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%* | 20%* | ||
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).