The Consumer Choice Plan is a high deductible medical plan that features the lowest medical plan contribution per paycheck than other major medical plans available through ACS. The Consumer Choice Plan covers preventive care, including Well-Child, Well-Woman, and prostate screenings, at 100% with NO deductible for in-network. For other services, the plan pays 80% of covered expenses within the network after you have met the deductible.
Consumer Choice Plan participants are also automatically provided a Health Savings Account (HSA), and ACS makes a monthly contribution of $45 per month for individual coverage or $90 per month for family coverage to your HSA account. Additionally, you may contribute to your HSA account, up to $2,510 for individual coverage or $5,070 for family coverage in 2010. You may use the funds in your HSA account to pay for your out-of-pocket medical plan expenses throughout the year, including your annual deductible.
The ACS PPO Plan costs more per paycheck than the Consumer Choice Plan, but less than HMO medical plan options (if an HMO is available in your area). Preventive care, including Well-Baby care, is covered up to $500 per calendar year at 100% with NO deductible. The $500 maximum does not apply to Well Baby Care for children under the age of 2 or for in-network colonoscopies.
The ACS PPO Plan features co-pays for physician office visit and for other specified services. After labs, X-rays, and other expenses that apply to the annual deductible are satisfied, the plan pay 80% for covered network services.
Certain areas also have an HMO option. HMOs have the highest cost per paycheck of all available medical plan options. Coverage for services generally feature co-pays for most services, as outlined in the HMO’s Summary Plan Description or Certificate of Coverage. If an HMO is available to you, review your personalized Annual Enrollment Kit (mailed to you in late October) and BenefitsWeb for additional information.
Here’s a table comparing a few main features of the Consumer Choice Plan and the ACS PPO Plan:
Consumer Choice Plan |
ACS PPO Plan |
|
Preventive care is covered at 100%, with no deductible and no annual limits. |
Preventive care is covered at 100% after a $25 copay. $500 annual limit per covered member. |
|
In- and out-of-network coverage available. |
In- and out-of-network coverage available. |
|
Lower per-paycheck cost |
Higher per-paycheck cost |
|
Pay a deductible and coinsurance for all services except preventive care. You can use your HSA funds to pay or reimburse yourself for deductible and coinsurance. |
Pay a copay for office visits. For all other services, pay a deductible and coinsurance. |
|
Health Savings Account (HSA) is automatic: - ACS makes a monthly contribution - You may make pre-tax contributions - Reimbursements are not taxed - No “use-it-or-lose-it” rule – balance carries over year to year - Account earns tax-free interest and earnings and can be invested - Funds are available as they are deposited in the account - Portable |
Health Care Flexible Spending Account (FSA) is optional: - No ACS contribution - You may make pre-tax contributions - Reimbursements are not taxed - “Use-it-or-lose-it” each year – unused balance is forfeited at the end of each year - Account does not earn interest/cannot be invested - Total annual contribution amount is available at the beginning of the year - Not portable, except under COBRA |
|
If you enroll only yourself, you must meet the individual deductible and out-of-pocket limit. If you enroll one or more family members, your family must meet the family deductible before the plan starts sharing expenses. In addition, your family must meet the family out-of-pocket maximum before the plan starts paying 100% of eligible expenses. |
Each individual must meet the individual deductible and individual out-of-pocket limit. However, if three family members meet the individual deductible, the entire family will have met the family deductible. And, if three family members each meet the individual out-of-pocket limit, the entire family will have met the family out-of-pocket limit. |
|
Higher deductible; however, all expenses you pay count toward the deductible. |
Lower deductible; however, copays do not count toward the deductible. |
|
Prescription drugs are subject to the annual deductible and out-of-pocket maximum. |
Prescription drug coverage has a separate deductible as well as copays and coinsurance. Out-of-pocket costs for prescription drugs do not apply to out-of-pocket maximum. |
No matter which plan you participate in, be sure you’ve identified and you’re comfortable with both the amount and how you will be paying for your medical services.
- ———————————————————–
- Questions about your employee benefits or other Human Resources issues? Contact the Workplace Solutions Center at (888) 471-2271.