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Direct Access High Deductible Health Plan with HSA

A Health Savings Account (HSA) is a savings account that is paired with a high-deductible health plan (HDHP). This special account helps you save – in so many ways! Plus, it is yours to keep forever – even if you change insurance plans, take a new job or retire.

The University and you can contribute to your HSA to cover IRS-eligible, out-of-pocket medical expenses. You can use money in your HSA to cover things like copays and coinsurance for medical care and prescription drugs, and qualified dental and vision expenses for yourself or your family members, even if they are not covered by your medical plan. You can find a full list of HSA-eligible expenses on the IRS website at irs.gov/forms-pubs/about-publication-502. An HSA will be opened for you automatically by WEX when you elect your annual contribution level during enrollment in this Plan. Your contributions will be deposited into your HSA each pay period.

The Direct Access HDHP Plan with HSA is a high-deductible, consumer driven health plan with a Health Savings Account offering members a different approach to how you pay for today’s health care with an opportunity to save for your future health care expenses. This plan has an in-network deductible of $3000 for an individual and $6000 for those members in a two-person or family contract.  Members who enroll in the DAHDHP/HSA plan will be provided with a Health Savings Account to help pay for some of these out-of-pocket medical expenses including deductibles, copays and other healthcare expenses. The Health Savings Account is funded by the University on a per-pay basis, the annual funding divided by 26 pays; $750 annual for those members in an employee only contract and $1500 for those members in a two-person or family contract. 

In New Jersey, members have access to all doctors, specialists and hospitals that participate in Horizon’s Managed Care Network (Direct Access Network). Outside of New Jersey throughout the United States and worldwide, members have access to doctors and hospitals through the BlueCard® PPO program. There is no benefit coverage outside of the Managed Care Network.

In-network preventive care services as defined by the plan are covered at 100%, meaning you do not pay for these types of services. For all other in-network services, you are responsible for paying the full cost of care until you reach the plan’s deductible ($3000 individual/$6000 family). Once you meet the deductible, services are covered at 100% plus the applicable copay for the service and/or facility. Copays are $25 for primary care office visit, $45 for specialist office visit and $150 for emergency room visit. Laboratory services must be performed at the in-network lab facility, LabCorp or Quest.

Prescriptions are subject to the plan deductible before copays apply. The copays are $10 for preferred generic drugs, $25 for preferred name brand drugs and $50 for non-preferred drugs. Preventive or maintenance drugs as defined by the plan are not subject to the deductible. There is a mail-order option through Prime Therapeutics which can result in cost savings. Refer to the Plan Comparisons for additional information.

A Few Things to Know About HSAs

There is a limit to how much you can save every year in your HSA. For calendar year 2023 the limit is $3850 if you have individual medical coverage; if you are covering others too, the limit is $7750. And if you are age 55 or older you can save an extra $1000 a year. NOTE, these limits include the amount that the University contributes.

  • You can start, stop, or change your contributions at any time.
  • Unlike flexible spending accounts, there is no use-it-or-lose-it with an HSA. The money continues to grow until it is used.
  • The money in your HSA is yours to use forever – even if you change jobs, change insurance plans or retire. You can use it to pay for current medical expenses or save the funds for future use.
  • The money is your HSA earns interest when your balance reaches a certain amount.
  • Contributions are deducted from your paycheck before taxes are calculated so you are not taxed on your contribution. Your contribution reduces your taxable income.
  • If you are enrolled in Medicare, Part A or B, or any other group health plan you are not eligible for an HSA.
  • If you have funds remaining in your flexible spending account (FSA) you will need to use the remainder of the funds.
  • You cannot enroll in FSA if you enroll in the HSA
  • If you have funds in an HRA, your HRA will become a limited purpose HRA meaning those funds can only be used for dental or vision expenses until your medical deductible is met.