Frequently Asked Questions

We know that health care plans and tax-favored accounts can be confusing, so we’ve developed a list of the most frequently asked questions and the answers. We understand that this won’t answer all the questions you may have, so please contact your campus benefit representative or the HR Service Center (573-882-2146 or HRServiceCenter@umsystem.edu) if you have additional questions that we haven’t answered here.

 

Q. How are the Healthy Savings Plan (formerly myOptions), Custom Network Plan (new in the Columbia area), and the PPO Plan (formerly myChoice) different?

A. You might want to begin by watching our video called Making Your Medical Plan Choice, which describes the three medical plans:

VIDEO: Making Your Medical Plan Choice

The Healthy Savings Plan is an IRS-qualified high-decuctible health care plan that offers a lower premium with a higher deductible. Because it is qualified by the IRS, it can be paired with a Health Savings Account (HSA) to offset your higher deductible. Plus, the University contributes to your HSA to help pay the higher deductible and any out-of-pocket medical, dental and vision expenses. You may choose to contribute to your HSA, too, up to the IRS maximums, but you do not have to do so to earn the University contribution.

The Custom Network Plan and the PPO Plan work in much the same way. The Custom Network Plan is offered only in the Columbia area, however, and offers a network that is specially selected to keep costs low. It offers the middle-level of montly premiums, if you are comparing against the other two plans, but the lowest deductible ($0 for in-network services). The PPO Plan has the same nation-wide network as the Healthy Savings Plan and has the highest premium but a lower deductible.

Generally speaking, with both the Custom Network Plan and the PPO Plan, you will pay less per medical service than with the Healthy Savings Plan until you meet the respective deductibles. The Custom Network Plan and PPO Plan have a higher out-of-pocket maximum than the Healthy Savings Plan.

The Custom Network Plan and PPO Plan can be paired with a Flexible Spending Account to offset out of pocket health care expenses.

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Q. How does the deductible and out-of-pocket maximum work with the Healthy Savings Plan?

A. The deductible is the total amount members are required to pay each year before the plan begins to pay a benefit. Under the Healthy Savings Plan, if you have individual coverage, you must satisfy the individual deductible of $1,500 for network services ($3,000 for non-network services) in 2015 before any benefit will be paid. If you have family coverage (two or more are covered), you and/or your dependents must satisfy the family deductible of $3,000 for network services ($6,000 for non-network services) before any benefits will be paid for any member. Your 2015 Annual Enrollment Decision Guide -- both the Columbia version and the Kansas City, Rolla and St. Louis version -- provides more details about the plan.

Both Medical and Pharmacy (prescription drug claims) services combined accumulate toward the Healthy Savings Plan deductible and maximum out-of-pocket amounts.

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Q. How does the deductible and out-of-pocket maximum work with the Custom Network Plan?

A. The deductible is the total amount members are required to pay each year before the plan begins to pay a benefit. Under the Custom Network Plan, there is a $0 deductible (i.e, no deductible) for network services. Each member must meet the individual deductible of $500 for non-network services or three family members may meet their deductible to reach the maximum $1,500 family deductible for non-network services before a benefit will be paid for any covered member. Your 2015 Annual Enrollment Decision Guide -- just the Columbia version -- provides more details about the plan.

These deductible amounts apply only to Medical services under the Custom Network Plan; a separate deductible applies to prescription drugs purchased at a retail pharmacy.

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Q. How does the deductible and out-of-pocket maximum work with the PPO Plan?

A. The deductible is the total amount members are required to pay each year before the plan begins to pay a benefit. Under the PPO Plan, each member must meet the individual deductible of $350 for network services ($700 for non-network services) or three family members may meet their deductible to reach the maximum $1,050 family deductible for network services ($2,100 for non-network services) before a benefit will be paid for any covered member. Your 2015 Annual Enrollment Decision Guide -- both the Columbia version and the Kansas City, Rolla and St. Louis version -- provides more details about the plan..

