The Consumer Choice Plan gives you control over how you spend your benefit dollars, including those provided by ACS. This control encourages you to be a wiser health care consumer by researching options available to you and making choices that balance costs versus needs.
Here’s how it works:
The Consumer Choice Plan is a traditional health care plan with a high deductible. You pay eligible expenses equal to the deductible before you begin sharing expenses with the plan. And ACS makes contributions to a health savings account (HSA) to help you pay your health care expenses. Preventive care provided by network providers is covered at 100%, with no deductible and no co-payments.
ACS provides you with money in a Health Savings Account. You use this money to pay your deductible and out-of-pocket expenses. For non-preventive care expenses, including prescriptions, you pay an annual deductible before the plan begins sharing costs with you. Once you meet the deductible, you and the plan share expenses up to the annual out-of-pocket limit. Once you meet the annual out-of-pocket limit, the plan pays 100% of eligible expenses for the rest of the year.
Prescription Drug Coverage for Consumer Choice Plan
Prescription drugs are covered the same as any other expense in the Consumer Choice Plan. You pay 20% of the discounted drug price after the deductible when you use a participating pharmacy or mail-order pharmacy and 40% after the deductible if you use an out-of-network pharmacy. Medco provides the pharmacy network for the Anthem Lumenos-administered Consumer Choice Plan. Prime Therapeutics provides the pharmacy network for the BCBS-administered Consumer Choice Plan.
Advantages of Using Network Providers
You can receive care from any provider you choose and fill your prescriptions at any pharmacy you select.
However, using network providers offers the following advantages:
> Network preventive care is covered at 100% with no deductible;
> Network providers agree to charge you negotiated rates; you are not responsible for expenses over negotiated rates;
> Your share of the cost is generally lower;
> Your out-of-pocket maximum (the amount you must pay before the plan begins paying 100% of eligible expenses) is lower; and
> After the deductible, your share of prescription drugs is 20% versus 40% when you use a non-participating pharmacy.
How the Health Savings Account Works
The HSA allows you to set aside money on a before-tax basis to pay health care expenses, including medical, dental and vision. In addition, ACS funds your HSA each year based on your coverage level and the number of full months you participate. You may also contribute to your HSA account.
The HSA is similar to a health care spending account, with these important exceptions:
- Any money left over in your account at the end of the year carries over into the next year. You do not forfeit funds in your HSA at the end of the year.
If you’re age 55 or older, you’re also eligible to contribute an additional $1,000 per year to your HSA as a catch-up contribution.
If you enroll in the Consumer Choice Plan, you choose whether to add money to an HSA.
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- You will receive a debit card which will be funded each month with ACS’ contributions and your own contributions. You can use the card to pay for all eligible medical, dental and vision expenses until the amount in your account is depleted.
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- You can be reimbursed only up to the amount you have in your account at any time. As ongoing deposits are made, you may reimburse yourself for eligible expenses from those deposits.
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- You can earn interest on money in your account.
Finding a Network Doctor or Pharmacy
The Consumer Choice Plan is administered by Anthem Lumenos if you live in the following states:
> California > Georgia > Maine > Ohio
> Colorado > Indiana > Nevada > Virginia
> Connecticut > Kentucky > New Hampshire > Wisconsin
The network is provided by Blue Cross Blue Shield. To find out if your health care provider/pharmacy is a participant in this network, visit www.info.lumenos.com. You’ll need the following ACS-specific information to access the site:
> Username: acs6
> Password: acs567
You may also call a Customer Service Advocate at 877-875-5978.
If you live in a state other than those listed above, the Consumer Choice Plan is administered by Blue Cross Blue Shield and the network is provided by Blue Cross Blue Shield. To find out if your health care provider/pharmacy is a participant in this network, visit www.bcbstx.com, click on “Provider Finder” and search by name, health plan or provider type. Be sure to select the appropriate state from the list. If you search by health plan and live in:
> Texas, choose the BlueChoice option; or
> Outside of Texas, choose the BlueCard PPO.
If you have questions about the Consumer Choice Plan
> Lumenos customer service can be reached at 877-875-5978, Monday through Friday, 8 a.m. to 10 p.m. Eastern time; or
> Blue Cross Blue Shield customer service can be reached at 866-584-0456, Monday through Friday, 8 a.m. to 8 p.m. Central time.
HSA and health care flexible spending account
If you participate in the Consumer Choice Plan, you should use your HSA for eligible medical, dental and vision expenses, because you never forfeit any unused balance — it is simply carried forward from year to year. However, if you feel you will have dental, vision and certain over-the-counter (OTC) drug expenses in 2009 that will exceed the maximum allowable contribution to your HSA, you may want to consider adding money to a limited use FSA as well. Just remember that the limited use FSA is just that; it can only be used for eligible dental and vision expenses and the following OTC expenses:
- - Eye care items including contact lens solution, lubricant eye drops, eye patches and reading glasses;
- - Home diagnostic tests or kits for blood pressure, cholesterol screening, diabetes (e.g., glucose monitors), colorectal and HIV screening;
- - Smoking cessation relief such as patches and gum;
- - Dental care including toothache relief and denture adhesive;
- - Pre-natal vitamins with a doctor’s note of medical necessity;
- - Iron pills with a doctor’s note of medical necessity; and
- - Weight loss pills with a doctor’s note of medical necessity.
Your HSA can be used for all expenses listed above and all other eligible medical, dental and vision expenses.
Questions about your employee benefits or other Human Resources issues? Contact the Workplace Solutions Center at (888) 471-2271.