Help Me Understand: Benefit Definitions
CDHP: Consumer Driven Health Plan. A medical plan that offers lower employee premiums, but the participants assume more of the costs when receiving treatment. We make a contribution to your HSA if you participate in the CDHP.
HSA: Health Savings Account. You make before-tax contributions that help you pay for expenses such as your annual deductible. Account balances roll over year to year and is portable so employees can take it with them if they change jobs.
POS ll Plan: Point of Service Plan. A medical plan with higher employee premiums that allows you to receive care from either in-network or out-of-network providers, with lower out-of-pocket expenses for in-network services.
HCFSA: Health Care Flexible Spending Account. An account that allows you to make before-tax contributions that helps pay eligible out-of-pocket medical expenses not covered by your health plan from 1/1-12/31. Any money left in the account at the end of the calendar year will be forfeited.
Deductible: The amount of money that you must pay before your insurance plan begins to pay certain covered expenses. For example, if your deductible is $600, your plan does not pay benefits until you’ve paid $600 out of pocket for covered health care services subject to the deductible
Out of Pocket Maximum:Â The yearly maximum you will have to pay for covered medical expenses before your insurance plan begins to pay 100% of covered medical expenses.
Copay: A copay, like in our POS II Plan, is a fixed amount you pay for a health care service when you visit your health care practitioner or pharmacy. Amount varies by the type of service.
Coinsurance: After you pay your deductible, a coinsurance is your share of a health care service cost. For example, if your plan pays 90% of your health care services after you’ve paid your deductible, then your coinsurance is 10%.
Imputed Income: A term the Internal Revenue Service (IRS) applies when they require a value of a benefit or service to be considered as income for the purposes of calculating your federal taxes. This can apply to life insurance and if you are covering a domestic partner on your healthcare plan.
R &C: Reasonable and Customary. The amount that Aetna considers reasonable for an out-of-network medical service based on providers specialty and geographic area where the service was provided. If an out-of-network provider’s fee for a given service is more than the R&C charge determined by Aetna, Plan benefits apply only to the portion of the charge that is considered reasonable.
DCFSA: Dependent Care Flexible Spending Account. An account that allows you to make before-tax contributions to pay for qualified child care and eldercare expenses from 1/1 through 12/31. Any money left in the account at the end of the calendar year will be forfeited.
EAP:Â Employee Assistance Program is a resource for assistance with a wide range of everyday needs, at no cost to you. You and covered dependents are eligible for 10 free face to face visits and unlimited telephonic assistance. Employees and household members can confidentially address and resolve personal, legal, financial and work/life challenges through the EAP.
Transit Program:Â Allows employees to make before-and after tax contributions to pay for transportation to work and have them automatically delivered to your home, or order a debit card to use when paying commuting expenses.
Parking Program:Â If you park near where you work, or near where you board public transit you take to work, allows employees to make before- and after-tax contributions and pay for your parking through WageWorks.
401(k): A retirement savings plan sponsored by an employer. It lets workers save and invest a piece of their paycheck before taxes are taken out. The Company also contributes towards your savings.
Click here to view some examples of the terms listed above! For details on your plan’s out-of-pocket costs and the services covered, check the Summary of Benefits and Coverage, which is included in your enrollment materials.