An independent licensee of the Blue Cross and Blue Shield Association

City of Rocky Mount

2009 Open Enrollment

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Your 2009 Medical Plans: How They Compare

Medical Plan Option PPO(in network)

HSA (in network)

Copayments $40 PCP$75 Specialist

You pay 100% for services until you meet your deductible.

All Preventive care covered at 100% (before deductible)

Coinsurance 80% 80%

Calendar Year Deductible $1,250 Individual$3,750 Family

$1,500 Individual$3,000 Family

Out-of-Pocket Maximum $5,250 Individual$15,750 Family(includes the deductible)

$3,500 Individual$5,000 Family (includes the deductible)

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Blue Options HSA

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High Deductible PPO Plan

Health Savings Account (HSA)

(for medical expenses)+

What is Blue Options HSA?

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• High deductible PPO Health Plan– Designed to put you more in control of health care spending:

• No co-payments (you pay 100% of health care and prescription costs until you meet deductible)

• Learn to make more informed decisions about health care.

• HSA – Tax-free savings account for medical expenses

• You and/or City of Rocky Mount contribute money tax-free• You use money in your account to pay for medical expenses tax-free• Money earns interest over time and grows tax-free! • You control how to use funds in your account.• You can use your funds now or save them for future expenses

What is Blue Options HSA?

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1 Referrals may be needed for mental health and substance abuse services

• Choose the doctor you want from our large network

• Option of out-of-network benefits

• Access to specialists with no referrals1

• You save big with our provider discounts.

• Nationwide, worldwide coverage

Different from current plan:

• High deductible – required by federal government

• Aggregate family deductible• Use your health savings account

to pay for health care services• No co-payments for services –

you pay 100% until you meet your deductible

• Preventative care covered at 100%

How is Blue Options HSA different from the Traditional PPO plans?

Similar to your current plan:

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Covered Preventive Care Services

Preventive Services Covered at 100% without having to meet your deductible

• Well baby and well child care

• Adult preventive care

• Routine Screening tests (adult and child)

• Immunizations (adult and child)

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Health Savings Account Features

• Pay for current and future qualified medical expenses with funds in your account using a debit card

• City of Rocky Mount contributes tax-free money: – $500 per benefit period for individual coverage

– $500 per benefit period for family coverage

Note: City of Rocky Mount will contribute the company contribution

up front.

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How should I contribute to my HSA?

• You have many options:

– Contribute through payroll deduction, tax-free– Make quarterly or monthly contributions on your own (deduct on your tax

return)– Contribute the maximum at the beginning of the year (deduct on your tax

return)– Contribute throughout the year, as you can (deduct on your tax return)

• Your 2009 contribution limits after the City of Rocky Mount contribution:– $2,500 per year for Employee only – $5,450 per year for family coverage– $1,000 per year catch-up contribution (55 or older by 12/31/09)

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How does a trip to the doctor work?• Visit a Blue Options in-network provider

• Your provider may collect an estimated amount or bill you later

• BCBSNC processes your claim for the negotiated amounts and sends you an explanation of the benefits

• The provider bills you for any remaining amount of the services

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How do you pay for expenses from the HSA?

– Deductible and coinsurance amounts– Visits to your doctor– Medical procedures– Prescription drugs– AND, some things you wouldn’t expect, like:

• Over-the-counter medications

• LASIK eye surgery

• Bandages

– Visit www.irs.gov/publications/p969 for a complete list

Qualified medical expenses include:

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Why will I like Blue Options HSA?• Tax savings

– Contribute tax-free– Save funds in your HSA tax-free– Pay for medical expenses tax-free

• Aggregate deductible– All family expenses count toward a single

deductible• 100% coverage after out-of-pocket max

– If you spend more than your out-of-pocket maximum, BCBSNC pays all of your covered expenses (including prescription drugs) for the rest of your plan year.

– This protects you from catastrophic expenses

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Why will I like Blue Options HSA?• Savings

– The money you don’t use for medical expenses can grow over time

• Portability– Take your HSA funds with you if you leave your

current job– You can use them now or in the future – even in

retirement• Easy online access

– See all your claims and benefit information at www.bcbsnc.com/memberservices

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What information is available to help me make health care decisions?

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How do I get started?1. Enroll in Blue Options HSA during the Open Enrollment

2. Decide how much you want to contribute for the year (in addition to your employer’s contribution)

3. Open your Credit Union HSA Account

4. Begin funding your HSA through automatic payroll deduction, electronic funds transfer or tax-deductible lump-sum deposit.

5. Receive and begin using your Credit Union debit card on July 1, 2009

The Credit Union will be at the following meetings:

• April 17th 8am – 1pm Environmental Services

• April 22nd City Hall 1pm – 5pm

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Thank you!