UPMC Health Plan | Health Insurance

MEMBERS

Benefit Information

Click on the links below to learn more about the benefits of UPMC Health Plan.

Consumer Advantage – Consumer Directed Health Plans

Health Reimbursement Account (HRA)

The UPMC Consumer Advantage Health Reimbursement Account (HRA) is owned and funded by the employer and can be used by the employee to help pay for any covered health care expenses during the deductible period. An HRA can pay for:

Copayments
Coinsurance
Prescription drugs
Many other covered medical expenses

Employees must be enrolled in UPMC Consumer Advantage to be eligible for the HRA that can help cover a portion of the deductible. Employees receive a tax benefit because payments for qualified medical expenses from the HRA are not taxed.

Any additional costs for medical services are paid by the employee, out-of-pocket, until the deductible is met. Once the deductible is met, claims are paid in full through a PPO plan design, subject to any coinsurance for which the employee is responsible.

The employer owns and funds the HRA and determines if any unused funds in the HRA can be rolled over for the next benefit year. Also, employees can only access and use the HRA funds while they are employed by the employer.

Health Savings Account (HSA)

UPMC Consumer Advantage offers a Health Savings Account (HSA) powered by ACS/Mellon. HSAs are an important part of a revolution in health care funding — a revolution offering health care savings, control, and ownership. With the UPMC Consumer Advantage HSA, your employees can take advantage of tremendous tax savings and build a reserve for current and future health care expenses so they can continue to enjoy the security of health care coverage that protects them and their families.

An HSA is a savings account that is owned by the employee and can be funded by the employee, employer, or both. It is like a health care “piggy bank” with federal tax advantages:

Contributions are tax-free.
Potential interest and investment gains accumulate tax-free.
Distributions are tax-free when used to pay for qualified medical expenses.
The remaining balance rolls over from year to year, regardless of job changes or retirement.
In addition to the federal advantages, most states mirror this tax-free status with state tax deductions and/or rebates.

Tax-free HSA funds can be used by your employees to pay for almost all health care expenses, such as doctor and hospital visits, or copayments, eyeglasses, and prescriptions. If the employee’s combined expenses — whether small expenses, routine costs, or a serious accident or injury — exceed their health plan deductible, an out-of-pocket maximum caps costs while coverage continues. You can view a full list of qualified health care expenses at the IRS website, www.irs.gov.

Growing the HSA
Each year, contributions can be made up to the annual IRS limit. For 2008, that maximum equals $2,900 for individuals and $5,800 for families. If the employee is age 55 or older, additional catch-up contributions of up to $900 can be made. The employee can make contributions pretax through automatic payroll deduction, if available, or through an after-tax lump sum check, taking a deduction on their taxes at the end of the tax year.

No “Use It or Lose It”
Unlike other medical savings accounts, the HSA has no provision insisting the employee must “use or lose” their account dollars at year’s end. Any funds not used in a given plan year remain in the account, building a larger, interest-bearing account for future health care expenses.

Invest in Interest-bearing Savings
The ACS/Mellon HSA SolutionSM features investment options including multiple equity, balanced, and fixed income options. Fact sheets, prospectuses, and historical performance information for all funds are available at www.hsamember.com.

Life Transitions
Because an HSA is owned by the employee, they can continue to contribute and use the account funds even if they leave the company – as long as they continue to be enrolled in a qualified high-deductible health plan.

Invest in the Future
At a certain level of savings, employees can begin directing some of their HSA savings into Dreyfus investment accounts. Much like a 401(k), an HSA can become an investment fund.

Pharmacy

Condition Management

Consumer Advantage – Consumer Directed Health Plans

Health Reimbursement Account (HRA)

Health Savings Account (HSA)

MyFlex Advantage — Flexible Spending Accounts

Vision

Care while traveling — Assist America

MyHealth Advice Line

MyHealth Community

Behavioral Health Management