A GUIDE TO UNDERSTANDING THE
CONSUMER-DIRECTED HEALTH PLAN (CDHP)
AND HEALTH SAVINGS ACCOUNT (HSA)
ENTER
WELCOME
CDHP AND HSA
BASICS
A GUIDE TO THE
CDHP AND HSA
USING THE HSA
TO PAY FOR CARE
At The Hartford, we offer competitive benefits and programs to help you
live well—and coverage options that give you control over how you spend
your health care dollars. The Consumer-Directed Health Plan (CDHP)
options and the Health Savings Account (HSA) give you more power to
manage your health care—and encourage you to make informed health care
decisions.
LEARN MORE
If you enroll in a CDHP, it’s important to understand how the plan works
before you need care, so when the time comes you know what to do.
Click the tabs to the left to learn more about the CDHP, and how it works
together with the HSA—and how using the plan wisely can save you money
on health care expenses today and in the future.
LET’S GET STARTED
This guide is intended to provide a
general overview of certain benefits.
Details about those benefits are
provided in official plan documents,
which govern eligibility for the benefits
and the operation of the plans. Any
differences between this guide and the
plan documents are not intended, but
if any differences are found to exist,
the plan documents will govern.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
CDHP AND HSA BASICS
A Consumer-Directed Health Plan (CDHP) is a little different than a traditional health plan
that you may be used to, but taking time to get to know the plan could mean extra money in
your pocket. CDHPs are designed to give you more control over how you spend your health
care dollars.
These plans cost less per pay period, but have higher deductibles than other plans. CDHPs
allow you to contribute to a special tax-advantaged Health Savings Account (HSA) you can use
to pay for qualified health care expenses—like doctor’s bills, hospital charges and pharmacy
expenses. Your HSA funds can also be used for dental and vision expenses. Any remaining
funds in your HSA carry forward from year to year, so you can build your savings. You own
your HSA, not The Hartford, so the money is yours to take with you—wherever you go!
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
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WELCOME
CDHP AND HSA
BASICS
THE CDHP OPTIONS AT A GLANCE
CDHP at a Glance
Here are some highlights of how the CDHP options work:
How Your Medical
Care Is Covered
• In-network preventive care services are covered at 100%, so you pay
nothing.
Paying for
In-Network Care
• You have access to both in-network and out-of-network providers—you’ll
pay less when you stay in-network.
What Happens
When You Visit
Your Health Care
Provider?
•Y
ou pay 100% of eligible medical and prescription drug expenses (except
for preventive care expenses) until you satisfy the annual deductible.
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
• After you satisfy the deductible the Plan pays a portion of eligible
expenses and you pay the rest (the coinsurance). If you cover
dependents, you must satisfy the family deductible.
• An out-of-pocket maximum protects you from the high cost of a major
illness or injury.
In addition, the CDHP options offer you the unique ability to save tax-free
money through an HSA to pay for health care expenses now—or save for
the future.
