Health Care

HMSA Preferred Provider Organization HMSA’s Preferred Provider Organization (PPO) health plan is a cornerstone to our approach to health. The HMSA PPO Plan provides the security of comprehensive coverage with a focus on preventive care. As a member of the HMSA health plan, you can take an active role in your health care decisions, by choosing HMSA Participating Providers. This approach gives you more control of your health care expenses. The HMSA health plan also provides you with educational resources, decision-making tools and easy access to information.

See page 19 for benefit premiums/price tags.

Providers You should use the providers in the network offered by HMSA to receive the highest level of benefits. These in-network providers are contracted at a savings for both plan and member. Your benefits may be different depending on the category of provider that you receive care from. In general, you will get the maximum benefit possible when you receive services from an HMSA participating provider.

HMSA also provides national access to a comprehensive network of providers, including on the mainland through BlueCard PPO.

It is the member’s responsibility to confirm they are using an in-network provider prior to the first visit or service.

Prescription Drug Coverage HMSA provides you with comprehensive prescription coverage, as part of your HMSA benefits. The national network of pharmacies provides 30-day supplies to plan members as well as 90day supplies at preferred providers and mail-order prescriptions. HMSA provides members with important pharmacy information, including your claims and benefits, medication education and prices, and mail-order services.

Preventive Care The HMSA PPO health plan covers preventive care at 100%. This means you and your covered dependents are eligible for important preventive services, which can help you avoid illness and improve your health. You will not have to pay towards your deductible and cost-share to receive preventive health services from an in-network provider. These services include recommended screenings, vaccinations and counseling.

Health Care Flexible Spending Account A Flexible Spending Account (FSA) is provided to allow you to pay for eligible expenses with pre-tax dollars. The Health Care FSA may be used for reimbursement of eligible medical expenses incurred by you and/or your eligible dependents. • Your minimum annual deposit to the FSA is $250 • Your maximum annual deposit to the FSA is $2,750 You do not have to be enrolled in the health plan to enroll in the FSA. FSA dollars do not rollover from year to year and must be used by March 15 of the following plan year.