Jack is single and considers himself a healthy guy. He does not have any health conditions or take any prescription drugs on a regular basis. He gets a flu shot every year and sees his primary care physician for an annual preventive exam and health screening. He does not anticipate the need for any other medical care. Jack is interested in the Cigna Choice Fund HSA Plan because the bi-weekly payroll contributions are lower and MAA will make contributions to his HSA that he can use for unplanned medical expenses in the future.
Cigna Choice Fund HSA Plan
Cigna Choice Fund HRA Plan
Bi-Weekly Medical Premium (Less than 2 years of service and does not use tobacco)
$58.27
$86.00
Annual Medical Premiums (26 pay periods)
$1,515.02
$2,236.00
MAA Annual Contribution to HSA/HRA
$250
None
Motivate Me Wellness Incentives Earned (contributed to HSA/HRA)
$350
$175
Jack’s Out-of-Pocket Expenses (assumes Jack goes in-network for all medical care)
Deductible $2,000
Coinsurance 20%
Deductible $1,500
Jack’s Medical Care and Prescriptions
Copay
Copay
Coinsurance 20%
1 preventive adult exam and health screening (assumes $347 in provider and lab charges) *Jack earns MotivateMe Wellness Incentives 1 sick visit with primary care physician (assumes $197 office visit charge) 1 retail generic prescription drug (assumes $20 for 30-day supply) 1 preventive flu shot at CVS Minute Clinic *Jack earns a MotivateMe Wellness Incentive Total Combined Out-of-Pocket Costs for Medical Care and Prescriptions (All of which can be paid with HSA/HRA funds)
N/A
$0
$0
$0
$0
$0
N/A
$197
$0
$30
$0
$0
N/A
$20
$0
$0
$0
$4
N/A
$0
$0
$0
$0
$0
$217
$34
Total Annual Payroll Contributions
$1,515.02
$2,236.00
Total Annual Payroll Contributions + Jack’s Total Out-of-Pocket Expenses
$1,732.02
$2,270.00
Total Costs Net of HSA/HRA Funds
$1,515.02
$2,236.00
Jack’s Choice Jack elected the Cigna Choice Fund HSA Plan. Under this plan, his payroll contributions and out-of-pocket expenses were the lowest of the two options. Jack used $217 of the $600 that MAA contributed to his HSA to pay his out-of-pocket expenses and the remainder of the money will carry over to next year.
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