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An exceptional, high-quality health plan from MESSA MESSA ABC:
An exceptional health plan that costs less
A smart choice
MESSA ABC is a lower-premium, higher-deductible MESSA ABC includes coverage features that add value for health plan that's compatible with a health savings account (HSA). It features quality coverage, peace of 1. Access to the largest statewide provider network and mind, and outstanding personalized member service.
the benefit of discounted provider fees when paying With MESSA ABC, you receive: for in-network medical services.
• A large choice of doctors, hospitals and other providers 2. FREE in-network preventive care services such as adult • Superb wellness and member education support and child immunizations as recommended by the U.S. Preventive Services Taskforce, well-baby visits and • In-network discounts annual physicals.
• A HealthEquity HSA 3. Hundreds of FREE preventive prescriptions with no If you've never had a lower-premium, higher-deductible deductible or copayment, including contraceptives health plan like MESSA ABC before, study the plan's for women, prenatal vitamins, medications for high features to maximize the benefits of having a health cholesterol and high blood pressure, and medications savings account. Our goal is to ensure members are for weight loss and smoking cessation.
satisfied with MESSA ABC and HealthEquity — and we're here to help you learn how to effectively use and > Taking an active role in managing your health care
manage your plan.
and HSA will help you get the most from your plan. We urge members to take time every month to review medical claims and HSA account transactions. Click.
Read.
Learn.
> Helpful tips and videos at
What's next?
A HealthEquity HSA account is included with MESSA Members who enroll in MESSA ABC will receive: ABC for each member. Think of an HSA as a "tax-free" • A new MESSA insurance card and a welcome packet zone that allows members and employers to set aside with key plan details.
money for the members' health care. An HSA can • A special "Welcome to MESSA" packet — for groups be used to pay for qualified medical care expenses, new to MESSA — with information and tips so you including deductible expenses.
can familiarize yourself with our organization.
Three facts about HSAs: • A HealthEquity Visa HSA card to use to help pay 1. HSA accounts are portable — the member owns the for qualified medical expenses if you have money in account forever.
the account.
2. All unspent money carries over from year to year; there's no "use it or lose it" rule.
If you want to learn more:
3. With an HSA, members can enjoy a triple tax • Attend local benefit or enrollment meetings offered advantage: Save money with pre-tax payroll by your MESSA Field Representative.
contributions, earn tax-free interest and investment • Go to www.messa.org/MESSAABCs or call MESSA's income, and access tax-free withdrawals for qualified East Lansing-based Member Service Center at medical expenses.
800.336.0013 for questions about the MESSA ABC medical plan.
> Attend benefit and enrollment meetings
• Go to www.healthequity.com or call HealthEquity's Member Services department at 877.218.3432 for when they're offered. If you cannot attend, questions about the HealthEquity HSA.
ask a colleague to pick up copies of materials distributed—and call your MESSA Field Representative at 800.292.4910 with questions. Th s is your HealthEquity
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1475 Kendale Boulevard, P.O. Box 2560, East Lansing, MI 48826-2560 MESSA ABC Plan Options
Medical Plan Highlights
All services must be medically necessary, performed by a qualified provider, and covered under the plan.
Single Coverage 2-Person & Family
2-Person & Family
Applies to all services and prescription drug purchases except preventive care MESSA ABC Plan 1*
and certain preventive prescriptions.
By federal law, when two or more lives are covered under this plan, the entire family MESSA ABC Plan 2
deductible must be met before claims are paid for any individual.
MESSA ABC Plan 3**
*The MESSA ABC Plan 1 deductible is subject to change each Jan. 1 in order to remain HSA-compatible according to IRS rules governing HSAs. **After the deductible is met, MESSA ABC Plan 3 includes a member coinsurance responsibility of 10% of the approved amount on in-network services and 30% of the approved amount on out-of-network services. Annual Out-of-pocket Maximum
2-Person & Family
2-Person & Family
The out-of-pocket maximum includes copayments and coinsurance plus the deductible. Charges above approved amount and charges for services not covered under the plan do not count toward the out-of-pocket maximum.
