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Anthem Lumenos CDHP/HSA

 IntroductionHealth Savings AccountWellness IncentivesCDHP # 1 Coverage - CDHP #2 Coverage2014 Rates –  FAQ –  Forms/Documents

For Open Enrollment 2015 information, forms and rates, please visit the Open Enrollment Page.

What is a Lumenos Consumer-Driven Health Plan with Health Savings Account (CDHP/HSA)?

A Lumenos CDHP/HSA is a consumer-driven high deductible health plan designed to promote wellness and provide consumer tools that empower you to take control of your health, as well as the dollars you spend on health care.  The Lumenos CDHP/HSA features assist you in improving and maintaining your health.  This plan provides you with 

  • On-line resources for getting healthy, staying well and becoming a more effective “shopper” of healthcare,

  • Consumer tools, such as Rx pricing and health risk assessments, and

  • Wellness incentives, including healthy weight and tobacco-free programs.

Your Lumenos CDHP/HSA pays 100% of the cost for nationally recommended preventive services and allows unlimited provider choice, because quality of care starts with the right doctor.  The plan also places limits on your annual out-of-pocket costs for covered services.
 
The CDHP includes a Health Savings Account (HSA) with pre-tax University contributions (and employee contributions if elected) which are deposited into your own HSA bank account.  Your HSA account is available to pay for medical care, prescriptions, and other eligible healthcare expenses.  And since remaining dollars deposited to an HSA account are not forfeited at the end of the plan period, your account balance can grow over time.
 
Plus you can earn financial rewards – additional dollars deposited in your HSA account – for doing good things for your health.  On-line services are also available as a resource for every aspect of your health.

Are you ready for a Healthier Health Plan?  Read on or view one of the presentations below to find out whether the Lumenos CDHP/HSA plan is right for you.

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Health Savings Account (HSA) with Mellon Bank

The Health Savings Account is a bank account in the employee’s name, funded with pre- or post-tax dollars, which can be used to help pay for medical care and prescriptions, and other eligible healthcare expenses.  You may use the provided HSA account debit card or checkbook to pay your healthcare provider or pharmacy for eligible medical expenses.
 
During open enrollment, you will have the option to open an HSA if you choose a Lumenos Consumer-Driven Health Plan.  To assist you in beginning your HSA, the University will make contributions to your account.  In 2014, those contributions from USI can be as much as $600 to $1,200 for CDHP #1 and $750 to $1,500 for CDHP #2.  All participants receive a portion of the USI contribution initial funding in January or when first joining the plan, followed by prorata contributions each pay period.  Newly eligible participants entering after January 1 will receive an initial contribution plus regular pro-rated annual employer contributions for the months in the plan.  You will also be able to make your own contributions to the account, and you can earn additional financial rewards for engaging in healthful behaviors. 
 
Contributions to your HSA account are federally tax-deductible.  Contributions can be made to your HSA up to the limits set by the IRS and U.S. Treasury.  These limits include contributions from any sources, as well as any rewards earned.  For 2014, the individual and family maximum annual contribution amounts are to $3,300 and $6,550, respectively.  An additional catch-up contribution amount, available to those 55 or older, is limited to $1,000.

Spousal Medical Benefits That Limit Your Participation or Make You Ineligible for the HSA. We want to remind you that your ability to participate in the Lumenos CDHP/HSA could be affected by choices a spouse makes regarding coverage at another employer. The limitations described below are based on IRS interpretation of what constitutes prohibited “other insurance.” Please read this carefully if you have signed up for family or employee/spouse coverage, or if you signed up for single coverage but you or your spouse has other health coverage as well.

  • If both you and your spouse are covered by your spouse’s medical plan (such as PPO, HMO, CDHP), you make yourself ineligible for the Health Savings Account benefit at the University.
  • If your spouse is covered by a general purpose flexible spending account for medical, you are also ineligible for the Health Savings Account benefit at the University.
  • You may be enrolled in a Lumenos HSA while your spouse is covered under a PPO/HMO at his/her employer in which you are not enrolled, as long as your spouse does not have a general purpose flexible spending account for medical. In this case, you would be allowed to reimburse your spouse’s out-of-pocket expenses with your HSA dollars even though s/he is not covered under your Lumenos High Deductible Health Plan. However, you may only use the single coverage annual HSA contribution limit ($3,300 for 2014).
  • You and your spouse continue to be eligible for the HSA at the University if your spouse has a limited-purpose flexible spending account. Such limited purpose FSA’s accept vision and dental expenses only and do not allow coverage of any medical expenses.
  • You and your spouse may both have separate HSA’s provided you both have an HSA with a qualified high deductible health plan (HDHP). If a family has all its members covered under two HSA-qualified HDHPs, or some family members are on one qualified plan and the other family members are under another qualified plan, the maximum annual contribution to the account members remains in force. This means you must divide the annual maximum family contributions between the two HSA accounts and not exceed the 2014 limit of $6,550 in the combined contributions to the two HSA plans.
 
