Medical Plans

Information at Your Fingertip

Carlisle offers three high-deductible health plans (HDHP). If you are a Medicare recipient or have another first-dollar benefit plan, you are not eligible for the Carlisle HSA Plan as defined by the IRS. However, you may enroll in the Carlisle Medical Plan or Carlisle HRA Plan.

Annual Contributions by Plan

	Carlisle HSA Plan	Carlisle Medical Plan	Carlisle HRA Plan
Eligibility	You are enrolled in an HSA-eligible high deductible health plan only	You are covered by a non-HDHP (i.e., spouse’s health plan, health care FSA or HRA), Medicare, TRICARE, VA benefits or claimed as a dependent on someone else’s tax return	You are enrolled in an HRA-eligible high deductible health plan only
Account Ownership	You decide when to use the funds for eligible medical, dental, and vision out-of-pocket. It’s yours when you retire or leave the plan	Not Eligible	Funds are held in your name and used to pay medical, dental and vision claims (by the insurance company) while you are in the plan
Annual Carlisle Contributions*	Individual – $750 You + 1 or more Dependents - $1,500	Not Eligible	Individual – $500 You + 1 or more Dependents - $1,000 Wellness incentives added to HRA; will be in addition to the amounts above
Your Voluntary Annual Contributions	Individual – up to $3,850 less Carlisle contributions and your wellness incentive dollars You + 1 or more Dependents – up to $7,750 and your wellness incentive dollars	Not Eligible	Not Eligible
Your Catch-up Contributions	$1,000 at age 55 or older	Not available	Not available
Investment Options	You may invest in mutual funds if you have $1,000 in account; earnings are tax-free	Not available	Not available

Note: HRA account balances will be limited to the calendar year in-network, out-of-pocket maximum.

* Carlisle prorates the annual employer HSA and HRA employer contributions if coverage begins after January 1.

NOTE: In-network deductible and out-of-pocket maximum apply to in-network services only. Out-of-network deductible and out-of-network maximum apply to out-of-network services only.

Medical Plan Comparison

Learn more about the Tax-Advantaged Accounts.

	Carlisle HSA Plan	Carlisle Medical Plan	Carlisle HRA Plan
	IN-NETWORK	OUT-OF-NETWORK	IN-NETWORK	OUT-OF-NETWORK
Calendar Year Deductible
Individual	$1,500	$3,000	$1,500	$3,000
+1 or more dependents	$3,000	$6,000	$3,000	$6,000
Calendar Year Out-of-Pocket Maximum (Includes Deductible)
Individual	$3,000	$6,000	$3,000	$6,000
+1 or more dependents	$6,000	$12,000	$6,000	$12,000
Lifetime Maximum	Unlimited
	Carlisle HSA Plan	Carlisle Medical Plan	Carlisle HRA Plan
Yearly Employer Contributions
Individual	$750	Not Eligible	$500
+1 or more dependents	$1,500	Not Eligible	$1,000
Coinsurance You Pay
Preventive Care	$0	40%*	$0	40%*
Primary Care Physician	20%*	40%*	20%*	40%*
Specialist	20%*	40%*	20%*	40%*
Diagnostics, X-Ray and Lab	20%*	40%*	20%*	40%*
Urgent Care	20%*	20%*	20%*	20%*
Emergency Room	20%*	20%*	20%*	20%*
Inpatient Hospital Care	20%*	40%*	20%*	40%*
Outpatient Surgery	20%*	40%*	20%*	40%*
Pharmacy You Pay
Retail Rx (up to 30-day supply
Preventive Generic	Preferred Preventive generics are covered at no charge and excluded from the plan deductible.
Generic	20%*	20% after the 20% member copay	20%*	20% after the 20% member copay
Brand	20%*	20% after the 20% member copay	20%*	20% after the 20% member copay
Specialty	20%*	20% after the 20% member copay	20%*	20% after the 20% member copay
Mail Order Rx (up to 90-day supply)
Generic	20%*	Not covered	20%*	Not covered
Brand	20%*	Not covered	20%*	Not covered
Members are required to fill a 90-day supply at either CVS Caremark Mail Service Pharmacy or your local CVS pharmacy. You can contact Aetna to opt out of this requirement.

* After deductible

For Your Protection

The out-of-pocket maximum provides financial protection in the event of a serious illness or injury. The out-of-pocket maximum includes your payments for covered in-network or out-of-network expenses, as applicable, and is withdrawn from your funds. The out-of-pocket maximum includes the deductible. After you reach your out-of-pocket maximum, the plan covers all eligible expenses up to 100% for the rest of the year.

Benefits Documents

For all other plan documents, visit MyCarlisle (ADP).

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