Frequently asked questions about
2018
HealthFlex Exchange plans:

 

 

 

QUESTION: If a participant is enrolling in a High Deductible Health Plan, and the participant or a spouse in in the plan is enrolled in Medicare Part A or Part B, but also has dependent children enrolled in the plan, is the HDHP HSA still only limited to the IRS individual amount? Or can the participant use the family limit of $6,900? I’m assuming it is the adult participants in the plan who are taken into account and there would only be the individual limits ($3,450/$4,450).

ANSWER: If the participant is enrolled in Medicare, he or she can enroll in the HDHP, but cannot elect an HSA.

If the participant is enrolled in the HDHP and is not enrolled in Medicare, but the participant’s spouse is enrolled in Medicare and is also covered under the participant’s HDHP, the participant can contribute up to the family limit.

The contribution limit is based on whether the participant enrolled in single coverage or family coverage. If the participant has family coverage and the spouse or dependents also have other coverage, the participant is still eligible to contribute up to the family limit.

QUESTION: If you are converting your Flexible Spending Account (Medical Reimbursement Account) to full use, is there documentation required to prove to Wage Works?

ANSWER: Yes, the participant would have to complete a form and provide proof (usually Explanation of Benefit from Blue Cross/Blue Shield).

QUESTION: Are there any groups that cannot make their elections via the Online MyChoice?

ANSWER: Yes: retired individuals, MSP, disabled, continuation, split couples, grandfathered individuals. However, they should be able to contact Businessolver to have someone walk them through MyChoice over the phone. They also can still access ALEX.

QUESTION: Is the bronze level High Deductible Health Plan an embedded deductible or a non-embedded deductible?

ANSWER: All of the High Deductible Health Pans, including the bronze HDHP H3000, have a non-embedded deductible. The out-of-pocket maximum for all plans is embedded (individual only has to meet individual OOP max).

QUESTION: It is my experience that expenses on an HSA do not need to be substantiated, unlike the HRA and FSA with which you need to send in the EOB, etc., to the TPA. Is that the case for this HSA, as well?

ANSWER: If the HealthFlex debit card is used, expenses will generally not need to be substantiated, especially if the provider is IIAS certified. There is also a “pay myself” option for the HSA for which WageWorks does not require receipts. We encourage participants to save receipts for their records or in case of an IRS audit.

QUESTION: How can I find out if my dentist is in the Cigna network?

ANSWER: Click here, then click the dental tab to search for a dentist. Once a dentist is selected, those in the DPPO Advantage network will see this indication:

QUESTION: With dental, do you have to use an in-network provider, or will you still get some benefits, just maybe at a lower level, if you use an out-of-network dentist?

ANSWER: The PPO plan has reduced out-of-network benefits, but the Passive PPO 1000 and the passive PPO 2000 have the same benefit levels in and out of network. Out of network, you are not protected from balanced billing.

QUESTION: Is there a direct link to the Decision Help Tool, ALEX?

ANSWER: Yes: Click here.

QUESTION: How do I access WebMD if I have forgotten my username/password?

ANSWER: If you have never logged in before, go to Healthflex/WebMD from Wespath.org, then, when it prompts for login, click on New User, REGISTER and follow the prompts. If you have just forgotten your password, click on Forgot Username and Password, then follow the prompts.