Unused dollars are saved, are not forfeited at the end of the plan year, and are yours to keep if you retire or leave the University.
 
You will earn interest on your HSA funds and will also have the opportunity to invest your funds once your HSA balance reaches $1,500.  You will need to maintain the minimum $1,500 balance in your account, but you can invest any additional amount in the available investment options.
 
You will be responsible for annually reporting use of your HSA funds to the IRS.  To assist you with tax preparation, you will receive monthly statements from BNY Mellon showing all account activity and you will receive IRS forms 1099 and 5498 near tax time.
 
Health Savings Account (HSA) – Frequently Asked Questions

More Frequently Asked Questions for Health Savings Account (HSA)

HSA Qualified Medical Expenses

Health Savings Account (HSA) Election Form

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Wellness Incentives

Financial rewards are one of the ways the Lumenos CDHP/HSA plan makes it easier for you to do the right things when it comes to your health. This program provides additional HSA dollars to encourage you to take certain steps toward maintaining and improving your health.
 

assessment MyHealth
Assessment
$50 reward for online completion
of one family member
MyHealth Assessment is an online health profile that takes only a few minutes to complete.  It helps you identify possible health risk factors, based on your current health, family history, lifestyle and other factors.  The MyHealth Assessment is confidential—the information is not shared with your employer and it is protected by the highest level of online security available.  You and your family members are eligible to complete the MyHealth Assessment (limited to one reward per family per year).
coaching Health
Coaching
Participation
$100 reward for Health Coaching enrollment
for each eligible family member
The Health Coaching programs team consumers who have certain ongoing health conditions and other health needs with a specially trained registered nurse to help them identify goals, and understand and manage their health condition.  The Health Coaching programs are available at no cost to all Anthem health plan consumers, and include ConditionCare, MyHealth Coach, Future Moms and ComplexCare.  If you or your covered family members have an eligible condition and qualify to participate in a Health Coaching program, you’ll receive $100 in your HSA for enrolling (one reward per covered person per year).
health assessment Health
Coaching
Completion
$200 reward for Health Coaching graduation
for each family member
If you or your covered family members enroll in a Health Coaching program, you can earn an additional $200 for your HSA by achieving your health goals and successfully completing the program (one reward per covered person per year).
     
Healthy
Lifestyles
$50 reward for Healthy Lifestyles completion
for you and your spouse
Healthy Lifestyles: Tobacco-Free Program
The Tobacco-Free Program is a step-by-step program that uses proven techniques and personalized support to help you stop using tobacco and improve your health for total well-being.  It features one-on-one telephone counseling sessions to help you develop your own Tobacco-Free plan, including determining what nicotine replacement products may work best for you.  The program also includes coverage for nicotine-replacement productions (gum or patch).  You and your covered family members over age 18 are eligible for this program.
 
Healthy Lifestyles: Healthy Weight Program
The Healthy Weight Program includes one-on-one counseling sessions designed to help you achieve a weight that supports good health.  Working with a registered dietitian and health educator, you’ll have confidential phone sessions to discuss topics like healthy eating, physical activity and exercise, stress management, maintenance and relapse.  It’s available to you and your covered family members age 18 or older who have a Body Mass Index (BMI) of 25 or higher.
 
You and your spouse are eligible to receive $50 in your HSA for completing these programs (one reward per person per lifetime).

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Coverage for CDHP #1

Anthem Lumenos CDHP Plan # 1 Highlights

  • 100% Preventive Care Coverage
  • Deductible (Network & Non-network combined) - $1,500 individual and $3,000 family (Family deductible must be met before coinsurance applies for any level of family coverage)
  • Out-of-pocket maximum
    • Network - $4,000 individual and $8,000 family
    • Non-network - $8,000 individual and $16,000 family
  • Co-Insurance
    • Network - 90%/10%
    • Non-network - 70%/30%
  • Prescription Co-Payments
    • Retail Pharmacies (30-day supply) - 90% after deductible
    • Mail Order (90-day supply) - 90% after deductible

Anthem Lumenos CDHP # 1 2014 Summary of Benefit Coverage (SBC)

