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General Frequently Asked Questions

[fusion_menu_anchor name=”Medical”/]Medical

Q – How much of my medical costs do I pay?Back to top
A – The company subsidizes 70% and employees pay approximately 30% depending upon the plan you select. Your contributions are paid for with pre-tax dollars.

Q – What is a deductible? Back to top
A – A deductible is the portion of eligible expenses you must pay before the plan begins to pay a percentage of your eligible expenses.

Q – What is coinsurance?Back to top
A – Coinsurance is the portion of a medical expense that you must pay once you have reached the plan deductible. The other portion of the medical expense that you do not pay is paid through your insurance.

Q – What is a PPO Plan?Back to top
A – PPO Plans or “Preferred Provider Organization” plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.

Q – What are the advantages of going to an in-network provider?Back to top
A – There are many advantages when you go in-network. Typically:

• Your deductible will be higher if you are treated by an out-of-network provider.
• Your in-network provider is already preauthorized by the insurance carrier.
• You receive a higher level of benefits at participating providers (doctors, hospitals and other health care facilities) who have agreed to provide their services at reduced fees.
• Preventive care services in-network are covered at 100%.

Q – How does a PPO plan work out of network?Back to top
A – Generally, you may choose any covered health care provider, but your cost will typically be higher and you have certain added responsibilities. For example:

• Every year, you must pay part of your eligible out-of-network expenses before the PPO plan begins to pay a benefit. This payment is called the deductible.
• After you pay the deductible, the PPO plan will reimburse you for a percentage of your eligible expenses and you will pay the balance. The percentage you pay is called a coinsurance percentage.
• You must get preauthorization for certain covered expenses such as elective surgery.If you do not get the required preauthorization, the amount of benefits available will be reduced or the expenses will not be covered at all.
• You may need to complete claim forms and file claims with your health care company to receive payment of benefits.
• The plan will not cover any benefit reductions due to failure to preauthorize certain treatments.

Q – I have not received my medical ID card. How do I go about printing a temporaryID card? Back to top
A – You can log into the UHC website directly at www.myuhc.com and print out a temporary card. You must first register and create a username and password.

Q – Can I make a change/enroll or waive coverage mid-year?
A – Changes can only be made if you experience a ‘qualifying life event’. This would include: change in your marital status, change in your number of dependents (birth,adoption, etc.), change in your work schedule /eligibility, change in dependents status (reaching age26). You must register your change within 31 days of the actual event date (i.e.: marriage, birth, etc.).

[fusion_menu_anchor name=”HSA”/]Health Savings PPO Plan and Tax Free Health Savings Account

Q – What is a Health Savings Account (HSA)?Back to top
A –The HSA is a tax advantaged account that allows you to pay or be reimbursed for certain qualified medical dental and vision expenses (as defined by the IRS).You can only establish an HSA in conjunction with a high deductible health plan(HDHP). Money in the HSA account helps pay for out-of-pocket expenses, the deductible, coinsurance, copayments and other qualified medical, dental and vision expenses not covered by your plan.

Q – Who is eligible to establish an HSA?Back to top
A –Any “eligible individual” can establish an HSA. An “eligible individual” is any person who a) is covered under a HDHP, b) is not also covered by another health plan that is not an HDHP c) is not entitled to benefits under Medicare, and d) may not be claimed as a dependent on another person’s tax return.

Q – Who can put money into an HSA account? Back to top
A –The HSA account can be funded through any source (not just account holder),however, only the account holder and their employer receive tax deductions. In order to establish and contribute to an HSA account, an individual must be enrolled in an HDHP.

Q – What are the contribution limits for 2018? Back to top
A –The contribution limit for 2018 is $3,450, for individual coverage and $6,900 for one or more family members. If you are age 55+ at any time during the calendar tax year, you are eligible for an additional $1,000 catch-up contribution.

Q – What types of medical expenses can be paid from an HSA? Back to top
A –Qualified medical, Dental and Vision expenses can be paid from an HSA. A list of eligible expenses is available online at www.irs.gov.  You can only pay for eligible expenses incurred as of your benefit effective date.

Q – Whose expenses can be paid from an HSA account?Back to top
A –An eligible individual, an employer, or both may contribute to an individual’s HSA in a given year. Any other individual may contribute on a family member’s behalf as long as the person who holds the account is an eligible individual.