A NOTE ABOUT HOW DEDUCTIBLES WORK UNDER THE CDHPs
If you cover dependents, you must meet the family deductible, not the individual deductible, before the
CDHP options begin paying benefits. One family member, or all family members combined, can satisfy
the deductible. So, for example, if you elect family coverage under the CDHP Standard option and you
have a $3,000 expense in February, you and your family must incur an additional $2,000 in expenses
to satisfy the $5,000 family annual deductible (even though you personally have exceeded the $2,500
individual deductible). Let’s suppose you incur an additional $2,000 of expenses in March. Then, the
annual deductible has been satisfied for you and all of your covered family members for the remainder
of the year.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
HOW YOUR MEDICAL CARE IS COVERED
CDHP Value
CDHP Standard
CDHP Basic*
In-Network
Out-of-
Network
In-Network
Out-of-
Network
In-Network
Out-of-
Network
Preventive care Plan pays 100%,
no deductible
Plan pays 60%
after deductible
Plan pays 100%,
no deductible
Plan pays 60%
after deductible
Plan pays 100%,
no deductible
Plan pays 60%
after deductible
Deductible
$1,500 individual $3,000 individual $2,500 individual $5,000 individual $3,500 individual $7,000 individual
$3,000 family
$6,000 family
$5,000 family
$10,000 family
$7,000 family
$14,000 family
Office visits (non-preventive care visits with primary care
physician/specialist)
Plan pays 90%
after deductible
Coinsurance (Your share 10%
after deductible for
other covered services)
Out-of-pocket maximum (includes deductible)**
Plan pays 60%
after deductible
Plan pays 80%
after deductible
Plan pays 60%
after deductible
Plan pays 80%
after deductible
Plan pays 60%
after deductible
40%
20% 40%
20%
40%
$4,000 individual $8,000 individual $5,000 individual $10,000 individual $6,450 individual $12,900 individual
$8,000 family
$16,000 family
$10,000 family
$20,000 family
$12,900 family
$25,800 family
*This option does not provide creditable prescription drug coverage under Medicare Part D; if you or your spouse will be over age 65 any
time during the plan year, at the time you apply for Medicare Part D coverage you may be subject to a premium penalty if enrolled in this
plan. See the Notice of Creditable Coverage for more details.
**After a family member reaches the individual maximum, all eligible expenses for that family member are covered 100% by the plan even
if the family maximum has not been met.
TIP: SAVE MONEY BY USING IN-NETWORK PROVIDERS
Keep in mind that you will generally pay less when you use in-network providers, rather than providers who are
out-of-network. The plan pays 100% of the cost of in-network preventive care for you and your covered family
members, so be sure to take advantage of preventive care screenings and wellness visits. To find an in-network
provider, check the online provider directory at anthem.com.
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WELCOME
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
When considering cost, remember that you’ll need to meet your deductible before the plan starts sharing any
non-preventive care or prescription drug costs. Once you satisfy the deductible, you and the plan share in the cost
of covered services (your coinsurance). If you reach the out-of-pocket maximum, the plan pays the full cost of
covered services for the remainder of the year.
PREVENTIVE
CARE
THE PLAN
100%
FREE TO YOU!
ELIGIBLE MEDICAL AND
PRESCRIPTION DRUG EXPENSES
}
YOU
100% UP TO
DEDUCTIBLE
YOU THE PLAN
OUT-OF-POCKET
MAXIMUM
CDHP at a Glance
PAYING FOR IN-NETWORK CARE
DEDUCTIBLE
CDHP AND HSA
BASICS
THE PLAN
100%
COINSURANCE
Remember, you may use your HSA funds to help offset your out-of-pocket expenses—or save them for future
health care expenses.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
WHAT HAPPENS WHEN YOU VISIT YOUR HEALTH CARE PROVIDER?
When you visit an in-network provider, you will generally pay nothing at the time of your visit. So, when and how do you
pay for care? Just follow these steps:
1. Present your Anthem health plan ID card. Generally, you do not need to pay anything at the time of your visit.
Paying for
In-Network Care
2. A
fter your visit, your provider will send a bill to Anthem.
What Happens
When You Visit
Your Health Care
Provider?
4. You will receive a separate bill from your provider. You have a choice to:
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
3. Y
ou will receive your Explanation of Benefits (EOB) from Anthem—the amount listed under “Member Responsibility”
is the amount you owe your provider.
—P
ay the bill using funds from your HSA—Use your HSA debit card or check to pay your bill, if you have money in
your account, or pay out-of-pocket and get reimbursed later. Learn more about how to use your HSA to pay for
eligible expenses.
OR
—P
ay out-of-pocket and save your HSA funds for future use—You may decide that you prefer to save your HSA
funds for a future expense. For example, maybe you are saving your funds for a planned surgery next year—or you
prefer to use your HSA as a way to save for medical expenses after retirement.