Anthem Lumenos CDHP # 1 2014 Plan Certificates - Single Plan

Anthem Lumenos CDHP # 1 2014 Plan Certificates - Family Plan

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Anthem Lumenos CDHP/HSA #1 2014 Rates

Anthem Lumenos CDHP/HSA - Salary $38,000 and above ($3,166.67 monthly, $19.49 hourly)

2014 Rates Employee's Bi-weekly Premium Employee's Monthly Premium
Single Plan $45.32 $90.64
Employee + Child(ren) $77.39 $154.78
Employee + Spouse $103.84 $207.68
Family Plan $130.18 $260.36

Anthem Lumenos CDHP/HSA - Salary below $38,000 ($3,166.67 monthly, $19.49 hourly)

2014 Rates Employee's Bi-weekly Premium Employee's Monthly Premium
Single Plan $36.69 $71.38
Employee + Child(ren) $61.40 $122.80
Employee + Spouse $82.62 $165.24
Family Plan $103.75 $207.50

For COBRA Rates, contact a Benefits Representative.

USI's Contributions to HSA for CDHP #1

  Single Family (any level)
Initial Funding $210 $420
Prorata Per Pay per month up to $390 per month up to $780
Total for 12 month Participation $600 $1,200

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Coverage for CDHP #2

Anthem Lumenos CDHP Plan # 2 Highlights

  • 100% Preventive Care Coverage
  • Deductible (Network & Non-network combined) - $2,500 individual and $5,000 family (Family deductible must be met before coinsurance applies for any level of family coverage)
  • Out-of-pocket maximum
    • Network - $5,000 individual and $10,000 family
    • Non-network - $10,000 individual and $20,000 family
  • Co-Insurance
    • Network - 80%/20%
    • Non-network - 70%/30%
  • Prescription Co-Payments
    • Retail Pharmacies (30-day supply) - 80% after deductible
    • Mail Order (90-day supply) - 80% after deductible

Anthem Lumenos CDHP # 2 2014 Summary of Benefit Coverage (SBC)

Anthem Lumenos CDHP # 2 2014 Plan Certificates - Single Plan

Anthem Lumenos CDHP # 2 2014 Plan Certificates - Family Plan

 

Anthem Lumenos CDHP/HSA #2 2014 Rates

Anthem Lumenos CDHP/HSA #2 - The premium is inclusive of medical and prescription drug coverage.

Anthem Lumenos CDHP/HSA - Salary $38,000 and above ($3,166.67 monthly, $19.49 hourly)

2014 Rates Employee's Bi-weekly Premium Employee's Monthly Premium
Single Plan $31.77 $63.54
Employee + Child(ren) $52.95 $105.90
Employee + Spouse $70.41 $140.82
Family Plan $87.79 $175.58

Anthem Lumenos CDHP/HSA - Salary below $38,000 ($3,166.67 monthly, $19.49 hourly)

2014 Rates Employee's Bi-weekly Premium Employee's Monthly Premium
Single Plan $23.83 $47.66
Employee + Child(ren) $39.71 $79.42
Employee + Spouse $52.81 $105.62
Family Plan $65.85 $131.70

USI's Contributions to HSA for CDHP #2

  Single Family (any level)
Initial Funding $282 $525
Prorata Per Pay per month up to $468 per month up to $975
Total for 12 month Participation $750 $1,500

 

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CDHP/HSA Frequently Asked Questions

Anthem Lumenos CDHP/HSA - Frequently Asked Questions

Health Savings Account (HSA) – Frequently Asked Questions


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Forms and Documents

Anthem Employee Enrollment Application

Anthem Employee Change Form

Health Savings Account (HSA) Election Form

Anthem Tiered Drug List

Anthem Specialty Drug List

 

To learn more about the Lumenos CDHP/HSA plan, visit the Anthem Lumenos website.

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Open Enrollment Dates

TIAA-CREF Representative

Lori Matthews of TIAA-CREF will hold individual appointments in the HR Training Room on the below dates. To schedule an appointment, contact 800/732-8353. 

2014 Dates

  • Wednesday, Jan 22
  • Tuesday, Feb 18
  • Thursday, Feb 20
  • Wednesday, Mar 19
  • Tuesday, Apr 15
  • Thursday, Apr 17
  • Wednesday, May 14
  • Tuesday, June 17
  • Thursday, June 19
  • Wednesday, July 23
  • Tuesday, Aug 19
  • Thursday, Aug 21
  • Wednesday, Sep 24
  • Tuesday, Oct 21
  • Thursday, Oct 23
  • Wednesday, Nov 19
  • Tuesday, Dec 9
  • Thursday, Dec 11