California Health Insurance Quotes » Health Insurance

Lumenos® Health Savings Account (HSA) plan

admin — Wed, 26 Aug 2009 00:33:34 +0000

When you enroll in our Lumenos HSA plan, you’ll get:

Health Savings Account (HSA)

An account funded by your tax-free contributions to use on qualified medical expenses and prescriptions. Others may also contribute to your HSA. Qualified medical expenses are defined by Internal Revenue Code Section 213(d).

You may use available HSA funds first to pay the cost of covered medical expenses and prescriptions.

Unused funds rollover year-to-year.

Unlimited choice of providers. If you see in-network providers, you may pay less for your care.

Plus, get 100% coverage for nationally recommended preventive care services with no deduction from your HSA and no out-of-pocket costs to you if you see an in-network provider.

Traditional Health Coverage

A comprehensive health plan providing added protection for you and your family after you have met your plan’s annual deductible.

Traditional Health Coverage begins after you have used your HSA balance (if you choose to use HSA funds to pay for covered services) and paid a limited amount out-of-pocket – called your Bridge – needed to satisfy your plan’s annual deductible.

Your total expenses are limited to a maximum amount each year, after which you receive 100% protection for covered services.

Unlimited choice of providers. If you see in-network providers, you may pay less for your care.

Personalized Services and Tools

We provide you with online tools and personalized resources to help you live a healthier life.

Use our ProviderFinder online directory to find doctors and hospitals that participate in our network.

Find tools to help you stay healthy, manage a health condition and prepare for a surgical procedure. Also make comparisons on quality and find cost information for medical services and prescription drugs.

Track your account activity, claims and benefits.

Get personalized help managing a condition from a health coach if you qualify.

Talk to registered nurses about minor health concerns on our 24/7 NurseLine.

The above information does not constitute legal, tax, or benefit plan design advice. Anthem strongly encourages consultation with a tax advisor before establishing a Health Savings Account. Any Health Savings Account will be established between the individual account holder and the HSA custodian or trustee. Anthem is responsible for the administration of the health plan, and the custodian is responsible for the administration of the HSA.

Your HSA with Mellon

The Lumenos HSA Plan includes account servicing for your HSA through Mellon Trust of New England. While you are not required to use Mellon for your HSA, the features and services included with the Mellon HSA were designed to meet all of your HSA needs.

Key Features

The Mellon HSA provides many useful features, tools and services for your HSA.

a single point of contact for health plan and HSA customer service

a single online health site to access your benefits and HSA details

competitive interest rates and investment options for your HSA funds

Interest and Investments

You will earn interest on your HSA funds and will also have the opportunity to invest your funds once your HSA balance reaches $3000. Investment options include seven different mutual funds from the Dreyfus family of mutual funds. Once you are ready to invest, you can request a prospectus for each fund for more details.

Debit Cards and Checkbooks

Use your MasterCard® debit card or your HSA checkbook to pay your health care provider directly for eligible medical expenses, or to access cash from your account.

One Stop Customer Service

Contact an Anthem Customer Service Advocate for help with your health plan and HSA questions. You can also logon to the online health site and visit the My Account page to find answers to many of your questions like “What is my HSA balance?”

Account Activity Statements

Each month you will receive an HSA Monthly Statement from Mellon that shows all of your account activity. You will also receive a 1099 form and a 5498 form near tax time so you can file your taxes.

HSA Welcome Kit

After you enroll in your Lumenos HSA Plan with Mellon, your HSA account with Mellon will automatically be established – a separate application for your HSA is not required. Soon after enrollment, you will receive an HSA Welcome Kit with all of the banking documentation and instructions for how to activate your HSA. To activate your HSA, you’ll need to complete a simple signature process – online or by mail.

