Medical
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High Deductible Health Plan (HDHP)
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In-Network vs Out-of-Network
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Annual Account Contributions by Plan
Key features of both plans:
Carlisle HSA Plan | Carlisle HRA Plan | |
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Account Ownership | You decide when to use the funds for eligible out-of-pocket expenses. It’s yours when you retire or leave the plan | Funds are held in your name and used to pay claims (by the insurance company) while you are in the plan |
Annual Carlisle Contributions* | Individual - $750 You + 1 dependent - $1,500 You + 2 or more Dependents - $2,000 | Individual - $500 You + 1 Dependent - $1,000 You + 2 or more Dependents - $1,500 |
Your Voluntary Annual Contributions | Individual - up to $3,500 less Carlisle contributions You + 1 or more dependents - up to $7,000 less Carlisle contributions | Not Eligible |
Your Catch-up Contributions | $1,000 at age 55 or older | Not available |
Investment Options | You may invest in mutual funds if you have $2,000 in account; earnings are tax-free | Not Available |
Not Eligible for Health Care FSA | Use It or Lose It | |
Optional Health Care Flexible Spending Account (FSA) | You cannot contribute to or receive employer contributions in an HSA account if you have a Health Care FSA account balance. | You can contribute up to $2,650 to pay eligible out-of-pocket expenses incurred within the calendar year. |
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Medical Plan Comparison
$400 Deductible | $1,850 Deductible w/HSA | $2,850 Deductible w/HSA | |
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* Out-of-network expenses are subject to reasonable and customary limits. ** You pay the full cost of your medical and prescription drug expenses until your deductible has been met. *** Out-of-Pocket Maximum includes the deductible. **** Health care reform requires that all medical plans cover a specified list of preventive care services at 100% when received in-network (list subject to change based on recommendations from federal guidelines). Cost sharing may apply for network visits when preventive care services are provided in conjunction with an office visit. |
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Provider Network | A large network: Cigna Open Access Network |
A large network: Cigna Open Access Network |
A limited network: Cigna LocalPlus Network |
Deductible (Individual / Family) | |||
In-network | $400 / $800 | $1,850 / $3,700** | $2,850/$5,700** |
Out-of-network* | $2,500 / $5,000 | $3,700 / $7,400** | $5,700/$11,400** |
Health Savings Account (HSA) | |||
Western Union Contribution (Individual/Family) |
Not applicable | $500 / $1,000 per year | $500 / $1,000 per year |
Annual Out-of-pocket Maximum (Individual / Family)*** | |||
In-network | $2,200 / $4,400 | $3,500 / $6,500 | $5,500 / $11,000 |
Out-of-network* | $4,400 / $8,800 | $7,000 / $13,000 | $11,000 / $22,000 |
Preventive Care**** (Plan pays…) | |||
In-network | 100% no copay | 100% no deductible | 100% no deductible |
Out-of-network* | 60% after deductible | 60% after deductible | 50% after deductible |
Coinsurance (Plan pays…) | |||
In-network | 80% after deductible | 80% after deductible | 70% after deductible |
Out-of-network* | 60% after deductible | 60% after deductible | 50% after deductible |
Office Visit (Plan pays…) | |||
In-network | 100% after $20 Primary Care Provider copay / $40 specialist copay | 80% after deductible | 70% after deductible |
Out-of-network* | 60% after deductible | 60% after deductible | 50% after deductible |
MDLIVE Consultations | $20 copay | $44 until deductible is met, then coinsurance applies | $42 until deductible is met, then coinsurance applies |
Emergency Room (Plan pays…) | |||
In-network | 80% after $150 copay | 80% after deductible | 70% after deductible |
Out-of-network* | 80% after $150 copay | 80% after deductible | 70% after deductible |
Prescription Drugs | |||
Retail (up to 30-day supply) |
$10 copay generic $30 copay brand formulary $60 copay brand non-formulary |
80% after deductible | 70% after deductible |
Mail order (31 to 90-day supply) |
$25 copay generic $75 copay brand formulary $150 copay brand non-formulary |
80% after deductible | 70% after deductible |
How Much You Pay Each Month | See your 2018 medical plan rates. |