Lifetime Benefit Maximum
Type of Service
Plans 1 & 2: 100% of approved amount of approved amount Free Preventive Prescriptions
MESSA ABC covers an extensive list of FREE preventive prescriptions that have no deductible and no copayment including No deductible, No copayment cholesterol and blood pressure medications, weight loss medications,prenatal vitamins, contraceptives and many more.
Other Prescription Drug Coverage (See reverse for details)
After deductible, Under federal law governing HSA-qualified plans, prescription drugs 75% of approved amount are subject to the deductible (other than MESSA's free preventive copayments apply up to prescriptions). After deductible is met, MESSA ABC Rx coverage out-of-pocket maximum and copayments apply.
Plans 1 & 2: 100% Semi-private room and board (includes supplies and services) Physician charges of approved amount of approved amount Plans 1 & 2: 100% Includes: surgeon, assistant surgeon and anesthesiologist of approved amount of approved amount Plans 1 & 2: 100% Emergency room facility and physician charges of approved amount of approved amount Preventive Care – www.messa.org/FreePreventiveCare
(except for mammograms which Services such as annual exams, screenings, childhood and adult immunizations and preventive drugs including contraceptives.
are covered Plans 1 & 2: 80% Not subject to deductible Immunizations provided by a Public Health Department or at a Plan 3: 70% of approved MESSA-sponsored event are considered in-network.
amount after deductible) Chiropractic Services including Modalities
Plans 1 & 2: 100% Up to 38 visits (combination of in-network and out-of-network visits) per calendar year. Some providers may charge more than of approved amount of approved amount the approved amount for MESSA-specific benefits.
MESSA ABC
Medical Plan Highlights
Type of Service
Plans 1 & 2: 100% Diagnostic Lab and X-Ray, Radiation, and Chemotherapy
of approved amount of approved amount Plans 1 & 2: 100% Allergy Testing and Therapy
of approved amount of approved amount Additional Covered Services
Medical supplies and equipmentAmbulance Plans 1 & 2: 100% Same as in-network (plan limits apply) Skilled nursing facility (120 day annual limit applies) of approved amount Hospice (limits apply)Home health care Plans 1 & 2: 100% Human Organ Transplant
when authorized and performed at a BCBSM-approved facility (plan limits apply) Mental Health and Substance Abuse
Plans 1 & 2: 100% Inpatient and Outpatient Care
Mental health care of approved amount of approved amount Substance abuse treatment Outpatient Physical, Occupational, and Speech Therapy
Plans 1 & 2: 100% Up to a combined benefit maximum of 60 visits per individual per calendar year, whether obtained from an in-network or of approved amount of approved amount Free Preventive Prescription Drugs – A MESSA Value Added Benefit
Before members pay anything toward their deductible, MESSA provides 100% coverage for an extensive list of prescription drugs including cholesterol
and blood pressure medications, prenatal vitamins, contraceptives, weight loss medications, smoking cessation products and many more.
No deductible. Zero copayment. Members pay nothing for these preventive prescriptions.
Prescription Drug Coverage
Group prescription drug coverage is included with this plan.
, there is a $2 copayment for generic maintenance After applicable deductible is met
medications for specific chronic conditions and diseases. There is a $10 copayment for all other generics. There is also a $10 copayment for listedOver-the-Counter (OTC) medications used to treat heartburn and seasonal allergies. There is a $20 copayment (reduced from $40) for specific brandname maintenance drugs used to treat diabetes and asthma. There is a $40 copayment for brand name drugs when no generic product exists.
Please refer to your Plan Coverage Booklet for full details, limits and exclusions.
Medical Case Management (MCM)
MESSA offers Medical Case Management (MCM), a unique program tailored to meet the medical needs of our members who may need
extraordinary care if diagnosed with a catastrophic illness or injury. It is designed to help MESSA members and their families through these
difficult times by providing flexibility, support and direct involvement in the management of their health care.
MESSA Help Lines – NurseLine and Healthy Expectations
Plan participants have access to a 24/7 NurseLine for general medical information. To access NurseLine, call 800.414.2014 to speak to a speciallytrained Registered Nurse who can answer your medical questions and provide health-related information. MESSA's prenatal information and supportprogram for expectant mothers is Healthy Expectations. Please call the MESSA Member Service Center at 800.336.0013 for information or to enroll.
