Acom Benefit Guide - Class 2 - Eligible Employees: Bi-Weekly

Health Reimbursement Arrangement

Acom offers a Health Reimbursement Arrangement (HRA) that funds a portion of the calendar year deductible for you and your covered family members if you elected the Humana Copay Plan. The actual deductible on this plan is $6,000 for an individual and $12,000 for family coverage. Under this HRA, the employee responsibility is the first $2,500 and the company will then reimburse up to $3,500 of the remaining calendar year deductible for an individual. Where there are two or more eligible dependents, the HRA will reimburse the second calendar year deductible for the same amount as the first should your dependent(s) meet the second calendar year deductible.

Health Reimbursement Arrangement (HRA) Illustration Employee Only Illustration

Plan Arrangement

Funding $2,500

Employee pays first $2,500

HRA pays next $3,500 to equal $6,000 plan deductible

$3,500

Coinsurance now pays at 100% (except for copays of any type) Employee is liable for $1,900 in copays to equal out-of-pocket max

$6,000 $7,900 $4,400

Employee out-of-pocket maximum equals $4,400

Employee + Dependent(s) Illustration

Plan Arrangement

Funding $5,000 $7,000 $12,000 $15,800 $8,800

Employee pays first $5,000

HRA pays next $7,000 to equal $12,000 plan deductible Coinsurance now pays at 100% (except for copays of any type) Employee is liable for $3,800 in copays to equal out-of-pocket max

Employee out-of-pocket maximum equals $8,800

8 Acom Integrated Solutions 2022 Enrollment Guide

Made with FlippingBook - professional solution for displaying marketing and sales documents online