Anthem Blue Cross Small Group PPO 3500 HSA Compatible Plan:

As the popularity of health savings accounts continue to grow, you may need to investigate your options as a business owner to offer this type of coverage. The tax benefits from using a health savings account are quite large and many people are making the switch. Here’s what the PPO 3500 Plan has to offer.

Annual Deductible - There is a $3500 deductible per person, or a $7000 deductible for an entire family. This amount is aggregated, to allow more flexibility and less expenditures.

Annual Out-of-Pocket Maximum - For a single person covered by this plan there is a $4000 maximum amount for out-of-pocket expenses. It moves up to $7500 for a family.

Office Visits - There is a $35 office visit co-pay. This will take effect once the deductible has been met. Once your employees’ have met their deductible, this plan will pay 100% of the negotiated fee. If a non-participating physician is consulted, it will require a payment of 50% of the negotiated fee.

Professional Services - The PPO 3500 Plan provides 100% coverage for professional services that an employee would receive.

Hospital Inpatient Care - A pre-service review is required for inpatient care services. Anthem Blue Cross will pay 100% of the fees for inpatient care, after the deductible has been met. If a non-participating hospital is used, an employee would be required to pay 50% of the negotiated fee and 100% of any extra fees, as well as all charges minus $650 per day. Professional services received as an inpatient are also subject to an annual deductible, but as long as the service is provided by a participating facility, all of the costs will be covered.

Outpatient Care - Once again, there is a pre-service review required for some procedures that are classified as "outpatient care." If the review is positive, Anthem Blue Cross will pay for 100% of the services provided under this plan after the deductible has been met. If a non-participating provider is used, the employee will be responsible for 100% of the charges, minus $380 per day.

Prescription Drugs - This plan has $10 co-pay for generic medication, and a $25 co-pay for brand name medications. Your employees will be able to purchase a 30-day supply from a participating pharmacy, or a 60-day supply if ordered online or through the mail. If a pharmacy is not participating in the plan, the costs for the same medication are then 50% of the limited fee schedule and 100% of any excess fees. Self injectables, with the exception of insulin will cost 30%.

Physical Exam - An annual physical exam is extremely important in maintaining overall good health. This plan has a $35 co-pay for the office visit.

A health savings account compatible health plan is vitally important to your employees. The tax benefits you will experience are also useful to others. There’s a lot to be learned out there and Anthem Blue Cross in on the way back home. :woohoo:

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