These services are not intended to replace regular medical care by a doctor or other qualified medical professional.
Covered Services and Approved Amounts
In-network providers bill BCBSM directly. Payments for covered services are based on BCBSM's approved amounts. Your liability is limited to the
plan deductible and coinsurance requirements.
Out-of-network providers may or may not bill BCBSM directly. The member is responsible to the provider for deductibles, and amounts that are in
excess of the approved amount for the service. These amounts may be substantial.
Medical benefits underwritten by Blue Cross Blue Shield of Michigan (BCBSM) & 4 Ever Life Insurance Company. BCBSM is an independent licensee of the Blue Cross and Blue Shield Association. Additional Benefits for You
Life and AD&D insurance may be continued following termination of employment by direct payment to MESSA. AD&D terminates at age 65 or Accidental Death & Dismemberment Insurance (AD&D) when employment terminates, whichever happens last.
Life and AD&D insurance underwritten by Life Insurance Company of North America. This is a brief summary of the MESSA ABC Plans. For additional information, including eligibility, limitations and exclusions, please contact MESSA at 800.336.0013.
MES - PlanOptions Rev. 06/05/14 Pr. 1 PDF MESSA ABC Rx Coverage
An overview
In-network pharmacies
Most Michigan retail pharmacies are in-network with your MESSA ABC plan. When you travel out-of-state, ask if the pharmacy is considered in-network with Blue Cross Blue Shield before purchasing a prescription.
As required by federal law, prescriptions are subject to the plan deductible with the exception of certain preventive prescriptions when prescribed for specific diagnoses. Member costs for each prescription are limited to the charge that Blue Cross Blue Shield of Michigan has negotiated with the pharmacy. MESSA ABC covers hundreds of free preventive prescriptions at no charge to the member. There is no copayment or deductible charge. For a complete list, visit the MESSA ABC area at www.messa.org/MESSAABCs. Once the in-network plan deductible is met, member costs are limited to the following schedule of copayments for each covered drug or refill when obtained from a network pharmacy: x $2 for certain generic drugs used to treat specific chronic conditions (asthma, coronary artery disease, diabetes, high blood pressure and high cholesterol). x $10 for all other generic drugs. x $10 for specific, over-the-counter medications for the treatment of seasonal allergies and heartburn (requires written prescription). Covered medications include Allegra®, Allegra D®, Claritin®, Claritin D®, Zyrtec®, Zyrtec D®, Prevacid®, Prilosec®, and Zegerid®. x $20 (instead of $40) for specific brand name maintenance drugs used to treat diabetes and asthma, including insulin, glucagon emergency kits, fast-acting and long-lasting inhalers, and the drugs Zyflo® and Zyflo CR®. x $40 for all other brand name drugs, including single-source drugs where no generic is available. Members will face
additional cost if they insist on a brand-name drug when a less expensive generic is available and medically
appropriate. The additional costs do not apply to your annual deductible or out-of-pocket maximum.
x Compounded medications and other drugs that are not FDA-approved are not a covered benefit. After the in-network deductible is met for the calendar year, out-of-pocket costs for the rest of the calendar year are $1,000 for Single coverage plans and $2,000 for 2-Person and Family coverage plans. With all three plans, if you reach the in-network out-of-pocket cap, your in-network prescriptions and medical services are fully covered at 100% by your MESSA ABC health plan for the remainder of the calendar year. You can fill prescriptions for maintenance medications and receive a 90-day supply for just two copays instead of three. Out-of-network pharmacies
Prescription drug purchases from an out-of-network pharmacy are subject to the MESSA ABC out-of-network deductible. MESSA's free preventive prescription benefit is not available when using an out-of-network pharmacy. If you purchase a prescription from an out-of-network pharmacy, you must pay the pharmacy and submit a claim form and proof-of-purchase to MESSA. Once your applicable out-of-network deductible has been met, MESSA will reimburse you for 75% of the approved amount for the drug (100% for emergency pharmacy services) minus your copayment (if any). For additional information about your MESSA ABC prescription drug coverage, review your plan coverage booklet at
www.messa.org/MESSAABCs or call MESSA's Member Service Center at 800.336.0013.
Health savings account: Can I have one and how can I use it?