Q – Can I have a High Deductible Health Plan (HDHP) with an HSA if my dependent child does not meet the federal tax definition for a dependent?Back to top
A –Yes, the situation of covered dependents does not impact the account-holder’s eligibility for the HSA. However, a non-tax dependent’s medical expenses generally cannot be covered as qualified distributions. So while an overage dependent child is allowed to be covered by the HSA-compatible HDHP and will cause the account-holder to be able to contribute up the family annual limit (because they are covering more than just themselves under the plan), their expenses cannot be covered in a tax advantaged way by the funds in the HSA. Any distribution for their expenses would be non-qualified and would likely be subject to regular income taxes and penalties.

Q – If I have an HSA but my children are covered under my spouse’s health plan, can I use my HSA dollars to pay for their medical expenses incurred under his or her health plan, such as co-pays and co-insurance? Back to top
A –Yes, you can use your HSA dollars for your non-covered dependents as long as the expenses are Qualified Medical Expenses as defined by the IRS. These expenses include things like dental and vision expenses, orthodontia; prescription medications, COBRA premiums, and much more.

Q – Can I use my HSA funds for medical expenses of my child if my former spouse claims that child as a tax dependent? Back to top
A – Yes, a child of parents that are divorced separated, or living apart for the last 6 months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child’s exemption.

Q – Can I use my HSA funds for medical expenses of my child if my former spouse claims that child as a tax dependent? Back to top
A –Yes, a child of parents that are divorced separated, or living apart for the last 6 months of the calendar year is treated as the dependent of both parents whether or not the custodial parent releases the claim to the child’s exemption.

Q – Can I use my HSA funds for medical care I receive outside the US? Back to top
A – Yes, you can. However, any medication you receive must be legal in that country and in the US. Any medications you purchase in other countries and import legally are covered.

Q – Can I use my HSA funds to pay for my medical insurance premiums?Back to top
A –Insurance premiums are not qualified medical expenses unless the premiums are for Long-term care insurance, health care continuation coverage (COBRA), healthcare while receiving unemployment compensation or Medicare or other health care coverage if you are 65 or older (other than a Medicare supplemental policy).

Q – Is the money in a Health Savings Account available up front like it is in a Flexible Spending Account? Back to top
A –No, any amounts you elect to fund over the course of the year are not available until the money is deposited – just like a standard checking or savings account. For example, if you are a Single and want to contribute $2,000 to your HSA over the course of the year via payroll deduction, $166.66 will be taken out of your paycheck pre-tax each month and deposited into your HSA. Only once those funds are deposited can you actually use them to pay for medical expenses. Because the funds can only be spent once deposited, this eliminates the need to submit receipts in order to get your money back, but it is always advisable to retain your receipts in case you are audited and need to prove that the distributions were to reimburse for qualified medical expenses.

Q – Can I change my HSA contribution amount during the year?Back to top
A –Yes, you can start, stop or change the amount you are contributing to your HSA during the year through pre-tax payroll deductions by visiting www.DANbenefitsplus.com. Once you are on the main page, select ‘EnrollNow’ which will take you to the enrollment website.

Q – If both spouses are 55 and older, can both spouses make “catch-up” contributions?Back to top
A –Yes, if both spouses are eligible individuals and both spouses have established an HSA in their name. If only one spouse has an HSA in their name, only that spouse can make a “catch-up” contribution of an additional $1,000.

Q – How do I withdraw money from my HSA?Back to top
A –You can use your HSA debit card to pay for qualified medical expenses or make a payment using the online tool by logging into www.myuhc.com.

Q – How will I know how much is in my HSA? Back to top
A – You can monitor your HSA Account online to view a fund balance via www.myuhc.com.

Q – If I have a medical expense that is eligible for payment from my HSA, am I required to use the money? Back to top
A –No. You have the flexibility to choose how you use the money you’ve accumulated in your HSA. You could choose to pay the expense out of pocket with after-tax dollars and leave the money in your HSA to grow tax free for use in the future. Your expenses incurred any time after you have established your HSA will be eligible for reimbursement as a qualified distribution in the future.

Q – Can I use the money in my HSA for anything other than eligible medical expenses?Back to top
A –You can withdraw the money from your HSA at any time and use it for any purpose. However, if the money is used for anything other than qualified healthcare expenses, you will be subject to income taxes on the amount withdrawn as well as a 20% IRS penalty. If you are over age 65 or disabled, non-health expenses will not incur the 20% penalty, but will be taxed as regular income.