ALWAYS CHECK YOUR EOB CAREFULLY
FOR ACCURACY
It’s important to check your EOB carefully to be sure
your health services were billed correctly. For example,
preventive care services are generally covered at 100%;
if you think you were billed for what should have been a
preventive care service, be sure to contact your provider.
Sometimes health care services can be miscoded by
providers resulting in billing errors. Checking your
statements may save you from overpaying.
Questions about coverage or bills? Call Anthem at
1-800-801-6308 for assistance.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING TH HSA TO
PAY FOR CARE
LEARN MORE
THE CHOICE IS YOURS
When you incur an eligible expense—for example, a bill from your doctor before you’ve met your deductible,
or prescription drug costs at the pharmacy—you can choose to use your HSA funds to pay the expense.
Or, you can pay out-of-pocket and save your HSA funds for later. The choice is yours:
USE YOUR FUNDS TO
COVER EXPENSES
THIS YEAR
PLAN FOR THE
FUTURE
Before you satisfy the annual deductible
to pay for:
Do you have a chronic condition and aren’t
sure how much care you’ll need each year?
•P
rovider visits and other health care
services
Are you thinking of retiring soon and want
to set aside money for medical expenses?
• Prescription drugs at the pharmacy
After you satisfy the annual deductible:
o pay your share of the
2016 • T
coinsurance
Do you expect to have a surgery in the
next few years?
2017
2018
2019 2020
2021
ACCESS TO THE HARTFORD’S HSA CONTRIBUTION BEGINS RIGHT AWAY…
Remember, the company makes an annual contribution to your HSA if you enroll in either the Value or
Standard CDHP options ($400 for individual coverage/$800 for family coverage). You’ll receive the
full deposit as of the first pay period after you open your account, so you can begin using these funds
immediately to help offset your deductible. Keep in mind, the annual company contribution is prorated
if you enroll in the CDHP after January 1st.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
MAKE THE MOST OF YOUR VISIT TO THE DOCTOR
Your primary care physician plays a key role in diagnosing health problems,
discussing options for care including screening and disease prevention strategies
and health promotion, and making referrals as needed for quality care.
Be Prepared for a Medical Appointment
When you go to the doctor, there’s usually a lot to consider in a short amount of
time. It’s easy to overlook a symptom you meant to bring up or a question you
meant to ask. It helps to be well prepared for your appointment. Here’s how.
• Know your medical history, including: allergies, family health history, drug,
alcohol, and tobacco use, and current exercise program.
• Write down any current prescription medications, over-the-counter medications,
vitamins, herbal or natural remedies, and supplements you’re taking, including
the dosage.
• Have there been any major life changes or stresses you’re currently experiencing?
• Take a few minutes before your appointment to make a list of your questions,
concerns, and symptoms, and refer to the list during your appointment.
Feel Confident about Asking Questions
Asking questions, lots of questions, is the number one best step you can take
towards getting better health care, and having greater peace of mind about the care
you get.
Here are some tips to help you ask questions and get more answers:
• If possible print out or write down all of your questions and bring them to your
appointment.
• Bring a family member or friend with you to take notes so that you can
concentrate on what the doctor is saying. If you can’t bring someone, write down
or record the discussion, with your doctor’s permission, so you can review it later.
• If you don’t understand something, anything, ask the doctor or nurse to explain it
again. It’s their responsibility as medical professionals to make sure you are well
informed about your care.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
After Your Appointment
Stay In Touch with Your Doctor
• Be sure to check in with your doctor when planned even if you are feeling better.
• Call your doctor immediately if you experience an unexpected side effect from the treatment or prescription.
Paying for
In-Network Care
• Make sure you go to your follow-up appointments
What Happens
When You Visit
Your Health Care
Provider?
• Contact ConsumerMedicalTM if you have any medical claims questions or problems
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
• If you don’t hear back on any laboratory results, make sure to follow up with your doctor’s office
Whether you have a newly-diagnosed condition or have been living with a chronic illness for many years, important
treatment decisions will need to be made. Knowing the benefits, risks and any possible complications will help you
make the best choices for you and your loved ones. Here are some things to do when faced with a treatment decision:
• Think about what’s important to YOU in terms of quality.
