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1. What will my medical options be for next year?

   You will have the choice between two medical plan options. The choices are:

   • A Consumer-Directed Health Plan with a Health Savings Account (CDHP + HSA)
   • A Consumer-Directed Health Plan with Health Reimbursement Account (CDHP + HRA)

   Be sure to check out the Medical Matchup interactive feature so you can see which medical plan may be right for you.

2. Who is the Medical Plan claim administrator?

   AmeriBen will be the medical plan claims administrator. You will continue to utilize the same BCBS network of providers. When you have a question, need to file a claim, or search for a doctor, you will reach out to the AmeriBen Customer Care Contact Center. Representatives will answer your questions and assist you as needed. AmeriBen also offers a suite of health and wellness support options.

   To find an in-network doctor visit MyAmeriBen.com and use the Find a Doctor feature or call 1-866-215-0976.

3. Will I receive Medical Plan ID cards?

   If you are a new enrollee or change medical plans for 2024, AmeriBen will send you new ID cards for you and your dependents. If you do not make any medical plan changes, you may continue to use your current ID cards. The ID cards will have the policy number, and the Customer Care Center contact numbers. Be sure that your home address in MyHR is correct. You should receive your new card in late December.

4. How are the CDHP + HSA and CDHP + HRA different?

   There are several differences between the plans. Please see the Benefits Guide for a comparison of the plans to help you determine which plan is right for you and your family.

5. How does an HRA work?

   When you enroll in the CDHP + HRA, you will not have a separate account, like you will with the CDHP + HSA. Instead, a credit is applied to your account in January. When you receive services, you simply present your HRA debit card and medical ID card and have the doctor or other provider file your claim with AmeriBen.

   If you are filling a prescription, you can simply use your HRA debit card to make a payment, up to the current balance in the HRA account. When you present your CVS/caremark ID card, the pharmacist should be able to calculate the amount you owe for your prescription, if you haven’t reached your deductible. Remember to check your HCA balance before using your debit card. You will be charged a fee if you have insufficient funds.

6. How do I pay for services under the CDHP + HRA?

   Since you need to meet the deductible before benefits begin (except for in-network preventive care, covered at 100%, or primary care doctor visits and generic prescriptions, where you pay a copay), your provider should file your medical claim with AmeriBen before you make any payments to them. Make sure you present your HSA Debit Card and BCBS member ID cards to the provider at the time of service. If your in-network medical provider asks for full payment, point out to them that you are in a consumer-directed health plan and should not be required to pay the full cost of service up front. When you receive your explanation of benefits (EOB) from AmeriBen, you will know the exact amount owed, if any. You can pay for eligible expenses in one of two ways:

   1. Pay for services and products upfront. Then submit the proper form and receipts for reimbursement. You can have your funds automatically deposited into your checking or savings account or receive a check.
   2. Pay eligible expenses with your HSA Debit Card. Payments are automatically withdrawn from your HRA, so you don’t have to pay out-of-pocket when you are purchasing.

7. What’s the easiest way to check my HRA balance?

   You can register on the Wex Health Inc. website at Benefitslogin.wexhealth.com. In the New User section, click “Get Started” and complete the required information to set up your account. Once you set up your user access, you will be able to review your balance and view account activity.

8. How does an HSA work?

   When you enroll in the CDHP + HSA, the Partnership dollars, and any money you contribute, will go into a separate, tax-advantaged bank account under your name. The Partnership will place a portion of your HSA dollars in the account every pay period. You will receive a HSA Bank Visa card to present at the time of service, and the amount owed to your provider will be debited from your HSA.

9. How do I pay for services under the CDHP + HSA?

   Since you need to meet the deductible before benefits begin (except for in-network preventive care, covered at 100%), your provider should file your medical claim before you make any payments to them. In some cases medical providers require payment prior to filing a claim. If so, you should use your PNC Bank debit card, if funds are available. If your in-network medical provider asks for full payment, point out to them that you are in a consumer-directed health plan and should not be required to pay the full cost of service up front. Then, when you receive your explanation of benefits (EOB) from AmeriBen, you will know the exact amount owed and can pay your provider using funds in your HSA with the PNC Bank debit card or out-of-pocket.