HSA eligibility
Federal law governing tax-free savings accounts restricts who is eligible to have a tax-free health savings account (HSA).
The law also defines the "qualified medical expenses" that can be covered or reimbursed from an HSA. Additionally,
there are restrictions on which family members an accountholder can spend HSA dollars to cover or reimburse for their
qualified medical expenses. In order to qualify to have an HSA and make tax-free contributions to it, an employee:
x Must be covered by an HSA-qualified high deductible plan (MESSA ABC plans are HSA-qualified). x Cannot be claimed as a dependent on someone else's tax return. x Cannot be covered by another person's health plan if the other person's plan is not HSA-qualified. x Can still be eligible for an HSA if her spouse has a non-HSA-qualified health plan, provided the employee is not covered by the spouse's plan. x Cannot be enrolled in Medicare or Medicaid.
x Cannot have utilized VA benefits in the three months leading up to enrollment in the HSA plan. x Generally cannot make contributions to an HSA if she has a medical Flexible Spending Account (FSA) or a Health Reimbursement Account (HRA) that reimburses qualified medical expenses (even if the employee is covered by a high deductible health plan). Whose expenses can your HSA cover?
Under federal tax law, HSA expenditures are tax-free if used for qualified medical expenses for you and your spouse, any
dependents you claim on your tax return, and, with certain exceptions, any person you could have claimed as a
dependent.
x You and your spouse: This is true whether or not your spouse or dependent is covered by a high deductible health plan. Even if both spouses have an HSA, one spouse can pay for qualified medical expenses for the other. x Any dependents you claim on your tax return. In general, you can pay qualified medical expenses for your child if he/she lived with you for more than half of the year and is under 19, or under 26 if a full-time student. In certain instances, you can use HSA funds to pay qualified medical expenses of other family members who you claim as a dependent for income tax purposes. x You can use HSA funds for qualified medical expenses for any person you could have claimed as a dependent on your return except when the person filed a joint return, had a gross income of $3,700 or more, or if you or your spouse, if filing jointly, can be claimed as a dependent on someone else's return. If you have questions about your eligibility to have an HSA, review IRS Publication 969 at irs.gov/publications/p969.
For questions on who will qualify as your dependent for purposes of reimbursing medical expenses from your HSA,
review IRS Publication 502, Medical and Dental Expenses, at irs.gov/publications/p502/. Also, for specific questions or
concerns, consult with your tax preparer or a tax attorney.
Questions?
If you have questions about your MESSA ABC medical plan, go to www.messa.org/MESSAABCs or call MESSA's East
Lansing-based Member Service Center at 800.336.0013.
If you have questions about your HealthEquity HSA, go to www.healthequity.com or call HealthEquity's Member Services department at 877.218.3432.
1475 Kendale Blvd., PO Box 2560 East Lansing, MI 48826-2560 HSA eligibility and opting out of your HealthEquity® HSA
HSA eligibility
Under federal law, contributions to a Health Savings Account (HSA) from eligible individuals and contributions made on
behalf of eligible individuals by their employers are not taxed. Interest, investment earnings and disbursements from the
HSA for eligible medical expenses are also not subject to taxes. In order to enjoy the tax-free benefits of an HSA,
employees must be eligible under IRS rules.
To be considered an eligible individual and qualify for an HSA, an employee must meet the following requirements: x Employee must be covered by an HSA-qualified high deductible plan (MESSA ABC plans are HSA-qualified). x Employee cannot be claimed as a dependent on someone else's tax return. x Employee with an HSA-qualified high deductible health plan cannot be covered by another person's health plan that is not HSA-qualified. x If an employee's spouse has a non-HSA-qualified health plan, that employee can still be eligible for an HSA provided the employee is not covered by the spouse's plan. x Employee cannot be enrolled in Medicare or Medicaid. x Employee cannot have utilized VA benefits in the three months leading up to enrollment in the HSA plan. x An employee covered by a high deductible health plan and a medical Flexible Spending Account (FSA) or a Health Reimbursement Account (HRA) that reimburses qualified medical expenses generally cannot make contributions to an HSA. For additional information on eligibility, review IRS Publication 969 at www.irs.gov/publications/p969. Your HealthEquity HSA:
When MESSA receives your enrollment information for MESSA ABC, we will inform HealthEquity to activate your free
HSA account. Soon after enrollment you should receive a welcome kit and Visa® Health Account card directly from
HealthEquity. In order to use your Visa® Health Account card to pay for qualified medical expenses, the HSA account
must contain adequate funds. Please note: Some employee groups may bargain or choose to use a different HSA
administrator than HealthEquity. If you are unsure about your group, check with your association leadership or
employer's business office.
