Medical Benefits

We’re proud to offer you the following medical plan choices designed to help you and your family get the care you need at an affordable price.

Health Maintenance Organization (HMO)

The HMO plan provides coverage through in-network doctors from which you will select a primary care physician (PCP) who refers you to specialists if you need them. You are responsible for copays when you receive services.

Coverage for out-of-network providers is not available with this plan. If you seek treatment from an out-of-network provider, you will be responsible for the full cost of treatment.

Preferred Provider Organization (PPO)

The Preferred Provider Organization (PPO) plan offers the flexibility to choose an in-network or out-of-network provider each time you need care. Keep in mind, you will save money when you visit in-network providers.

High Deductible Health Plan with HSA

The HDHP HSA plan pairs a High Deductible Health Plan with a Health Savings Account (HSA). With this plan, you are responsible for most expenses up to a certain dollar limit, known as the deductible. After you meet the deductible, you will share a percentage of the expenses in the form of coinsurance. The out-of-pocket maximum limits the total amount you could be responsible for in a given year. If you reach the out-of-pocket maximum, the plan picks up the cost for all covered services from that point until the rest of the plan year.

When you enroll in the plan, you are eligible to open a Health Savings Account (HSA) to set aside pre-tax dollars to pay for medical, prescription drug, dental, and vision care needs. You can even use it to cover the expenses of your spouse and dependents, even if they are not on your plan.

HSAs offer many benefits, including the following:

  • Your contribution to the HSA is a pre-taxed benefit and you earn tax-free interest on HSA balances.*
  • You own your HSA, even if you change jobs or retire.
  • You don’t pay taxes when paying for qualified medical expenses.*
  • Your HSA balance can be carried over year after year.
  • You can use your HSA to help add to your retirement funds.
  • After you turn age 65, you can withdraw funds from your HSA for any reason without penalty.

Contributions can be made up to the IRS maximum. In 2018, you can save up to $3,450 for individual coverage and $6,900 for family coverage. Participants age 55 and older can save an extra $1,000 each year.

Keep in mind, if you are enrolled in Medicare or covered under another plan, you are not eligible to make contributions to an HSA.

*HSAs are never taxed at a federal income tax level when used appropriately for qualified medical expenses. Most states recognize HSA funds as tax-free with very few exceptions. Please consult a tax advisor regarding your state’s specific rules.

High Deductible Health Plan (HDHP) with HRA

The Health Reimbursement Account (HRA) is funded by your employer. The account works with your medical plan to help you pay the out-of-pocket costs for certain covered medical expenses.

Plans may vary. Below is a summary of how an HRA works:

  • At the start of the plan year, your employer deposits a specified dollar amount into your HRA.
  • The money in your HRA can be used to pay for eligible health care expenses and counts toward your deductible.
  • After the money in your account is used up, you are responsible for all of your health care expenses up to the annual deductible amount.
  • When you reach the annual deductible, you and the health plan share the costs (coinsurance) for covered services.
  • Your costs for covered services are limited by an out-of-pocket maximum as defined by your plan.
  • Funds not used during the plan year may or may not roll over to your account the next year (depending on your plan). Contact your employer for details.

See the Benefits Guide or benefit summaries for detailed plan information.

Stay Healthy with Medical Coverage


Find out how you can get the Advantage

Chris Lonergan
(541) 323-1211


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