   If you are filling a prescription, you can simply use your PNC Bank debit card to make the payment, up to the current balance in your HSA account. When you present your CVS/caremark ID card, the pharmacist should be able to calculate the amount you owe for your prescription, if your deductible has not been met. Remember to check your HSA balance before using your credit card. You will be charged a fee if you have insufficient funds and/or use the debit feature.

10. What if a health care expense is more than the amount I have in my HSA?

    You can use only the amount that is currently in your account. If there is not enough money in your account, you will have to pay for the service out of pocket. You always have the option of depositing funds directly to your HSA so money is there when you need it. You can deduct from your taxable income at year-end the amount sent directly to PNC Bank. This direct deposit feature is available whether or not you elect payroll deductions to fund your HSA.

11. Will contributing to a Health Savings Account (HSA) reduce my taxable income?

    If you enroll in the CDHP + HSA Medical Plan option, the Partnership will contribute to your HSA. Consider making additional contributions to the account as well. Contributions come out of your paycheck before taxes, which lowers your taxable income. Your account earns interest tax-free, and investment earnings on balances are tax-free. The most anyone can contribute to your HSA for 2024 is $4,150 for employee-only coverage and $8,300 for all other coverage levels. The maximum amounts include Partnership contributions of $750 for employee-only coverage and $1,500 for all other coverage levels.

12. What do I say if my provider’s office asks what my copay is?

    With the CDHP + HRA, you only have a copay when you visit your primary care doctor (not a specialist) or if you are filling a generic prescription at a retail pharmacy or through mail service. You pay a $50 copay for primary care doctor office visits and a $10 (retail) or $20 (mail service) copay for generic drugs. With the CDHP + HSA, you do not have copays. If your provider’s office asks, tell them you do not have a copay – you have coinsurance. For eligible preventive care, your care is covered at 100% in-network. For non-preventive care, you will pay for the cost of your care based on the discounted cost after your provider has submitted a claim through AmeriBen.

13. How do I get the tobacco-free premium discount?

    When you enroll, you will need to indicate if you are a tobacco user or non-tobacco user by checking the appropriate box on for you and your covered dependents over the age of 18:

    • Do not use tobacco products, and
    • Have not used them for the past three months.

    Remember, while the Partnership takes your self-elected designation with respect to your tobacco-free status, if it becomes known to the Partnership that you have misrepresented such status, you will be subject to removal from the Partnership’s Medical Plans and additional discipline, up to and including potential termination.

14. How can I get help to kick my tobacco habit?

    AmeriBen offers a Tobacco Cessation Program that can help you or any of your covered family members over the age of 18 to kick the tobacco habit. The Tobacco Cessation Program provides you with resources and tools like:

    • Personal Telephone Wellness Coaching – for help meeting tobacco cessation goals, and
    • Self-Directed Courses – which allow you to work at your own pace to meet your wellness goals.

    Log on to MyAmeriBen.com to learn more!

15. What other services does AmeriBen provide?

    In addition to claims management and finding doctors, AmeriBen offers many quality services to guide you through your health care needs. These services include:

    • Case Management – If you are hospitalized or receive a new diagnosis, a Registered Nurse Case Manager can help guide and support you throughout your illness or injury.
    • Disease Management – Registered Nurse Health Coaches will help you take control of your chronic health conditions.
    • Baby Steps Maternal Health Program – You can receive education, support, and a specially trained Maternal Health Registered Nurse to help you stay healthy before, during and after your pregnancy.

    To access these services and more visit MyAmeriBen.com or call 1-866-215-0976.

16. My doctor says I need to have a scan and maybe surgery. What do I need to do?

    Some non-emergency procedures such as MRIs, CT scans, and surgeries, require pre-certification. Whether you are considering an in-network or out-of-network provider, when your doctor mentions you need a non-emergency procedure or test, contact AmeriBen. The AmeriBen customer care representatives will walk you through the steps you need to take. Click here for a complete list of procedures that require pre-certification. Please note that if you do not receive pre-certification, your treatment may not be covered.