Opting out of your HealthEquity HSA:
If you are enrolled in a MESSA ABC plan and aren't sure you are eligible to make contributions to an HSA, check with
your tax adviser or legal counsel. If you want to opt-out and close your HealthEquity HSA account, call HealthEquity's
Member Services department at 877.218.3432.
Questions?
If you have questions about your MESSA ABC medical plan, go to www.messa.org/MESSAABCs or call MESSA's East
Lansing-based Member Service Center at 800.336.0013.
If you have questions about your HealthEquity HSA, go to www.healthequity.com or call HealthEquity's Member Services department at 877.218.3432. 1475 Kendale Blvd., PO Box 2560 East Lansing, MI 48826-2560 Medicare and HSA eligibility x 65 years-old and Medicare eligible x Not enrolled in Medicare x Single or married x Enrolled in single, two person or full family MESSA ABC x Not receiving Social Security Medicare eligibility alone does not disqualify you from contributing, or receiving employer contributions, to an HSA. If you are actively employed and are not receiving Social Security you will not be automatically enrolled in Medicare. x 65 years-old and Medicare eligible x Single or married x Enrolled in single, two person or full family MESSA ABC x Receiving Social Security, and therefore: Automatically enrolled in Medicare Part A You cannot contribute, or receive employer contributions, to an HSA. When you receive Social Security you are
automatically enrolled in Medicare at age 65. You cannot decline the automatic enrollment in hopes of participating in
an HSA. NOTE: Although no further funds can be contributed to your HSA once you are enrolled in Medicare, any funds
that remain in your HSA can still be used to pay for eligible medical expenses on a tax-advantaged basis.
x 65 years-old and Medicare eligible x Married to a spouse who is retired and receiving Social Security and Medicare x Enrolled in full family MESSA ABC Your spouse's receipt of Medicare benefits does not disqualify you from contributing, or receiving employer contributions, to an HSA. You may also contribute, or receive contributions, up to the two person limit. x 65 years-old and Medicare eligible x Enrolled in Medicare (either voluntarily or automatically) x Married to a spouse who is not Medicare eligible x Enrolled in full family MESSA ABC You cannot contribute, or receive employer contributions, to an HSA. However, as long as he is otherwise eligible, your spouse can establish and contribute to an HSA, up to the two person limit. Your spouse's contributions will be on an after-tax basis and he cannot accept contributions from your employer. But your spouse can use the HSA funds to pay your eligible expenses (except Medicare Part B & D premiums) even though you are not HSA-eligible. NOTE: Although no further funds can be contributed to your HSA once you are enrolled in Medicare, any funds that remain in your HSA can still be used to pay for eligible medical expenses on a tax-advantaged basis. Learn more at www.messa.org/MESSAABCs or call MESSA's Member Service Center at 800.336.0013.
Understanding deductibles
Health plan deductibles are similar to the deductibles on your auto and homeowners' insurance. A deductible is a fixed amount of money you must pay before the plan covers approved services. MESSA ABC plan deductibles apply to medically approved services and prescription drug purchases except certain preventive care and preventive prescriptions which are covered for free in-network (with no deductible, copayment, or coinsurance charge to the member). 2-Person & Family 2-Person & Family MESSA ABC Plan 1*
MESSA ABC Plan 2
MESSA ABC Plan 3
*The MESSA ABC Plan 1 deductible is subject to change each Jan. 1 in order to remain HSA-compatible according to IRS rules governing HSAs.