Health Savings Account Fee and Rate Schedule

The following administration and banking fees apply to the HSA with Mellon Bank:

Administrative fees

Banking fees apply

Monthly account fee $2.95

Debit card transactions no charge

Check writing no charge

ATM transactions $1

Card replacement fee $5

Check reorder $10

Non-sufficient funds $25

Stop check service $25

Duplicate check $5

Aetna* Managed Choice® Open Access High Deductible 3000 Health Insurance Plan

admin — Sat, 11 Oct 2008 23:05:49 +0000

Lower premiums
High deductible, then 20% for most visits and services
Allows you to open a tax-advantaged HSA

The Aetna Advantage Managed Choice Open Access High Deductible 3000 Plan is designed to work in conjunction with contributions to a Health Savings Account (HSA). An HSA allows you to pay for qualified medical expenses on a tax-advantaged basis. Your premium payments could be lower. The “high-deductible” part means that you’ll pay more out of pocket than with most other plans before coverage kicks in.

Features of the Managed Choice Open Access High Deductible 3000 Plan (in-network rates)
Lower Premiums

Annual deductible $3,000 individual; $6,000 family
Out-of-pocket maximum $3,000 individual; $6,000 family
Office visit copay 0% after deductible***
Prescription drug copay 0% after deductible****
Hospitalization 0% after deductible***
Skilled nursing, physical/occupational therapy, chiropractic care, home health care, durable medical equipment 0% after deductible***

Like other Aetna Managed Choice health insurance plans, the Managed Choice Open Access High Deductible 3000 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses. The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers.

Your next step
This page gives a quick overview of this health insurance plan and does not include all of its features and specifications. Health insurance plans contain exclusions and limitations. Before you decide if it’s right for you, be sure to get more detailed information below, or Get a Quote.

Review the coverages available to you:

Are you a small business looking to insure 2 to 50 employees? If so, please visit the Small Group Employer section of our website.

* Aetna Advantage Plans for individuals, families and the self-employed are underwritten by Aetna Life Insurance Company (Aetna) directly and/or through an out of state blanket trust and Aetna Health Inc. In some states, individuals may qualify as a business group of one and may be eligible for guaranteed issue, small group health plans.

** Investment services are independently offered through JPMorgan Institutional Investors, Inc., a subsidiary of JPMorgan Chase Bank.

*** For covered expenses.

**** Integrated Medical/Rx Deductible.

Anthem Blue Cross Smart Sense PPO

admin — Mon, 01 Sep 2008 01:07:15 +0000

Introducing SmartSense.

Smart health coverage with sensible savings.

If you want reliable, essential protection at some of most affordable monthly rates, SmartSense could be the health plan you’re looking for.
What makes SmartSense so smart is how it balances solid health coverage with opportunities to save money, including:

A wide range of annual deductible/monthly rate combinations. Just choose the one that fits your budget.
Lower rates on services when you use our network of more than 50,000 doctors and 400 hospitals. This means your share of medical costs will be lower, too.
Immediate benefits for your first three in-network doctor visits. You’ll just have copays with no deductible to meet.
A choice of prescription drug benefits (brand-name and generic drugs, or (generics only). This helps keep your out-of-pocket prescription costs to a minimum.
Health and wellness programs. The healthier you are, the more you’ll save on health care.
Out-of-state coverage. This protects you from the high cost of unexpected emergencies when you travel.

For a total benefit solution, we also offer a wide range of dental and term life coverage options.

