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•Welcome to Chapter 4 – Choice Plus with HRA
•As a reminder, please remember:
• All Chapters provided in the 2015 Benefits Guide are intended to be
part of a module series
•There are eight Chapters, several of which contain sub-chapters
• Follow along with and compile these into your own presentation
(see below) in the order they are presented
• Text items in red are variables. Please modify them as necessary in
order to fit your presentation’s and consumers’ needs
• Please pick and choose from the slides provided to create a custom
presentation that is right for you and your consumers. To do this, refer
to the instructions listed on the end slide of each Chapter
1
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN
with a HEALTH REIMBURSEMENT ACCOUNT (HRA)
ABOUT THE PLAN
You have the freedom to use any doctor
or hospital you want.
You save money when you use health care
providers in the Choice Plus network because
they’ve agreed to charge lower prices.
You will have coverage if you receive care
outside the network. However, you will likely
pay more.
You do not need to choose a primary
care provider (PCP).
But a PCP can be helpful in managing
your care.
You do not need a referral to see a
specialist.
See any doctor, including specialists,
without referrals.
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Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
THIS PLAN GIVES YOU AN HRA.
An HRA is an account that is funded by
your employer.
What’s the benefit of an HRA?
The money in the HRA is to help you
pay for covered health care services.
This includes paying for services that
apply to your deductible, such as doctor
visits.
•You won’t pay for covered
services until it’s spent.
•Your employer funds it
each year.
•Any money remaining will
roll over to use next year.
Even though your employer owns the
HRA, think of it as your money. You’ll
find that spending your HRA wisely can
help save you money.
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
THE HRA IS USED TO PAY FOR
COVERED HEALTH CARE SERVICES.
It can be used for services that apply to
your deductible, such as:
•Doctor visits
•Lab work
•X-rays
•Hospital stays and more
Your HRA can roll over.
If you have dollars remaining in
your HRA at the end of the year,
they will roll over so you can
use them next year.
THE HRA WILL PAY FIRST.
The HRA will automatically pay for all
covered services first. You won’t pay as
long as you have money in your HRA.
The money in the HRA may be enough
to cover all of your health care costs for
the year.
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Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
MAKING IT EASY TO USE YOUR HRA
Automatic payment1
If a service is covered by your health plan,
we will automatically pay the bill (claim)
from your HRA first, so you don’t have to.
Online claim form
If you need to submit a claim for
reimbursement, you can easily do so
online at myuhc.com. You can even sign
up for emails to stay up to date on claim
payments.
Health Care Spending Card
MasterCard1
This handy debit card makes
it easy to pay from your HRA.
You can use it to pay by
phone, online or at locations
that accept MasterCard.
1. May not be available for some plans
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
HOW THE PLAN WORKS
STEP
1. Your deductible
1
STEP
22. Your co-insurance
STEP
33. Your out-of-pocket limit
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
HOW THE PLAN WORKS
STEP
1
Your deductible
– Your HRA pays first.
• Your HRA automatically pays for all covered services first.
• If you spend all of the HRA, it’s your turn to pay.
• Preventive care is covered 100% when you use a network doctor.
STEP
1
Your deductible
Your HRA
pays first
+
You pay
Preventive care is covered 100% when you use a network doctor.
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
HOW THE PLAN WORKS
STEP
2
Your co-insurance – You and your plan share the cost of services.
• Co-insurance is when you and your plan share the cost of
•
•
covered services.
Your plan will pay a percentage and you will pay a percentage.
Your HRA will automatically pay if money remains.
After the deductible, you may have a co-payment
for prescriptions.
STEP
STEP
1
2
Your deductible
Your co-insurance
(After you reach the deductible)
Your HRA
pays first
+
You pay
Your plan
pays %
+ You pay %
Preventive care is covered 100% when you use a network doctor.
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
HOW THE PLAN WORKS
STEP
3
Your out-of-pocket limit –
You are done paying.
• When your deductible and co-insurance payments reach this
limit, you are done paying.
• The plan will pay 100% of covered expenses for the rest of the
plan year.
• This limit protects you if you have a major medical event.
STEP
STEP
STEP
1
2
3
Your co-insurance
Your out-of-pocket limit
Your deductible
(After you reach the deductible)
Your HRA
pays first
+
You pay
Your plan
pays %
+ You pay %
You are
done paying
When you reach the limit,
the plan pays 100%.
Preventive care is covered 100% when you use a network doctor.
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
CHOICE PLUS PLAN with HRA
HOW THE PLAN WORKS
1.
1 Your deductible — Your HRA pays first.
STEP
2.
2 Your coverage — You and your plan share the cost of services.
STEP
3.
3 Your out-of-pocket limit — You are done paying.
STEP
STEP
STEP
STEP
1
2
3
Your co-insurance
Your out-of-pocket limit
Your deductible
(After you reach the deductible)
Your HRA
pays first
+
You pay
Your plan
pays %
+ You pay %
You are
done paying
When you reach the limit,
the plan pays 100%.
Preventive care is covered 100% when you use a network doctor.
10
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• This ends Chapter 4 – Choice Plus with HRA
• Please open Chapter 5 – Choice Plus with HSA
• Copy and Paste slides from Chapter 5 to this Power Point
(Chapter 1)
1. Click on the first slide and then press shift while you click on the
last slide
2. Right click on the first slide and select copy
3. Go to the first section
4. Click below the thumbnail of the last slide in that section
5. Right click there and select Copy—Use Source Formatting
• Whichever slides from Chapter 5 that do not apply to your
customer, delete
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