This Qualified High Deductible Health Plan (QHDHP) allows you to contribute pre-tax dollars a Health Savings Account (HSA) to use for eligible medical expenses. Each time you visit the doctor or receive health care services, you can use your pre-tax dollars towards the expenses. The HSA covers incurred expenses by paying them from this allocation until the contribution dollars are exhausted.
KCOI is continuing a Domestic Tier, which allows employees to take advantage of services done at KCOI.
Per Pay Period Premium | |
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QHDHP Broad Network | |
Employee | $65.50 |
Employee + Spouse | $288.00 |
Employee + Child(ren) | $227.00 |
Employee + Family | $357.50 |
QHDHP Broad Network | ||||
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Network | Aetna Choice® POS II | |||
Domestic Tier: benefits when using KCOI or KCOA physicians & services | ||||
Annual Deductible (Individual/Family) | $3,300 / $6,600 | |||
Out-of-Pocket Maximum (Individual/Family) | $4,000 / $8,000 | |||
Co-Insurance (Member's Responsibility) | 0% | |||
Covered Services (Outpatient Specialis | N/A | |||
General Services (In-Network) | ||||
Annual Deductible Individual | $4,000 | |||
Annual Deductible Family | $8,000 | |||
Annual Out-of-Pocket Limit Individual | $4,000 | |||
Annual Out-of-Pocket Limit Family | $8,000 | |||
Co-Insurance (Member’s Responsibility) | 0% | |||
Office Services (In-Network) | ||||
Office Visits/Exam | Deductible | |||
Specialist Visit | Deductible | |||
Urgent Care | Deductible | |||
Preventive Care | No charge | |||
Outpatient Diagnostic (lab / X-ray) | Deductible | |||
Complex Imaging (MRI, CT / PET scans) | Deductible | |||
Hospital Services (In-Network) | ||||
Ambulance | Deductible | |||
Emergency Room | Deductible | |||
Inpatient Hospital Stay | Deductible | |||
Outpatient Surgery | Deductible | |||
Prescription Drugs (through Payer Matrix & Magellen - Tiers 1 / 2 / 3 / 4) | ||||
Retail Pharmacy (30-day supply) | Deductible | |||
Mail Order (90-day supply) | Deductible | |||
Preferred Specialty | Deductible | |||
Non-Preferred Specialty | Deductible |
You contribute pretax dollars to the HSA. Interest accumulates tax-free, and funds are withdrawn tax-free to pay for medical expenses.
You can use the money in your HSA to pay for eligible medical expenses and prescriptions. The HSA funds you use can help you meet your plan’s annual deductible.
THE OPPORTUNITY FOR LONG-TERM SAVINGS: Save unused HSA funds from year to year — you can use this money to reduce future out-of-pocket health expenses. You can even save HSA dollars to use after you retire.
You are eligible to open and fund an HSA if:
Once your account is open, you can access it via www.healthequity.com. You’ll set up your payroll contributions during open enrollment. You can make contribution changes at any time during the year through WEX. Note that it may take between one and two payroll periods for an HSA change to be processed.
The HSA is administered by Health Equity. Kansas City Orthpaedic pays the monthly administrative fee for your HSA. If your coverage status or employment status changes, you will be responsible for all HSA account holder fees.
You’ll notice two separate line items on your paycheck when you participate in the HDHP with HSA option — one
Employee Only – $4,300
Family – $8,550
Catch-up (age 55+) – $1,000
Our four medical plan options are offered through Meritain Health an Aetna Company. Need to connect?
Meritain Aetna Network
Technical support: 800-925-2272
Meritain portal support: servicehelp@meritain.com