2024-BenefitsGuide-V16-Final

What type of expenses does an HSA cover? You can use your HSA to pay for medical expenses that are not covered by a health plan and meet the IRS definition of a qualified medical expense for you, your spouse, and dependents. See IRS Publications 969 and 502 at www.irs. gov. Many medical and health expenses are covered by an HSA: • Health plan deductibles and coinsurance • Prescription drugs and insulin • Medical care and services • Dental and vision care (after deductible has been met) Understanding the Reliance Saver Plan The Saver Plan requires you to pay more of your medical expenses upfront before the plan begins to pay. Below is an example of how the Saver Plan would work compared to the High and Low PPO Plans. Note: In-network medical expenses include discounts and negotiated rates. Out-of-network medical expenses can cost you much more than the examples below.

LOW PPO PLAN You Pay 20% In-Network $850 Individual Deductible

SAVER PLAN You Pay 20% In-Network $1,600 Individual Deductible

HIGH PPO PLAN You Pay 10% In-Network $300 Individual Deductible

Medical Expense (In-Network) $100 Specialist Office Visit

Plan Pays

You Pay

Plan Pays

You Pay

Plan Pays

You Pay

$35 Copay No Deductible

$40 Copay No Deductible

$100 towards Deductible

$65

$60

$0

$200 Generic Preventive Rx

No Copay No Deductible

No Copay No Deductible

$200

$200

$200

$0

$125 Generic Non-Preventive Rx

$10 Copay No Deductible $300 towards Deductible + $50 (10% Coinsurance)

$10 Copay No Deductible

$125 towards Deductible

$115

$115

$0

$800 Outpatient Surgery

$450 (90% Coinsurance)

$800 towards Deductible

$800 towards Deductible

$0

$0

$50 towards Deductible + $130 (20% Coinsurance)

$575 towards Deductible + $25 (20% Coinsurance)

$700 Physician Fees (Non- Office Visit)

$630 (90% Coinsurance)

$70 (10% Coinsurance)

$100 (80% Coinsurance)

$520

Subtotal

$1,460

$465

$895

$1,030

$300

$1,625

LIVEHEALTH ONLINE Save time andmoney with LiveHealth Online. All you need is amobile phone/ tablet or a computer (with video camera) with an internet connection. You or your covered dependent may see a LiveHealth Online doctor for a $15 copay for PPO enrollees and $59 for Saver Plan enrollees. Inmost cases, a doctor can send a non-controlled substance prescription electronically to your local pharmacy.

Common concerns include: flu, minor rashes, sore throat, pink eye, allergies, fever, skin infections, headache, cold, diarrhea, anxiety, depression, andmuchmore.

DOCTOR VISITS

With your Employee Assistance Program (EAP), you can schedule a video visit with a licensed counselor when you need support. Use your phone, tablet, or computer with a camera to have a secure visit on LiveHealth Online fromhome.

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