• Know where to find the information that you need.
• Visit websites, make phone calls, ask questions, and BE INFORMED.
• Be an active participant in your care!
CONSUMERMEDICAL™
If you need care, be sure you are receiving the right care, from the right provider, at the right cost.
ConsumerMedical™, a benefit available to all employees and dependents at no cost, helps you obtain reliable,
current and personalized information and support with any health-related concern or issue.
Helpful tools from ConsumerMedical
•Q
uestions to Ask Your Physician
Questions developed by ConsumerMedical physicians and research teams to help you become an informed
consumer. Questions can be used as a guide when speaking to your own doctor.
•B
est Websites for a Condition
ConsumerMedical physicians and research teams have carefully reviewed and identified credible websites
on a variety of medical diagnoses. These websites can get you started on accessing high quality online
resources.
•C
onsumerMedical™ Price Transparency Tool, powered by Healthcare Bluebook, can provide the fair price
of specific tests and procedures in your area, as well as color-coded cost and quality ratings for providers in
your area.
Visit the ConsumerMedical website or call 1-888-361-3944 for more information.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
PRESCRIPTION DRUG COVERAGE UNDER THE CDHP OPTIONS
When you participate in The Hartford’s health plan, you automatically receive prescription drug coverage through
Express Scripts. With the CDHP options, you must satisfy the combined medical/prescription drug annual
deductible before prescription drug coverage begins. This means you will pay 100% of the cost of eligible
prescription drugs until you meet the deductible. Your out-of-pocket prescription drug expenses count toward the
combined medical/prescription drug out-of-pocket maximum. Keep in mind, however, that preventive drugs (as
mandated by the Affordable Care Act) are covered at 100% with no deductible. You may also use your HSA funds to
pay for your out-of-pocket prescription drug costs.
All of The Hartford’s health plan options include a formulary feature, which is a list of commonly prescribed
medications that have been shown to be clinically effective and cost effective, and includes four drug types:
• Generic
Prescription Drug
Coverage
• Preferred brand
Get to Know
Your HSA
• Patient Choice
USING THE HSA
TO PAY FOR CARE
LEARN MORE
• Non-preferred brand
You can purchase these medications through a participating retail pharmacy or by mail through the home delivery program.
HOW PRESCRIPTION DRUGS ARE COVERED
Retail Pharmacy (up to a 30-day supply)
Mail Order
(up to a 90-day supply)
After meeting the combined medical/prescription drug deductible, you pay…
Generic
20% up to a maximum of $200 per prescription 20% up to a maximum of
$400 per prescription
Preferred Brand
20% up to a maximum of $200 per prescription
20% up to a maximum of
$400 per prescription
Non-Preferred Brand
40% up to a maximum of $200 per prescription
40% up to a maximum of
$400 per prescription mail
Patient Choice Drugs*
50% up to a maximum of $200 per prescription 50% up to a maximum of
$400 per prescription
Annual Prescription Drug Out-of-Pocket Maximum
Included in combined medical/prescription drug out-of-pocket maximum
*Patient choice drugs include non-sedating antihistamines, weight loss drugs and drugs used to treat infertility and erectile
dysfunction.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
WHAT HAPPENS WHEN YOU NEED TO FILL A PRESCRIPTION?
You have two ways to fill a prescription:
How Your Medical
Care Is Covered
PAYING FOR
PRESCRIPTIONS
BEFORE YOU
MEET YOUR
DEDUCTIBLE
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
RETAIL PHARMACY
(up to a 30-day supply)
When you need a
prescription right
away, you can get your
prescription filled at one
of the thousands
of Express Scripts
participating pharmacies
around the country. Visit
express-scripts.com to
locate a participating
pharmacy.
