CASE SCENARIO
YOU ARE NEWLY ENROLLED (I.E., A SUBSCRIBER) IN A CONSUMER-DRIVEN HEALTH PLAN (CDHP) SPONSORED BY YOUR EMPLOYER.
LIKE ANY OTHER CDHP, YOUR OWN CDHP CONTAINS TWO SEPARATE BUT PAIRED ACCOUNTS: 1) AN EMPLOYEE PRE-TAX CONTRIBUTORY AND INTEREST-EARNING ACCOUNT IN THE FORM OF AHEALTH SAVINGS ACCOUNT(HSA) TO COVER YOUR COST-SHARING EXPENSES; AND 2) AHIGH-DEDUCTIBLE HEALTH PLAN(HDHP), WHICH NATURALLY HAS A HIGHER ANNUAL DEDUCTIBLE AND OUT-OF-POCKET MAXIMUM LIMIT THAN OTHER TYPES OF HEALTH INSURANCE, IN EXCHANGE FOR CHARGING YOU A LOWER-THAN-AVERAGE INSURANCE PREMIUM.WITH AN HDHP, YOU KNOW THAT THE ANNUAL DEDUCTIBLE MUST BE MET BEFORE YOUR PAYMENTS CAN BE MADE ON THE BASIS OF A COINSURANCE WHICH YOU THEN PAY UNTIL YOU MEET THE MAXIMUM OUT-OF-POCKET COST (ALSO KNOWN AS THE CATASTROPHIC LIMIT). ONCE YOU HIT THAT CATASTROPHIC LIMIT, YOUR CDHP WILL PAY 100% OF YOUR HEALTHCARE FOR THE YEAR.IN THAT SENSE, YOURHDHP PROTECTS YOU AGAINST CATASTROPHIC OUT-OF-POCKET EXPENSES FOR COVERED (IN-NETWORK) SERVICES.
YOUR HSA CONTRIBUTIONS AND MEDICAL EXPENSES
FOR THE YEAR 2019, YOU AND YOUR EMPLOYER CONTRIBUTED THE AMOUNTS BELOW TO YOUR HSA, AND YOUR VARIOUS 2019 MEDICAL EXPENSES BELOW (ALL IN-NETWORK) WEREALLCOUNTED TOWARD YOUR DEDUCTIBLE:
‣YOUR HSA BALANCE ON 01/01/2019 $ 0‣YOUR EMPLOYEE CONTRIBUTIONS:$2000‣YOUR EMPLOYER CONTRIBUTIONS:$ 0 (WILL START ONLY IN 2020)‣HSA INTEREST $ 0‣YOUR HEALTHCARE EXPENSES$4500(BROKEN DOWN BY EXPENSE ITEM BELOW):
•YOUR 2VISITS/CONSULTATIONCOPAYS TO MEDICAL SPECIALIST @$50 EACH = $100•YOURLAB 1 = $400•YOURLAB 2 = $500•YOUR SURGERY = $3000•YOUR PRESCRIPTION DRUG COST= $500
YOUR HDHP TERMS AND PROVISIONS
THE TERMS AND PROVISIONS OF YOUR HDHP FOR 2019 ARE AS FOLLOWS:
•YOURANNUAL 2019 DEDUCTIBLE = $3000•YOURCOINSURANCEAFTER YOU MEET THE DEDUCTIBLE=20%•HDHP FINANCIAL OBLIGATION AFTER YOU MEET THE DEDUCTIBLE =80%•YOUR 2019 MAXIMUM OUT-OF-POCKET COST = $5000
WHAT YOU NEED TO DO BEFORE TAKING THE CANVAS QUIZ
IT IS DECEMBER 31, 2019, AND THE YEAR 2019 IS PRACTICALLY OVER. IT IS TIME FOR YOU TO DO YOUR ACCOUNTING OF YOUR 2019 PLAN EXPENSES. BASED ON THE ABOVE INFORMATION, CALCULATE THE FOLLOWING:
•HOW MUCH YOU PAID OUT OF YOURHSABALANCE TO COVER YOUR 2019 EXPENSES. •HOW MUCH YOU PAID OUT-OF-POCKET IN 2019TOMEET/SATISFY THE PLAN DEDUCTIBLE.•HOW MUCH YOU PAID FORCOINSURANCE (AFTER MEETING/SATISFYING THE PLAN DEDUCTIBLE).•HOW MUCH WEREYOURTOTALHEALTHCARE (SUBSCRIBER) PAYMENTSFOR 2019 (I.E., EVERYTHING INCLUDED: PROCEDURES, TREATMENTS, COPAYS, DEDUCTIBLE, COINSURANCE, ETC.)?•HOW MUCHYOURCDHP PAIDIN TOTALFOR YOUR HEALTHCARE EXPENDITURES IN 2019?