These deductible amounts apply only to Medical services under the PPO Plan; a separate deductible applies to prescription drugs purchased at a retail pharmacy.

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Q: What is the coverage area for the Custom Network Plan?

A: The nine counties in and around Columbia, Missouri, are covered by the Custom Network Plan. See the coverage map (PDF).

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Q: What providers are in-network under the Custom Network Plan?

A: The Custom Network Plan is able to keep costs low by partnering with a select network of providers -- primarily from MU Health System. See the list of in-network facilities (PDF). Or, see the list of physicians sorted by last name or sorted by specialty.

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Q. What are the tax-favored accounts for health care expenses?

A. There are two tax-favored accounts available for 2015. Which you use will depend on what medical plan you choose. The two accounts are a Health Savings Account (HSA) and a Health Care Flexible Spending Account (FSA). The HSA is available to those people enrolled in an IRS-qualified high-deductible health plan. The only University medical plan that qualifies is the Healthy Savings Plan. The FSA is available to those employees enrolled in the Custom Network Plan or the PPO Plan. Both the HSA and FSA are described in more detail in other questions on this page.

(Keep in mind that a Dependent Care FSA is different than a Health Care FSA. A Dependent Care FSA is available to everyone, regardless of which medical plan you choose.)

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Q. What is an HSA?

A. If you choose the Healthy Savings Plan and are not covered by another plan (including Medicare) or claimed on another’s taxes, you are eligible to set up an HSA to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis. The account is owned and managed by the employee/retiree, and funds remain in the account from year to year if not used for qualified (medical , dental and/or vision) expenses. Penalties may apply when funds are withdrawn to pay for anything other than qualifying medical expenses. If you leave the university, the funds in the account go with you. Both you and the university can contribute to the account. The University makes an annual contribution to your HSA regardless of whether you make a contribution yourself. Learn more at Understanding Your HSA.

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Q. What is an FSA?

A. Faculty and staff enrolled in the Custom Network Plan or the PPO Plan, as well as faculty and staff who are benefit-eligible but not enrolled in any University medical plan, can enroll in a Health Care Flexible Spending Account (FSA). Retirees are not eligible for an FSA. An FSA allows money to be deducted from your paycheck on a pre-tax basis to pay for qualifying health care expenses. (Note: Any benefit-eligible faculty or staff member, regardless of the medical plan they are enrolled in, may also use a Dependent Care FSA for child/day care expenses, but this is a separate election.) By reducing your taxable income, a Health Care FSA can save you a substantial amount on a wide range of IRS-qualified medical, dental and vision expenses that are not covered by your insurance. Contributions to your FSA accounts are exempt from federal and, in some cases, state income taxes. The catch is that if you do not use all your contributions within the plan year, you forfeit any money left in your account at the end of the year. It is important to carefully budget your contributions and expenses for the year.

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Q. Do I have to have health insurance to have an HSA?

A: Yes. To be eligible to open and contribute to an HSA, you need to be enrolled in a qualified high-deductible health plan (HDHP). Enrollment in the University’s Healthy Savings Plan qualifies your for an HSA; it has an in-network deductible of $1,500 for Self-only and $3,000 for Family coverage.

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Q: Who owns the HSA?

A: The HSA is owned and managed by the employee/retiree. The minute the University's annual contribution is deposited in your account, it is yours to keep, even if you leave the University. Likewise, any contributions you make with your own money are yours to keep.

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Q: Who contributes to the HSA?

A: The employee/retiree and the employer may contribute a combined amount that equals up to the 2015 IRS annual limits. An additional catch-up contribution may be made if you are 55 years old or older. See the Understanding Your HSA webpage for details.

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Q: Does the money in my HSA earn interest?

A: Yes, and tax-free. HealthEquity calculates, compounds, and credits interest monthly based on the applicable rate for different tiers of the account balance. For current rates, see the interest rate page in the HealthEquity online resource center at HealthEquity.com.

