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>> This section of the video is for retirees that are not entitled to
Medicare at the time of their retirement. If you will be entitled to
Medicare at the time you retire, please watch the video entitled
Medical Plans for Retirees Entitled to Medicare.
As a retiree not yet entitled to Medicare you have several plan
options. The plans include Group Health Classic, Value or the
Consumer Directed Health Plan or CDHP, Kaiser Classic or CDHP, or
Uniform Medical Plan Classic or CDHP. Group Health and Kaiser do not
have providers in every county in Washington, check the PEBB website
or the Retiree Enrollment Guide to see if the plan is available in
your area. In most cases you must live in the medical plan's service
area to join the plan.
The map shows plan availability by county. The yellow and white
striped areas show the counties and zip codes within a county where
Group Health and Uniform Medical Plan are available. The blue and
white striped areas show the counties and zip codes within a county
where Kaiser and Uniform Medical Plan are available. UMP is available
in all counties in Washington, represented on the map by the white
areas. In addition, UMP has providers both nationwide and worldwide.
Review the map to determine which plans are available in your area.
In most cases you must live in the plan area to enroll in the plan.
Group Health, Kaiser, and UMP each offer two to three types of plans.
The types of plans include Classic, Value, and the Consumer Directed
Health Plan or CDHP. If you choose one of the classic plans from Group
Health, Kaiser, or UMP you can expect to pay a higher monthly premium
but, may pay less out of pocket when you require services. If you
choose the Value plan from Group Health, the monthly premiums will be
lower than the classic plan, but you may pay more out of pocket than
the classic plan when you require services. If you choose a CDHP from
Group Health, Kaiser, or UMP you will pay a lower premium, but you
will pay more out of pocket than the classic or value plans when you
require services.
The CDHP has two components: a high deductible health plan and a
Health Savings Account or HSA. The high deductible health plan is
exactly what it sounds like; you will pay more out-of-pocket before
the plan will begin to pay. The HSA is a tax-exempt savings and
spending account used to pay for qualified medical expenses that helps
off-set the higher out-of-pocket costs of the plan. Your HSA will be
partially funded through the premium you pay each month. You also have
the option to deposit money into the HSA through electronic bank
transfers or by mailing a check to Health Equity. You may fund your
HSA up to the annual maximum allowed by the IRS. The IRS has
guidelines as to who is eligible for an HSA. You must be eligible for
the HSA to enroll in the CDHP. Refer to the Retiree Enrollment Guide
or the PEBB website for eligibility requirements, contribution
amounts and annual maximums.
If you enroll in the CDHP as a single subscriber, which means no
family members are on your account, each month the Health Care
Authority will deposit $58.34 of your premium payment into your HSA
account for an annual total of $700.08. If you enroll yourself and at
least one other family member on your account, each month the Health
Care Authority will deposit $116.67 of your premium payment into your
HSA account for an annual total of $1,400.04. You have the option to
deposit additional funds by sending the deposit directly to your HSA
account. When making additional deposits to you HSA be sure you do not
exceed the annual maximum allowed by the IRS. For 2013 the IRS allows
a single subscriber to deposit up to $3, 250 for the year. For
subscribers with at least one other person on their account the IRS
allows a maximum of $6,450 for the year. If you are age 55 or older
you may contribute an additional $1,000 for the year. So if you are a
single subscriber age 55 or older you could deposit up to a maximum
of $4,250 in 2013. Or, if you are a subscriber with at least one other
person enrolled on your account and you are age 55 or older, the
maximum you could deposit is $7,450 for the year. When calculating the
amount you would like to deposit for the year remember to include the
amount deposited on your behalf by Health Care Authority. If your
maximum for the year is $4,250, HCA will deposit $700.08 of that
total. You would be able to deposit up to $3,549.92 for the year.
In addition to setting the maximum contribution allowed the IRS has
rules around who may be enrolled in an HSA. To be enrolled in an HSA
you must be enrolled in a qualified high deductible health plan. The
enrolled in other comprehensive health coverage that is not a high
deductible health plan; You cannot be enrolled in Medicare; You cannot
CDHP plans offered by PEBB meet this requirement; You cannot be
be claimed as a tax dependent on someone else's tax return; You cannot
have received care from the VA or one of their facilities, including
prescription drugs, within the last three months; You cannot be
enrolled in Tricare; and If you have a VEBA account you must make the
VEBA account a "Limited purpose" VEBA.
In addition, if you choose the CDHP and have family members entitled
to Medicare you may not enroll your family members on your account.
To include your family members entitled to Medicare on your account
you must choose one of the Classic or Value plans. If you and the
family members you wish to enroll are not entitled to Medicare you
may choose one of the CDHP plans.