will be sent out at the beginning of the Fall term to remind eligible employees to participate in the process.  Please be on the look out for more information this Fall.

Are there IRS limits to who the HSA dollars can be spent on?

Yes.  IRS section 152 limits the ability to use HSA dollars to the employee and their dependents.  Dependents have certain criteria that must be met to be able to satisfy.  The IRS has a website where you can determine if someone can be claimed as a dependent. Typically, this means that Domestic Partners or children over the age of 19 (if not in college) or 24 (if in college) on your medical plan would not be eligible to spend HSA dollars on.

Are there limitations to participating in the HSA?

If you have Medicare part A, you are not able to make contributions to a HSA and the college contributions can not be made to the HSA.  Also, if you do not have Medicare part A but have a spouse that does, there are limits to participation in a HSA.  Please contact Human Resources for more information.

  

This page will be updated as more questions and additional information becomes available.  Please check back or contact Melanie (x7142), Andrea (x5989), or Kerstin (x4068) if you have questions or need additional information.