Jill needs to cover herself and two children. Although no one in Jill’s family has a medical condition, she anticipates her children will have illnesses, a visit to the emergency room, and everyone will obtain their preventive care exams, screenings and flu shots. Jill is interested in the Cigna Choice Fund HRA Plan because she wants to pay the least amount out of pocket when she uses the plan… even if that means she has to pay more in premiums every pay period .
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)
$120.75
$155.77
Annual Medical Premiums (26 pay periods)
$3,139.50
$4,050.02
MAA Annual Contribution to HSA/HRA
$500
$250
MotivateMe Wellness Incentives Earned (contributed to HSA/HRA)
$350
$175
Jill’s Out-of-Pocket Expenses (assumes Jill goes in-network for all medical care)
Deductible $4,000
Coinsurance 20%
Deductible $1,500/$3,000
Coinsurance (20%)
Jill & Family Medical Care and Prescriptions
Copay
Copay
1 preventive adult exam and health screening (assumes $347 in provider and lab charges) *Jill earns MotivateMe Wellness Incentives 2 preventive well child exams (assumes $197 office visit charge per visit) 6 sick and follow up visits with primary care physician for Jill’s children (assumes $247 per office visit) 1 emergency room visit for Jill’s child (assumes $1,000 in charges) 4 preferred brand medications (assumes $50 each for 30-day supply) 3 preventive flu shots at CVS Minute Clinic *Jill earns a MotivateMe Wellness Incentive
N/A
$0
$0
$0
$0
$0
N/A
$0
$0
$0
$0
$0
6 visits at $247 each = $1,482
6 copays at $30 = $180
N/A
$0
$0
$0
N/A
$1,000
$0
$0
$1,000
$0
30% co-insurance = $15 x 4 = $60
N/A
$200
$0
$0
$0
N/A
$0
$0
$0
$0
$0
3 MDLive consultations (assumes $45 each)
3 visits at $45 = $135
N/A
$0
$0
$0
$0
Total Combined Out-of-Pocket Costs for Medical Care and Prescriptions (Some of which can be paid with HSA/HRA funds)
$2,817.00
$1,240.00
Total Annual Payroll Contributions
$3,139.50
$4,050.02
Total Annual Payroll Contributions + Jill’s Total Out-of-Pocket Expenses
$5,956.50
$5,290.02
Total Costs Net of HSA/HRA Funds
$5,106.50
$4,865.02
Jill’s Choice Jill elected the Choice Fund HRA Plan. Under this plan, her payroll contributions and out-of-pocket expenses were the lowest of the two options. All of the money that MAA contributed to her HRA was used toward her out-of-pocket expenses.
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