California Choice HSA Options – Q4 2016

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As the majority of group renewals are fast approaching, I wanted to outline the different HSA options available to CaliforniaChoice clients.  For the fourth quarter of 2016, there are twelve different HSA eligible medical policies from five different carriers. (Listed Below – Please note that not all plans are available in all 19 regions)

Note that there are not any PPO HSA options available to CaliforniaChoice clients at the moment.  You may assume that Anthem’s EPO policy would be a close fit, but beware the limited network without any out-of-network coverage, aside from emergencies.   While the private exchange offers employees the flexibility to choose various plans without the need for employers to meet specific participation requirements, the only way to offer a PPO HSA currently is outside of CaliforniaChoice.  For employers that wish to concurrently offer a PPO alongside Kaiser, you must have a minimum of 5 non-Kaiser employees that wish to enroll, which make up at least 25% of eligible enrollees.

While the state’s public exchange, Covered CA, has setup a mirrored network of health plans that offer the same participation flexibility as CaliforniaChoice, they are only offering six HMO HSA policies from three carriers: Kaiser, Sharp, and Western Health.

As premiums continue to increase, and plans become more limited and standardized, small group shoppers are losing their flexibility within private exchanges.  We can only hope that the insurance carriers and partners will loosen the reins in 2017.

Deductible – A specified amount of money that you must pay before an insurance company will contribute towards a claim.

Out of Pocket Max – The most you will have to pay for covered medical expenses in a calendar year.  The insurance company pays 100% of costs above this limit.

Co-insurance – The percentage of costs you will pay between the deductible and the out-of-pocket maximum.

Anthem Blue Cross B Bronze EPO (HSA)

  • Deductible: $5,000 individual, $10,000 family
  • Out of Pocket Max: $6,500 individual, $13,000 family
  • Co-insurance: 20%

Anthem Blue Cross A Gold EPO (HSA)

  • Deductible: $2,000 individual, $4,000 family
  • Out of Pocket Max: $4,500 individual, $6,850 family
  • Co-insurance: 20%

Kaiser C Bronze HMO (HSA)

  • Deductible: $4,500 individual, $9,000 family
  • Out of Pocket Max: $6,500 individual, $13,000 family
  • Co-insurance: 25%

Sutter Health Plus B Bronze HMO (HSA)

  • Deductible: $4,500 individual, $9,000 family
  • Out of Pocket Max: $6,500 individual, $13,000 family
  • Co-insurance: 40%

Sutter Health Plus C Silver HMO (HSA)

  • Deductible: $2,600 individual, $4,000 family
  • Out of Pocket Max: $4,500 individual, $9,000 family
  • Co-insurance: 20%

Sutter Health Plus D Silver HMO (HSA)

  • Deductible: $2,600 individual, $4,000 family
  • Out of Pocket Max: $6,250 individual, $12,500 family
  • Co-insurance: 20%

Sharp Performance B Bronze HMO (HSA)

  • Deductible: $3,850 individual, $7,700 family
  • Out of Pocket Max: $6,500 individual, $13,000 family
  • Co-insurance: 40%

Sharp Premier C Bronze HMO (HSA)

  • Deductible: $4,500 individual, $9,000 family
  • Out of Pocket Max: $6,250 individual, $12,500 family
  • Co-insurance: 40%

Western Health A Bronze HMO (HSA)

  • Deductible: $4,000 individual, $8,000 family
  • Out of Pocket Max: $6,350 individual, $12,700 family
  • Co-insurance: 40%

Western Health C Bronze HMO (HSA)

  • Deductible: $6,000 individual, $12,000 family
  • Out of Pocket Max: $6,000 individual, $12,000 family
  • Co-insurance: 0%

Western Health D Bronze HMO (HSA)

  • Deductible: $4,500 individual, $9,000 family
  • Out of Pocket Max: $6,500 individual, $13,000 family
  • Co-insurance: 40%

Western Health C Silver HMO (HSA)

  • Deductible: $2,600 individual, $4,000 family
  • Out of Pocket Max: $6,250 individual, $12,500 family
  • Co-insurance: 20%

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