MAIL ORDER (up to a 90-day supply)
You’ll pay the full
cost of all of your
prescriptions until
you reach your
deductible. For
example, if your
doctor writes a
prescription that
costs $150, you’ll
pay the full $150
at the pharmacy if
you haven’t met the
combined medical/
prescription drug
deductible for
the year. If you
have, you’ll only
pay a percentage
of the cost. You
can use your HSA
to pay for any of
these prescription
expenses.
You can have prescriptions you take
regularly (maintenance drugs) delivered
to your home through the mail order
program. You can conveniently manage your
prescriptions online while saving time and
money. Enroll online at express-scripts.com.
Note: For maintenance medications, the
Plan requires that you use the mail order
program beginning after the third fill.
Otherwise, even after you have met your
deductible, you will have to pay 100% of the
discounted cost of the drug.
Whether You Are Using A Retail Pharmacy or Mail Order, Remember:
1. You will need to present your Express Scripts ID card when you pick up your prescription at a
retail pharmacy. Remember, your prescription drug card is separate from your Anthem health
plan ID card.
2. T
he health plan annual deductible applies to all prescriptions, so you’ll need to meet the
deductible before the Plan begins to share the cost. This means you pay 100% of the cost of your
prescriptions until you satisfy the deductible.
3. O
nce you’ve met the deductible, you’ll pay your share of the discounted cost of the drug (based on
the type of prescription drug: Generic/Preferred, Non-Preferred or Patient Choice).
4. Use your HSA to pay your pharmacist by debit card or with your HSA checkbook, or pay out-ofpocket and get reimbursed later. Learn more about using your HSA to pay for eligible expenses.
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WELCOME
CDHP AND HSA
BASICS
GET TO KNOW YOUR HEALTH SAVINGS ACCOUNT (HSA)
CDHP at a Glance
One of the best things about the CDHP is that it gives you access to a Health Savings Account (HSA).
How Your Medical
Care Is Covered
HOW YOUR HSA IS FUNDED
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
You contribute to an HSA with pre-tax dollars. Depending on the CDHP option you elect,
The Hartford may contribute to your account, too:
• Contributions from You. You can contribute to your HSA on a pre-tax basis, up to the annual
IRS maximum. If you are age 55 or older, you can make an additional annual catch-up contribution.
• Contributions from The Hartford. If you enroll in either the Value or Standard option,
The Hartford will contribute either $400 if you have individual coverage or $800 if you cover
family members each year (prorated if you enroll after January 1)—provided you have opened your
account. Be sure to visit NetBenefits to open your account.
HSAs OFFER A TRIPLE TAX ADVANTAGE
• You can contribute on a pre-tax basis.
•T
he withdrawals you make to pay for qualified
health care expenses are tax-free.
• And, any investment earnings are tax-free!*
*All references to “tax-free” refer to federal income tax. State tax laws may vary. Also keep in mind that investing involves
risk. The value of your investment will fluctuate over time, and you may gain or lose money.
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WELCOME
HOW THE HSA WORKS FOR HEALTH CARE EXPENSES
CDHP AND HSA
BASICS
CDHP at a Glance
Health Savings Accounts are used to pay for current and future health care expenses. They never expire; unused balances automatically carry
over year-to-year, and the money is yours even if you go to a new employer, retire or transfer it to another HSA. If you enroll in a CDHP option,
consider using your premium savings to invest in a pre-tax HSA. Here’s how it works:
How Your Medical
Care Is Covered
Paying for
In-Network Care
1
Money goes in
tax-free
What Happens
When You Visit
Your Health Care
Provider?
Money
comes out
tax-free
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
2
3
Use it to pay
qualified health
care expenses
for you or
your covered
dependents
OR
You and the company
combined can
contribute, up to the
annual IRS maximum.
You can make a
$1,000 annual catchup contribution if you
are age 55 or older.
