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Human Resources - Self-Insured Medical Plan (HMA)

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1. How can I learn more about the 3 different medical plans?

To help you select the best plan option for your individual situation, please make an appointment (360) 778-5300 or stop by Human Resources in the Whatcom County Courthouse, Suite 107, anytime Monday - Friday 8:30 am - 4:30 pm.  Your Human Resource Representative will be available to answer any questions.

2. How are the three medical plan options the same?

All three plans use the same “Preferred Provider” (PPO) networks and use preferred and participating providers. All three plans are administered by Healthcare Management Administrators (HMA). There is no need to designate a Primary Care Physician or seek referrals to see a specialist under any of these plans and Preventive care is covered at 100% on all 3 plans. The main difference is the deductible level. Once met, the plans provide the same protection for medical coverage.

3. When do I have to make my 2018 medical plan decision?

The Medical Plan Election form must be returned to Human Resources by 4:30 pm on November 30, 2017. You MUST complete and submit a 2018 Medical Election Form, even if you are making no changes. You will be defaulted into the 2000 Plan for 2018 if we do not receive an election form from you.

The month of November is the “open enrollment” period. During this time you can make changes to your plan election. This is the only time during the year (without a qualifying event) you can change your plan election or change dependent enrollments.

4. Can I make a different plan choice in future years?

Yes, open enrollment will occur each November for the next year’s benefits.

5. What does “qualified” mean?

A “qualified” high deductible health plan meets Internal Revenue Service (IRS) guidelines and allows, if eligible, participation in tax-advantaged, employee-owned health savings accounts (HSAs).

6. Do prescriptions count toward the deductible under the QHDHP?

Yes, participants on the QHDHP who take medications must pay the full cost of prescriptions until the deductible is met.

Medications considered "preventive" are covered at 100% and are NOT subject to the deductible. See the Preventive Therapy Drug list for more details. Preventive Therapy Drug List

7. What is a Health Savings Account (HSA)?

A Health Savings Account (HSA) is a tax-exempt account that you or your employer can deposit funds into on your behalf. Any amount that you contribute can be deducted from your taxable income, giving you a tax savings. You can use the funds in your HSA to pay for IRS qualified out-of-pocket medical expenses (such as deductibles, copays, and coinsurance), including some expenses and services that may not be covered by your health plan. You can spend HSA funds on medical expenses for your spouse or other tax dependents, even if they are not covered under your plan.

When you enroll in the Qualified High Deductible Health Plan, you will have the option to elect to enroll in an Health Savings Account through Optum.
See also: HSA Frequently Asked Questions (FAQ)

8. Who is eligible for an HSA?

A person who is:

• Covered under a qualified high-deductible health plan (QHDHP).
• Not enrolled in other medical coverage (unless it’s another QHDHP plan)
• Not enrolled in Medicare
• Not claimed as a dependent on another person’s tax return

If you choose the Contributory Plan or 2000 Plan (Default Plan), you are not eligible for an HSA. However, you may want to consider a Flexible Spending Account (FSA) to set aside funds for the 2017 tax year (use it or lose it) on a pre-tax basis.

9. Who funds the Health Savings Accounts (HSA)?

For employees enrolled in a QHDHP, the employer and the employee can contribute funds up to limits set by the IRS. The county’s 1-time contribution, called “seed money,” is outlined in the collective bargaining agreement or in the Unrepresented Resolution as applicable. Seed money is available for 1st-time QHDHP enrollees only.

If you enroll in the QHDHP and want to personally contribute to an HSA, you must annually complete an HSA Payroll Deduction form. 2017 HSA Payroll Deduction Form

10. What does “seed money” mean?

The county’s one-time contribution toward employees’ HSA account is intended to give employees a head start on building savings to cover medical costs. New, first-time QHDHP enrollees in 2017 are eligible for county “seed money.” New and continuing QHDHP enrollees can build their HSA account by electing payroll deductions. Deduction amounts may be changed at any time. 2017 HSA Payroll Deduction Form

11. How much can be contributed to my HSA?

The total 2018 contribution limit is $3,450 for an individual or $6,900 for a family which is inclusive of any Whatcom County contribution. For those age 55 and over, there is an additional annual $1,000 per participant catch-up contribution.

12. Who administers the HSA?

Optum offers the HSA accounts and provides useful web tools for accessing and managing HSA accounts.

13. Are funds in the HSA “use it or lose it?”

No, any unspent funds in your HSA are yours and will remain in the account from year to year and follow you when you leave county employment. You can spend your HSA funds on current year qualified medical expenses or leave them for future qualified medical expenses during and after employment with Whatcom County. See page 5 of the IRS Eligible Expenses for more details. IRS Eligible Expenses

14. How do you make withdrawals from the HSA?

It works just like a bank account. You can use a debit card at the point of service or use online services to pay your provider or reimburse yourself for eligible expenses.
See also: HSA Frequently Asked Questions

15. Who keeps records to substantiate HSA reimbursements?

You do in order to respond to IRS inquiries.

16. What happens to my HSA account when I die?

In the event of the account holder’s death, any money in the HSA would go to the beneficiary the account holder designated during account set up.

17. What about “coordination of benefits?”

Coordination of Benefits (C.O.B.) occurs when a person has coverage under more than one insurance plan (for example, if covered on your County plan as well as spouse's plan, or you and your spouse both cover your dependents.) If you are covered by a QHDHP, you cannot be covered by any other “health insurance plan” that reimburses you for medical expenses unless it is another qualified high deductible health plan. Your spouse and dependents can be double-covered.

18. Can I have an HSA and a Flexible Spending Account (FSA) at the same time?

If you will have a 2017 Health Savings Account (HSA), IRS regulations do not permit you to also contribute to a 2017 Flexible Spending Account for medical expenses. However, you CAN choose to have a “Limited Purpose” Flexible Spending Account for dependent care, dental, orthodontics, and vision expenses in 2017.

19. When will I receive information about my 2018 Flexible Spending Account (FSA) ?

Information about the 2018 Flexible Spending Account is online.

2018 Flexible Spending Account