Group Three
POS High-Deductible Health Plans (Compatible with Health Savings Account)
Our High-Deductible Health Plans (HDHP)
High-Deductible Health Plan (HDHP) - Features a set dollar amount that you must spend before the plan begins to cover your health expenses. These plans offer greater predictability, because once you have reached the deductible, your eligible health care expenses are covered for the remainder of the policy year. are a good choice if you are comfortable with greater cost-sharing in exchange for a lower monthly plan premium
Premium (or price) – The monthly fee that is paid to ConnectiCare to provide health coverage, including doctor visits, hospitalizations, medications and other covered benefits. The amount of your premium depends, in part, on the level of your coverage. For example, a health plan with a higher deductible tends to have a lower premium.
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With an HDHP
High-Deductible Health Plan (HDHP) – Plans that feature a set dollar amount that you must spend before the plan begins to cover your health expenses. These plans offer greater predictability, because once you have reached the deductible, your eligible health care expenses are covered for the remainder of the policy year (copayment and coinsurance may apply depending on the plan).
, you are required to meet an upfront deductible
Upfront Deductible Plans – Plans in which most covered health care services you receive apply to a plan deductible, even when you are using an in-network provider. Once this contract year plan deductible is met, you pay a copayment or coinsurance amount and we pay for the rest of the covered service.
for the contract yearContract Year - The 12-month period that begins on the effective date of the policy and each 12-month period following the policy renewal date.. The deductible
Deductible - The amount of medical expenses that you must pay before an insurer will cover any expenses. The deductible amount and what applies to it, are determined by the specific health plan.
amount varies according to the plan you choose. In general, the higher the upfront deductible
Upfront Deductible Plans – Plans in which most covered health care services you receive apply to a plan deductible, even when you are using an in-network provider. Once this contract year plan deductible is met, you pay a copayment or coinsurance amount and we pay for the rest of the covered service.
, the lower the monthly plan premium
Premium (or price) – The monthly fee that is paid to ConnectiCare to provide health coverage, including doctor visits, hospitalizations, medications and other covered benefits. The amount of your premium depends, in part, on the level of your coverage. For example, a health plan with a higher deductible tends to have a lower premium.
. Once the deductible
Deductible - The amount of medical expenses that you must pay before an insurer will cover any expenses. The deductible amount and what applies to it, are determined by the specific health plan.
is met, covered services will be subject to a CopaymentCopayment - A flat fee you pay for certain benefits. The copayment amount may vary by service and whether that service is provided by a health care professional that belongs to ConnectiCare's network of providers. or coinsuranceCoinsurance - The percentage of the cost of benefits that you or ConnectiCare is legally responsible to pay..
If you are attracted to the premium
Premium (or price) – The monthly fee that is paid to ConnectiCare to provide health coverage, including doctor visits, hospitalizations, medications and other covered benefits. The amount of your premium depends, in part, on the level of your coverage. For example, a health plan with a higher deductible tends to have a lower premium.
savings of a ConnectiCare SOLO High-Deductible Health Plan
High-Deductible Health Plan (HDHP) – Plans that feature a set dollar amount that you must spend before the plan begins to cover your health expenses. These plans offer greater predictability, because once you have reached the deductible, your eligible health care expenses are covered for the remainder of the policy year (copayment and coinsurance may apply depending on the plan).
(HDHP), you may wish to combine it with a Health Savings Account (HSA)
Health Savings Account (HSA) – A tax-advantaged savings account for use with a High-Deductible Health Plan that allows you to set aside money to pay for uncovered medical expenses. The money can be invested and earn interest, and it can be left in the account for use in future years. You can withdraw money from the HSA at any time to pay for qualified medical expenses.
. (Do not open the HSA until your application to a ConnectiCare
SOLO HDHP is approved.) HSAs offer tax advantages that make it
easier to set aside money for meeting the health plan deductible
Deductible - The amount of medical expenses that you must pay before an insurer will cover any expenses. The deductible amount and what applies to it, are determined by the specific health plan..
Click here to
learn more about the advantages of an HSA.
Key Benefits:
- Low premiums
Premium (or price) – The monthly fee that is paid to ConnectiCare to provide health coverage, including doctor visits, hospitalizations, medications and other covered benefits. The amount of your premium depends, in part, on the level of your coverage. For example, a health plan with a higher deductible tends to have a lower premium.
- Plan begins to provide benefits after you reach the contract yearContract Year - The 12-month period that begins on the effective date of the policy and each 12-month period following the policy renewal date. plan deductible
Plan Deductible - The total amount of medical expenses that you must pay during the contract year for certain benefits before ConnectiCare insurer will begin paying for those benefits.
- Visit participating providers
Provider – A health care facility or professional, including a doctor, nurse, physician's assistant, who delivers medical services.
to receive the greatest level of benefits
- Visit the doctor of your choice out-of-network for a higher cost-share
- An HSA solution offers a tax-advantaged way for meeting the plan deductible
Plan Deductible - The total amount of medical expenses that you must pay during the contract year for certain benefits before ConnectiCare insurer will begin paying for those benefits.
Qualified Medical Expenses
The savings in an HSA can be used for any IRS-qualified medical expenses, including some that are not covered by the ConnectiCare SOLO plan. These expenses include over-the-counter drugs, eyeglasses, dental services, prescriptions and other medical supplies. For a partial list of qualified and non-qualified expenses, please refer to IRS Publication 502.
(Note: The contract-year deductibles can be reached by any combination of covered health services or covered prescription drug services. The individual contract-year deductible only applies if you are the policyholder and there are no other covered lives on the contract. If you have family coverage (two or more covered lives), then covered health services and covered prescription drugs will be applied to the family contract-year deductible until the total amount is met, without regard to which family member uses the benefits.)
These plans are now compliant with the new Health Care ReformPatient Protection and Affordable Care Act (PPACA) - More commonly know as Health Care Reform, is now the law of the land. It is a federal statue that was signed into law on March 23, 2010. law, in which preventive care
Preventive Care – Measures taken to prevent illness or injury, rather than to treat it. Preventive care can include immunizations, screening tests, and examinations to test for specific conditions based on an individual's family history.
is not subject to member cost-share.