Money
stays in
and may
grow,
tax-free
Pay for care outof-pocket and
allow your HSA
balance to grow,
with investment
earnings
Money
carries over
You never forfeit
unused funds
There is no carry
over limit
Your balance
stays with you
when you retire
or leave for any
reason
Only the CDHP with an HSA offers a triple-tax advantage and the ability to plan for health costs over the long term—
not just year-to-year.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
BUILDING YOUR HSA BALANCE
See below for the maximum amount you can contribute on a pre-tax basis for 2016 based on the CDHP option you
elect. Remember, you can change the amount of your HSA contributions any time during the year as your needs
change, so you may want to keep the IRS maximums in mind. To change your contributions, visit NetBenefits.
CDHP Basic
CDHP Standard
CDHP Value
The Hartford’s Contribution
None
$400 individual
$800 family
$400 individual
$800 family
Your Maximum HSA Contribution for 2016
$3,350 individual
$6,750 family
$2,950 individual
$5,950 family
$2,950 individual
$5,950 family
IRS Maximum HSA Contribution for 2016 (Your contributions + The Hartford’s contributions)
$3,350 individual
$6,750 family
$3,350 individual
$6,750 family
$3,350 individual
$6,750 family
Additional Catch-Up Contribution
(If you are age 55 or older)
$1,000
$1,000
$1,000
USING HSA FUNDS FOR FAMILY MEMBERS
Funds from your HSA can be used to pay for expenses incurred by your tax dependents, including
your spouse and children. However, generally you cannot use your HSA funds to pay for expenses
of family members whom you cannot claim as tax dependents on your tax return—for example, a
domestic partner or your adult child who is covered under your health plan but is not considered a
tax dependent according to IRS regulations.
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WELCOME
CDHP AND HSA
BASICS
CDHP at a Glance
How Your Medical
Care Is Covered
Paying for
In-Network Care
What Happens
When You Visit
Your Health Care
Provider?
Prescription Drug
Coverage
Get to Know
Your HSA
USING THE HSA
TO PAY FOR CARE
LEARN MORE
USE YOUR HSA FOR FUTURE
HEALTH CARE EXPENSES
The money in your HSA is yours to use now and in the future—
it’s your choice. So, if you don’t use all of the money in your HSA
during the year, it will carry over to the next year and you will
build savings to use for future health care expenses. You own your
HSA, not The Hartford, so the money is yours to take with you.
The CDHP offered in conjunction with an HSA gives you greater
control of your health care spending.
• You can take your HSA balance with you—wherever you go!
If you switch to another high deductible health plan—such
as your spouse’s plan—or if you leave The Hartford, you can
continue to use your HSA balance to pay for qualified expenses.
• Investment options. Once your HSA balance reaches a certain
amount ($2,500 for most investment options), you can choose to
invest your balance among a broad range of investment options
managed by Fidelity. The minimum balance may be lower for
some investment options. For more details, go to NetBenefits,
select “Health Savings Account” and choose “Contributing and
Investing.” You will be notified by Fidelity once your account
reaches the $2,500 minimum.
CHECKING YOUR HSA BALANCE IS EASY…
When you open an HSA, you can check your
balance at any time. Log on to NetBenefits, Click
on Health & Insurance, then click on your Health
Savings Account benefit.
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WELCOME
CDHP AND HSA
BASICS
USING THE HSA
TO PAY FOR CARE
How Much Should
You Set Aside in
Your HSA?
Using Your HSA
LEARN MORE
USING THE HSA TO PAY FOR CARE
HOW MUCH SHOULD YOU SET ASIDE IN YOUR HSA?
When you enroll in a CDHP and HSA, it’s very important to understand the cost for care and how
the plan works so you can accurately budget for your health care expenses. Knowing the general cost
of your medical care can help you ensure that you set aside enough money to cover any upcoming
expenses. You’ll need to cover your plan’s deductible with out-of-pocket funds or the money in your
HSA. So you’ll want to make sure to budget and plan ahead. A good place to start is by reviewing your
past expenses. You can access this information on your claims administrators’ websites (Anthem,
Express Scripts or Delta Dental).