SmartSense benefits at-a-glance These amounts show your share of costs after deductibles, if any.
Plan Benefit	In-Network Receive negotiated savings	Out-of-network Pay higher costs
Lifetime Maximum (combined for in and out-of-network)	Health plan pays up to $7,000,000 per member	Health plan pays up to $7,000,000 per member
Annual Deductible Choices (not combined for in and out-of-network)	Single member: $500/$1,500/$2,500/$5,000 Family maximum1: $1,000/$3,000/$5,000/$10,000	Single member: $5,000 Family maximum: $10,000
Annual Out-of-Pocket Maximum2 (in addition to deductible; not combined for in- and out-of-network)	Single member: $2,500 Family maximum: $5,000	Single member: $10,000 Family maximum: $20,000
Doctors’ Office Visits	$30 copay for first three visits3 per member per year (deductible waived); after three visits and once deductible is met, then 30% of negotiated fee	50% of negotiated fee plus all excess charges
Professional Services (x-ray, lab, anesthesia, surgeon, etc.)	30% of negotiated fee	50% of negotiated fee plus all excess charges
Hospital Inpatient (overnight hospital stays)	30% of negotiated fee	All charges except $650 per day
Hospital Outpatient (if you don’t stay overnight)	30% of negotiated fee	All charges except $380 per day
Emergency Room Services4	30% of negotiated fee	50% of customary and reasonable fees plus all excess charges
Maternity	Not covered	Not covered
Preventive Care	Annual physical exam(s): 30% of negotiated fee Routine mammogram, Pap and PSA tests5: 30% of negotiated fee Well Baby and Well Child (through age 6): 30% of negotiated fee	Annual physical exam(s): 50% of negotiated fee plus all excess charges Routine mammogram, Pap and PSA tests5: 50% of negotiated fee plus all excess charges Well Baby and Well Child (through age 6): 50% of negotiated fee plus all excess charges
Ambulance	30% of negotiated fee	50% of negotiated fee plus all excess charges
Physical/Occupational/Speech Therapy; Chiropractic Services	30% of negotiated fee Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropractic services	50% of negotiated fee plus all excess charges Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropractic services

Prescription Drug Coverage Options	In-Network Receive negotiated savings	Out-of-network Pay higher costs
SmartSense with Generic Prescription Drug CoverageGeneric (drugs on Generic Rx formulary only)	Generic: $15 copay (or 40%, whichever is greater)	Generic: $15 copay (or 40%, whichever is greater)
SmartSense with Comprehensive Prescription Drug Coverage (Anthem Blue Cross Formulary Drugs)	Generic: $15 copay (or 40%, whichever is greater) $500 annual brand-name/specialty drug Brand-name6: $15 copay (or 40%, whichever is greater7); 40% of negotiated fee for self-administered injectables, except insulin Specialty8: 40% $4,500 annual out-of-pocket maximum (the most you will have to pay) (In-network only and in addition to brand-name/specialty drug deductible)9 deductible (2-member maximum) applies before the following:	Generic: $15 copay (or 40%, whichever is greater) $500 annual brand-name/specialty drug Brand-name6: $15 copay (or 40%, whichever is greater7); 40% of negotiated fee for self-administered injectables, except insulin Specialty: Not covered deductible applies before the following:
1 Once a member meets their single deductible, their deductible is satisfied. After one family member’s single deductible is satisfied, the family maximum can be met by two or more family members. 2 Excludes non-participating charges in excess of the Anthem Blue Cross negotiated fee and non-participating charges in excess of customary and reasonable fees for emergency care. Copays/coinsurance to participating and non-participating providers apply to out-of-pocket maximum except where specifically noted in the policy. 3 Applies to first three preventive care visits and/or doctors’ office visits. 4 Additional $100 copay applies for each emergency room visit. Waived if admitted as inpatient. 5 Tests ordered by a physician are covered, including appropriate screening for breast, cervical and ovarian cancer. 6 If a member selects a brand-name drug when a generic equivalent drug is available, even if the physician writes a “dispense as written” or “do not substitute” prescription, the member will be responsible for the generic copay plus the difference in cost between the brand-name drug and the generic equivalent drug. The amount paid does not apply to the member’s brand-name deductible. 7 Not to exceed $500 maximum (the most you would need to pay) per brand-name prescription. 8 Specialty drugs include injected, infused, oral and inhaled medications that generally need to be closely monitored by your doctor. These drugs tend to be higher in cost and often require special handling and ordering. 9 The annual brand-name/specialty drug deductible and annual brand-name/specialty drug out of-pocket maximum are separate from the annual medical deductible and annual medical out of maximum. They are not combined for in-network and out-of-network.