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Q: Can I invest the money in my HSA?

A: Yes. Similar to an IRA, you may invest a portion of your account balance in mutual funds available through HealthEquity HSA.

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Q: How much money can I contribute to my HSA?

A: For 2015, the maximum contribution set by the IRS for an individual account is $3,350 and the maximum contribution for family account is $6,650. Those enrollees age 55 or older can make an additional catch-up contribution of $1,000 per year. These limits apply to the combined total of what you and the University contribute. See the Understanding Your HSA webpage for details.

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Q: What happens to the money in my HSA if I leave my job or retire?

A: The HSA is in your name. It is your account and goes with you if you leave employment with the University--including contributions made by the University. If you are on Medicare or go to another employer that does not have a qualified high-deductible health plan, you can still use your HSA money for qualified medical expenses but will not be able to continue to make contributions.

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Q: Does the money I have in my HSA roll over from year to year, or do I lose the money at the end of the year?

A: The money continues to accumulate from year to year. You don’t lose the money left in your HSA or the interest it has earned.  It is your money.

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Q: Can I take the money out of my HSA any time I want?

A: Yes. You can take money out any time tax-free and without penalty as long as it is used to pay for qualified medical expenses. If you take money out for other purposes, however, you will pay income taxes on the withdrawal plus a 20% tax penalty.

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Q: What medical expenses qualify under an HSA?

A: Qualified medical expenses are those that would generally qualify for the medical and dental expenses income tax deduction as outlined in IRS Publication 502 Medical and Dental Expenses. See www.irs.gov/publications/p502/index for a current complete list.

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Q: If my spouse is on Medicare, can I contribute to an HSA?

A: Yes. As long as you are not enrolled in Medicare yourself and are still enrolled in a qualified high-deductible health plan like the Healthy Savings Plan, you can contribute to your HSA.

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Q: Can I have an HSA account if my spouse has a Health Care Flexible Spending Account (FSA) through his/her employer?

A: You cannot have an HSA account if your spouse has a Health Care FSA through his/her employer under which money can be reimbursed for your eligible health care expenses.

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Q: What company is the HSA managed by?

A: For 2015, HealthEquity, in partnership with Coventry Health Care, will provide HSA accounts for eligible University faculty and staff.

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Q: How do I contact HealthEquity?

A: You can call HealthEquity’s dedicated service line for University of Missouri, which is 877-372-5383, available 24 hours a day, 7 days a week.

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Q: How do I contact Coventry?

A: You can call Coventry member services at 1-800-613-7721 or visit www.ummedcvty.com.

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Q: How do I determine which plan is best for me?

A: Utilize the myBenefit Decision Center located in myHR (navigate from Main Menu >> Self Service >> Benefits >> myBenefit Decision Center) to compare medical plan details, estimate your out-of-pocket expenses under each plan, and estimate your tax-favored account contributions.

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Q. How do I earn the $450 Wellness Incentive?

A:  The 2015 Wellness Incentive--running from October 1, 2014, to September 30, 2015--is a two-tiered incentive program. You can earn $150 in Tier 1, if you complete your activities by April 30, 2015. You can earn an additional $300 in Tier 2, if you complete your activities by September 30, 2015. You do not have to complete Tier 1 before getting started on Tier 2, but you must participate in Tier 1 to be a part of Tier 2. See the 2015 Wellness Incentive webpage for details.

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Q. Do I have to be enrolled in a UM medical plan to receive the Wellness Incentive?

A:  Yes. In fact, you must be the primary subscriber to your UM medical plan to receive incentive funds. In other words, the premiums for your medical plan must be paid out of your paycheck (not your spouse's) to be eligible to receive incentive funds. Any faculty or staff member may participate, but only primary subscribers may receive the funds.

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Reviewed 2014-09-23.