Remember, when you have an HSA, you can change your contributions during the year if your health
care or financial needs change by visiting NetBenefits.
REMEMBER TO OPEN YOUR HSA
You must visit NetBenefits to open your HSA. You can access HSA information by
clicking on Health Savings Account under Featured Resources on the NetBenefits home
page. Remember, you must establish an account online to be eligible to contribute your
own money and receive The Hartford’s contribution—so don’t miss out!
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WELCOME
CDHP AND HSA
BASICS
USING THE HSA
TO PAY FOR CARE
How Much Should
You Set Aside in
Your HSA?
Using Your HSA
LEARN MORE
USING YOUR HSA
You have four options to choose from when paying for qualified medical expenses from your HSA:
1
1. U
SE THE FIDELITY HSA®
DEBIT CARD
The HSA debit card is a signature-based
card and does not require a personal
identification number (PIN). Funds come
directly from the cash available in your
HSA and payment details show up on
your account statement so you can track
the expenses paid from your account.
If you request an HSA debit card
when you open your HSA, you
will automatically receive it within
approximately two weeks. To request
one at a later time, visit NetBenefits to
complete the Debit Card Application for
yourself or the Supplemental Debit Card
Application to obtain an HSA debit card
for your spouse or dependent.
3
3. WRITE A FIDELITY HSA CHECK
Like the debit card, a Fidelity HSA check
pays directly from the cash available in
your HSA and records the transaction
on your monthly account statement.
Additional fees may apply. To request
an HSA checkbook please complete
the Checkwriting Form available on
NetBenefits.
2
2. PAY ONLINE WITH FIDELITY BILLPAY® FOR HSAs
This convenient service enables you to make online payments
for qualified medical expenses to health care providers,
companies and individuals. Additionally, you can set up an
automatic schedule for recurring payments, keep track of
all bill payments and reimburse yourself for out-of-pocket
qualified medical expenses.
You can also choose to go paperless by signing up to receive
an eBill with providers who offer electronic billing. You’ll
receive an email notification when your online bill is available
and posted to your HSA BillPay account. This free online
service lets you pay bills electronically as long as you have
Internet access. Visit NetBenefits to enroll.
4
4. P
AY OUT OF POCKET AND REQUEST
A REIMBURSEMENT
If you pay out of pocket for a qualified health care expense,
you can get reimbursed from your HSA in one of four ways:
•T
ransfer money from your HSA into an existing Fidelity
account or an outside bank account.
•R
equest a check for yourself electronically through Fidelity
BillPay for HSAs.
• Write yourself a check using your HSA checkbook.
•C
ontact Fidelity to request that a withdrawal check be
mailed to you or to transfer money from your HSA to
another account.
Remember, money left in your HSA is yours—money will carry over from year to year allowing you to build savings for future
eligible expenses.
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WELCOME
CDHP AND HSA
BASICS
USING THE HSA
TO PAY FOR CARE
How Much Should
You Set Aside in
Your HSA?
Using Your HSA
LEARN MORE
USING HSA FUNDS FOR
OTHER KINDS OF EXPENSES
You can withdraw money from your HSA for any reason. But
keep in mind that there are tax implications if you use the funds
for non-eligible expenses. If you withdraw money before you
reach age 65 and don’t use it for eligible health expenses, you will
pay a 20% penalty. Also, the money will be treated as ordinary
income and subject to taxes (regardless of your age). To avoid
paying unnecessary taxes, be sure to think carefully at the time of
purchase. For example, if you grab a pack of gum at the pharmacy
while picking up your prescription, use your HSA for the
prescription only and pay for the gum with other money.
After the calendar year ends, your W-2 will show any contributions
made by you or The Hartford to your HSA. In addition, you will
receive a 1099-SA, which shows the withdrawals from your HSA.
It’s important to keep all of your Explanation of Benefits forms
and receipts throughout the year in case you’re audited. You’ll also
receive a Form 5498-SA from Fidelity. This form is used to report
distributions made from a health savings account (HSA). Keep this
form with your tax return copies in case you’re audited.