Tips to understanding your deductible:
x Use your MESSA insurance card every time you go to the pharmacy or any other medical provider to ensure out-of-pocket expenses you incur will be credited by MESSA toward your deductible. By using your MESSA insurance card, you will save money by receiving the discounted approved amount for in-network services. x Deductibles reset each Jan. 1. x If you have 2-Person or Family coverage, you must pay the entire family deductible before claims are paid for any individuals, as required by federal law for an HSA-qualified plan. x If a service, medication or supply is not a covered benefit, it will NOT count toward your deductible. x You pay the full cost of a prescription until your deductible is met, but you can use HSA funds to pay for a prescription. If you choose a brand name drug when a less expensive generic is available and medically appropriate, the additional costs for the brand name do not count toward the annual deductible or out-of- x Specific preventive care services and preventive prescriptions are not subject to your deductible. MESSA and HealthEquity can help
If you have questions about your MESSA ABC medical plan, go to www.messa.org/MESSAABCs or call MESSA's East
Lansing-based Member Service Center at 800.336.0013.
If you have questions about your HealthEquity HSA, go to www.healthequity.com or call HealthEquity's Member Services department at 877.218.3432. MESSA ABC health plans include coverage for
Free Preventive Prescriptions
MESSA ABC health plans include coverage for an extensive list of free preventive prescriptions that arecovered at no charge to MESSA ABC members (no copayment and no deductible charge). This coveragegives members who enroll in MESSA ABC additional ways to stretch their health care dollars and helpsthem limit their out-of-pocket costs.
Given the rapidly changing prescription drug market, this list is frequently updated. For the most
accurate and up-to-date listing, visit the MESSA ABC area at messa.org or call MESSA's Member
Service Center at 800.336.0013.
Preventive prescriptions that are covered for free under this MESSA ABC benefit include hundreds ofgenerics and numerous "single-source" brand name drugs (single-source brand name drugs are drugs forwhich no generic options have been brought to market yet).
Covering these important preventive prescriptions helps keep down the cost of MESSA ABC. Makingpreventive services and preventive prescriptions more affordable (and in many cases, free) for patientsmeans they are more likely to go see their doctor and follow their doctor's guidance. This helps MESSAmembers stay healthier and avoid higher cost services, such as emergency room visits andhospitalizations.
In order to be eligible for free preventive prescription coverage under this benefit, a prescription drugmust be an FDA-approved drug therapy from one of the following standard preventive drug categoriesand it must be prescribed for the condition specified by the category: Alcohol dependence Breast cancer prevention Contraceptives for women Fluoride preparations High blood pressure-lowering agents (Hypertension) Prenatal vitamins Smoking cessation Because the prescription drug market changes rapidly, this list is updated frequently. This version is
current as of December 18, 2014. For the most accurate and up-to-date listing, visit the MESSA ABC
area at messa.org or call MESSA's Member Service Center at 800.336.0013.
MESSA ABC: Free Preventive Prescriptions
Standard Preventive Drug List
(generic OTC - 81mg and 325 mg) Breast Cancer Prevention
Norgestimate and Ethinyl Estradiol Ortho Tri-Cyclen Lo OTC Contraceptives (with a Cholestyramine Light KarivaKelnor 1/35 Levonorg-Eth Estrad *Certain age and gender requirements apply. If you have questions about your eligibility for this coverage, call our Member Service Center at 800.336.0013. MESSA ABC: Free Preventive Prescriptions
Fluoride Preparations (cont.)
Metoprolol Succinate Metoprolol Tartrate Prevident 5000 Enamal Protect Prevident 5000 Sensitive Stannous Fluoride Folic Acid*
(generic only - 0.4 mg and 0.8 mg) Aldactazide 50/50 Teveten (except 600 mg) Cardene SRCardura XL *Certain age and gender requirements apply. If you have questions about your eligibility for this coverage, call our Member Service Center at 800.336.0013. MESSA ABC: Free Preventive Prescriptions
Ultimatecare One NF Paire OB Plus DHA (generic only - 15 mg drops) PNV – DHA + Docusate Citranatal 90 DHA Citranatal Assure Complete Natal DHA Prefera-OB plus DHA Complete-RF Prenatal Duet DHA with Ferrazone Prenatal Low Iron Prenatal Multivitamin with Iron Zatean – PN – DHA Zatean – PN – Plus Prenatal UPrenate DHA Smoking Cessation Products*
Gesticare DHAInatal Advance Buproban (generic Zyban 150 mg only) Prenate Essential Bupropion ER/SR (generic Zyban 150 PR Natal 400 – EC Nicotine OTC Patches and Gum Vitamin D*
Weight Loss Products
Taron Prex Prenatal Triveen – PRX – RNF *Certain age and gender requirements apply. If you have questions about your eligibility for this coverage, call our Member Service Center at 800.336.0013. MESSA ABC: Free Preventive Prescriptions
FAQs on MESSA ABC
Q: What is MESSA ABC?