Q – What type of records do I need to keep?Back to top
A –You are responsible for keeping records of eligible expenses. Your contributions through payroll deductions will be reported on your annual W-2 Form.You will also receive Form 1099-SA showing total annual distributions from your HSA, and Form 5498-SA showing the total annual contributions to your HSA. You must report all contributions to your HSA on Form 8889 with your annual tax return. If your tax return should get audited, you might be asked to provide receipts for the expenses that were reimbursed. You can use receipts to validate qualified medical expenses. Your HSA is regulated by the IRS, not by the Dentsu Aegis Network (DAN)BenefitsPLUS plan or UHC.

Q – What happens to my HSA if I leave DAN?Back to top

A –If you leave DAN or if you take insurance elsewhere, the money in your HSA goes with you. DAN cannot take back any unused funds. The Health Savings Account belongs entirely to you, and once funds are deposited the money is yours. The funds in the HSA can continue to be use, even if in the future you are no longer enrolled in an HSA-compatible health plan.

Q – Can I transfer my HSA account to another bank other than Optum Bank?Back to top
A –If you leave the company you can transfer your funds into a new HSA account with a different bank. You must however open up a qualified HSA.You cannot transfer your funds to an HSA account with another bank if you are an active employee.

Q – Am I eligible to use the money in my HSA account if I switch plans and I am no longer enrolled in a High Deductible Health Plan (HDHP)?Back to top
A –Yes, if you switch plans and have money in your HSA, the account is still yours to use for any current or future qualified medical expense incurred by yourself, your spouse, and any qualifying dependents. However, no future contributions to your HSA account are allowed while you are not enrolled in a HDHP, and you will be responsible for any maintenance fees on the account.

Q – Can I submit qualified medical expenses my domestic partner incurred through my Health Savings Account?Back to top
A – Federal IRS guidelines do not allow an employee to submit claims for their non-tax dependent domestic partner. However, the domestic partner of the DAN employee can open their own Health Savings Account (provided they are covered under a HDHP plan and do not have any other disqualifying coverage, such as a full FSA)and can contribute the full family amount. Example: David is covered by his domestic partner John’s family HDHP. David and John both have HSAs and are 45 years old. While the IRS hasn’t issued formal guidance on this point, it appears that each may contribute $6,550 to his own HSA in 2015.

Q – My Domestic Partner is my Tax-dependent can I submit qualified expenses?Back to top
A –Yes. As long as you are covering your tax dependent Domestic Partneron your HDHP plan

Q – Can you use HSA funds for children of Domestic Partners?Back to top
A – Yes, as long as the child is a qualified tax dependent

[fusion_menu_anchor name=”Dental”/]Dental

Q – Am I required to use specific dentists and dental specialists, or do I have the option to choose?Back to top
A – With the Dental PPO plan, you and your family members are free to visit any network or non-network dentist or specialist for your dental care. When network dentists are used, you will receive higher levels of reimbursement.

Q – How can I find a network dentist or dental specialist in my area?Back to top
A – You can locate a participating dentist using the on-line listing provided by your PPO at deltadentalins.com.

Q – How can I confirm what would be covered?Back to top
A – Predetermination of benefits is the process where the dental insurance company reviews the proposed treatment and tells you what procedures are eligible for reimbursement.It is a good idea to obtain a predetermination of benefits before services are performed.Have your dentist complete a form detailing the proposed treatment and submit it to your dental insurance company. DeltaDental will send your dentist an explanation of what benefits will be covered and what you would have to pay out of your pocket.You can then discuss your treatment options with your dentist.

[fusion_menu_anchor name=”Vision”/]Vision

Q – I enrolled in the vision plan, will I receive an ID card?Back to top
A – No, the VSP vision care providers only require your full name and your SocialSecurity Number to verify your eligibility in the plan.

Q – How can I find a network ophthalmologist in my area?Back to top
A – You can visit www.vsp.com and view all participating providers nationwide.

You can log into the UHC website directly at www.myuhc.com and print out a temporary card. You must first register and create a username and password.

Q – Can I make a change/enroll or waive coverage mid-year?Back to top
A – Changes can only be made if you experience a ‘qualifying life event’. This would include: change in your marital status, change in your number of dependents (birth,adoption, etc.), change in your work schedule / eligibility, change in dependents status (reaching age 26). You must register your change within 31 days of the actual event date (i.e.: marriage, birth, etc.).

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