DO YOUR PART TO MANAGE
YOUR HEALTH CARE COSTS
One of the best ways to manage your costs is by
preventing serious and costly conditions in the future.
Be sure to have preventive exams and screenings, and
take advantage of The Hartford’s wellness programs
to help you stay healthy, reduce your risks and, if
applicable, manage a chronic condition. Learn more
by viewing the Wellness eBook.
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WELCOME
CDHP AND HSA
BASICS
LEARN MORE
USING THE HSA
TO PAY FOR CARE
For information about the CDHP, visit NetBenefits to review the Summary Plan Description (SPD) or watch the short
descriptive CDHP and HSA videos on the Benefits Resource Site.
LEARN MORE
MANAGING YOUR HSA
Managing
Your HSA
Contact
Information
Important Terms
After you open your HSA, visit
NetBenefits to:
• View your account balance.
• Access investment information and
make investment transactions.
• Find forms and applications (debit
card application, check writing form,
automated BillPay, etc.).
• Access tools and information.
• Maintain beneficiary information.
• Change your address.
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WELCOME
CDHP AND HSA
BASICS
USING THE HSA
TO PAY FOR CARE
LEARN MORE
Managing
Your HSA
Contact
Information
Important Terms
CONTACT INFORMATION
For…
Contact… At…
General benefit questions HR Service Center
and help using your HSA 1-877-HR-AT-WORK (877-472-8967), say and
‘Health Care, Savings or Retirement,’ or
www.netbenefits.com/thehartford
Health plan coverage Anthem
questions
1-800-801-6308
or online at www.anthem.com
Prescription drug coverage Express Scripts
questions
1-800-233-7840
or online at www.express-scripts.com
HSA information
HR Service Center1-877-HR-AT-WORK (877-472-8967), say
‘Health Care, Savings or Retirement,’ or
www.netbenefits.com/thehartford
Health-related information
ConsumerMedical
888-361-3944, Monday through Friday,
8:30 a.m. to 5 p.m. ET or online at
www.myconsumermedical.com/TheHartford
Wellness program information My Wellness at Work
1-855-651-2910
or online at www.mywellnessmywork.com
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WELCOME
CDHP AND HSA
BASICS
IMPORTANT TERMS
USING THE HSA
TO PAY FOR CARE
Annual Deductible
The amount you pay for covered services each calendar year before the plan begins to pay benefits. The
amount paid toward the deductible also applies toward the out-of-pocket maximum.
LEARN MORE
Coinsurance
The percentage you pay for most covered expenses after you’ve met the annual deductible.
Managing
Your HSA
Contact
Information
Important Terms
Generic Drug
A drug product that is comparable to a brand/reference listed drug product in dosage form, strength,
route of administration, quality and performance characteristics, and intended use—yet, is available at a
lower cost than brand equivalents.
In-Network
Refers to doctors or healthcare facilities that are part of your medical plan’s network. Your deductible,
coinsurance, and out-of-pocket maximums are generally lower for in-network care compared to out-ofnetwork care.
Out-of-Pocket Maximum
The most you pay each calendar year for covered services. Your deductible and coinsurance count
toward your out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100%
for covered expenses for the rest of the year (excluding expenses above the Maximum Allowed Amount,
if out-of-network or penalties).
Patient Choice Drugs
Express Scripts classifies patient choice drugs as drugs taken by choice, rather than medical necessity,
such as non-sedating antihistamines, weight loss drugs and drugs used to treat infertility and erectile
dysfunction.
Preventive Care
Routine physical exams and health screenings (like routine blood tests, immunizations, Pap smears,
prostate screenings, and other age-appropriate health screenings), as defined by Health Care Reform.
Such Preventive Care services are generally covered at 100% when received through an in-network
provider.
Tax Dependent
All dependents you can claim on your tax form. Please see IRS regulations at www.irs.gov for specific
examples.
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