Q: Why is the deductible higher
Q: What preventive medical
with MESSA ABC?
services and prescriptions
A: MESSA ABC is a comprehensive
are covered for free?
medical plan that works with a A: HSA-qualified plans are
health savings account (HSA) to governed by federal law and A: Annual physicals, cancer
the IRS code, which specifies a screenings and certain lab tests are minimum deductible level. MESSA covered for free and are not subject • access to a large network of doctors, pharmacies and other ABC Plan 1 is set at the minimum to the plan deductible when you go medical providers deductible; the MESSA ABC Plan to an in-network provider. MESSA 1 deductible is subject to change ABC also covers hundreds of free • outstanding MESSA service each Jan. 1 in order to remain HSA- preventive prescriptions to treat compatible according to IRS rules certain common conditions.
• free preventive care and certain governing HSAs.
free preventive medications Q: Do I have to pay the full cost of
Q: When does the deductible start?
non-preventive prescription drugs
• lower premiums in exchange for that are subject to the deductible?
a higher deductible A: The deductible year is the
calendar year, Jan. 1 to Dec. 31.
A: Yes. Under federal law, all
• the opportunity to contribute non-preventive prescriptions are pre-tax dollars to an HSA, which Q: Does the deductible apply to
subject to the deductible. MESSA's lowers your income taxes all medical expenses?
underwriter, Blue Cross Blue Shield Each MESSA ABC member receives A: Under federal law, most medical
of Michigan, caps your cost at a HealthEquity HSA with no setup expenses, including the cost of the same amount the Blues has or administration fees.
prescription drugs, are subject to the negotiated with the pharmacy, deductible. If you have 2-person or Q: Can I choose my doctor and
which saves you money. Additional family coverage, the expenses of one out-of-pocket charges can apply if person can meet the full deductible.
you insist on a brand name drug A: MESSA ABC uses the same large
when a generic version is available provider network as MESSA Choices/ and medically appropriate.
Choices II, giving you the greatest (continued on reverse) choice of doctors and access to expert medical care from the best hospitals, including the Mayo Clinic and the Cleveland Clinic.
Q: Do I have to go to an in-network
Q: What happens after I meet the
Q: What is the difference between
preventive care and diagnostic
A: No, but it is always to your
A: With MESSA ABC Plan 1
financial advantage to do so. and Plan 2, once you meet your A: Preventive care refers to specific
In-network providers have agreed in-network deductible, you will be services proven to prevent or to accept a discounted fee for responsible for prescription drug identify problems early.
medical services from MESSA's copayments and the plan will Diagnostic services start when underwriter, Blue Cross Blue Shield pay 100% of the approved cost you already have signs of a health of Michigan. The Blues' discount of covered in-network medical problem; therefore, your doctor and your savings can be substantial. services, including doctor visits, may order tests to further diagnose Using in-network providers saves hospitalization and surgery.
your condition. When this happens, you money on out-of-pocket costs With MESSA ABC Plan 3, once you these services are subject to your and lower deductibles. It also saves meet your in-network deductible your MESSA health plan money, you will be responsible for helping to hold down costs.
Q: Where can I get a complete list
prescription drug copayments of my benefits?
Q: Are there separate deductible
and the plan will pay 90% of the levels for medical services received
approved cost of in-network A: To view your benefit coverage and
from in-network and out-of-network
medical services.
read your plan coverage booklet, go to www.messa.org and log into the Member Area.
A: Yes. The out-of-network
deductibles are twice the in-net- work deductible amounts. (Please note: Out-of-network providers may charge more than the amount approved by MESSA's underwriter, Blue Cross Blue Shield of Michigan, and these costs can be significant.) FAQs on health savings accounts (HSAs)
Q: What is an HSA?
Q: Who is eligible to contribute
Q: How much money can I
to an HSA?
