Consumer Directed Health Plans
Today’s healthcare landscape is quite different than it was five, even ten years ago. Our economy has effected many changes in the way people provide and receive healthcare and most importantly the costs associated with that care.
Health insurance is no different. Consumers are asking for lower premiums, better coverage, and financial support to help them pay for rising healthcare expenses. Hence, the creation of Consumer-Directed Health Plans, or CHDPs.
With CHDPs, employers and employees work in partnership to manage healthcare. These plans combine education, incentives and rewards, rollovers and accumulations. Ultimately they enhance the understanding of the management of healthcare for both parties.
At Optima Health, we’ve designed a suite of CHDPs that are coupled with Health Savings Account (HSA) and Health Reimbursement Arrangement (HRA) funding options and include high deductibles which offer lower monthly premiums.
These plans work differently than “traditional” medical insurance coverage in that they offer two medical office visits and two behavioral health office visits at the copay rate. All preventive, screenings and wellness visits are paid at 100%. You use the HRA or HSA funds to help pay for qualified out-of-pocket expenses, such as prescription medications, co-pays, coinsurance, etc. These funds are tax-free and are not totaled in with your annual salary.
By working with Optima Health, we are able to provide you with many useful tools and resources to educate and empower you. You will learn more about the costs of healthcare and make your own decisions on how to best use those funds.
About Consumer Directed Health Plans (CDHPs)
CDHPs are high-deductible, lower premium health plans linked with a Health Saving Account (HSA), Health Reimbursement Arrangement (HRA), or a similar qualified account. These accounts are used to pay for routine healthcare expenses, while a high-deductible health insurance policy protects the members from catastrophic medical expenses. Consumers direct how the funds are spent from these accounts for qualified medical expenses and provides greater control over their own health budgets.
CDHPs combine a high-deductible health plan with a funding option to cover deductibles and minimize out-of-pocket costs. These plans offer lower premiums (and lower overall costs) while creating an incentive for employees to take charge of their own health and be wise consumers of healthcare. CDHPs are becoming an increasingly popular choice for businesses across the country.1
Comparison of Optima Design and Optima Equity Features
About Health Reimbursement Arrangements (HRAs)
An HRA is a fund available for use in conjunction with a high-deductible, lower premium health plan. The funds are promised by the employer to help members pay for certain out-of-pocket healthcare expenses, such as deductible or coinsurance. The employer sponsors the account and it is not portable.
About Health Savings Accounts (HSAs)
An HSA is a savings and spending account linked to an IRS-qualified high-deductible health plan. HSAs offer members a way to pay for qualified medical expenses with pre-tax dollars as well as a tax-free way to save for future medical and retirement healthcare expenses. Employers may also contribute to the account, but members own the account even if they change employers.
Learn about Optima Design
Learn about Optima Equity
1 AHIP website, www.ahip.org, February 2009.
* Consult tax advisor for details.
** Certain tax rules may apply to owners of S Corps, LLCs, LLPs, partnerships, and sole proprietorships.