A: An HSA is a tax-favored account
contribute to my HSA?
that allows the account holder to A: To be eligible to open and
A: In 2015, the maximum tax-
save and pay for qualified medical contribute to an HSA, you must free contribution is $3,350 for expenses tax-free. To open an HSA, meet the following requirements: individuals and $6,650 for those you must be in an HSA-qualified • be covered under an HSA- with family coverage. People over health plan (such as MESSA ABC). qualified health plan on the the age of 55 can make an additional You can use funds in your HSA to first day of any month for which "catch-up" contribution of $1,000. pay for out-of-pocket expenses not eligibility is claimed (see IRS These limits are the same regardless covered by your health plan, as well Publication 969—Health Savings of the source of the contribution.
as other qualified medical expenses.
Accounts and Other Tax-Favored Q: What if I am covered under my
Q: I have a MESSA ABC plan now.
spouse's insurance but I want to
Where do I go to start an HSA?
• not be enrolled in Medicare enroll in one of the MESSA ABC
plans and contribute to an HSA?
A: When you enroll in a MESSA
• not be claimed as a dependent ABC plan, you also receive a on someone else's tax return A: If you are covered under
HealthEquity HSA. You will receive another medical plan that is not • have no other insurance except a member welcome kit directly HSA-compliant, you are not eligible what's permitted by the IRS from HealthEquity with account under IRS rules to contribute to an information. It is important that Q: Who owns the HSA?
HSA (see IRS Publication 969).
you take a few minutes to activate A: The money in the account
(continued on reverse) your account online. There are no belongs to you – for the rest of HealthEquity setup fees or monthly administrative fees for MESSA ABC Q: Who can put money in
plan members. Contact your school HealthEquity at 877.218.3432.
business office if your group has negotiated another HSA provider.
A: Anyone can contribute to your
HSA; however, only the account holder receives deductions on money contributed.
Q: Can I have an HSA AND a
for copays and qualified medical Q: Can I roll the money from my
expenses, but you won't be able IRA into my HSA?
A: In most cases, no. The IRS has
to contribute more money to your A: Yes. You can make a one-time
specific rules for insurance plans HSA. If you have a HealthEquity rollover from your IRA into your that are allowed to coexist with HSA, you will begin paying HSA. You can't, however, roll money an HSA and plans that would monthly account fees.
into your IRA from your HSA. Also, disqualify you from owning an HSA.
Q: What happens to any money
a rollover will count against annual For specific questions, contact
remaining in my HSA at the end
HealthEquity's Member Services
of the year?
department at 877.218.3432 or
A: The money rolls over from year
can I contribute to an HSA?
a financial or tax adviser for
to year. You don't lose the money left in your HSA or the interest it Q: Can I use the money in my
HSA to pay for my children's
Q: Can I take the money out of
A: Qualified medical expenses are
those that would generally qualify A: Yes. If you use the money
children are covered by my
for the medical and dental expenses to pay for qualified medical income tax deduction as outlined in health plan?
expenses, then you will not be IRS Publication 502—Medical and taxed or assessed a penalty. If A: You can use money from your
Dental Expenses. See www.irs.gov/ you take money out for other HSA to pay for your child's eligible publications/p502/index.html for a purposes, however, you'll have out-of-pocket expenses if the child current complete list.
to pay income taxes on the is claimed as a dependent on your withdrawal, plus a 20% penalty.
Q: Can I use my HSA dollars to pay
Q: Does the money in my HSA
Q: What happens to the money in
contacts and eyeglasses?
A: Yes, but these expenses will
A: Yes, and that interest is tax-free.
A: It's your account, so you take
not apply to your MESSA ABC that money with you. If you're on Q: Can the money in my HSA
Medicare or go to another employer be invested?
that doesn't have a qualified high- deductible health plan, you can still use your HSA money to pay YƵĞƐƟŽŶƐĂďŽƵƚD ŵĞĚŝĐĂůĂŶĚZdžĐŽǀĞƌĂŐĞ͍
Call MESSA's Member Service Center at 800.336.0013.

Source: http://lcs.sharpschool.net/UserFiles/Servers/Server_3097392/File/HR/HealthCareInfo/ABC_Packet.pdf