Who is eligible?
The PEBB Program offers CDHPs with HSAs to eligible members through Kaiser Permanente NW1, Kaiser Permanente WA2, and Uniform Medical Plan. When you enroll in a CDHP, you are automatically enrolled in an HSA. The plans' HSA trustee is HealthEquity, Inc.
1Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington and select counties in Oregon.
2Kaiser Foundation Health Plan of Washington.
You must meet certain eligibility requirements to enroll in a CDHP/HSA. If you (the subscriber) are not eligible for a CDHP/HSA and enroll, you may be liable for tax penalties.
You cannot enroll in a CDHP with an HSA if:
- You are enrolled in Medicare Part A or Part B or Medicaid.
- You are enrolled in another comprehensive medical plan—for example, on a spouse’s or state-registered domestic partner’s plan.
- You or your spouse or state-registered domestic partner is enrolled in a Voluntary Employees’ Beneficiary Association Medical Expense Plan (VEBA MEP) account, unless you convert it to a limited VEBA MEP.
- You have TRICARE coverage.
- You enrolled in a Medical Flexible Spending Arrangement (FSA) or health reimbursement arrangement (HRA). This also applies if your spouse has a Medical FSA, even if you are not covering your spouse on your CDHP. This does not apply if the Medical FSA or HRA is a limited purpose account, or for a post deductible Medical FSA.
- You are claimed as a dependent on someone else’s tax return.
Other exclusions apply. Check IRS Publication 969—Health Savings Accounts and Other Tax-Favored Health Plans on the Internal Revenue Service website, contact your tax advisor, or call HealthEquity toll-free at 1-877-873-8823. See The Complete HSA Guidebook for full details.
What is a consumer-directed health plan (CDHP)?
CDHPs offer lower premiums, a higher medical deductible, and a higher medical out-of-pocket limit than most traditional health plans.
Other features include:
- If you cover yourself and one or more family members, you must pay the entire family medical deductible before the CDHP begins paying benefits.
- Your prescription-drug costs count toward the annual medical deductible and out-of-pocket maximum.
- Preventive care services are covered at 100 percent with no medical deductible.
See benefits and coverage by plan for CDHP coverage details.
What is a health savings account (HSA)?
An HSA is a tax-exempt account anyone can deposit funds into on your behalf. You can deduct any amount you contribute from your taxable income, giving you a tax savings.
You can use your HSA to pay for IRS qualified out-of-pocket medical expenses (like deductibles, copays, and coinsurance), including some expenses and services that your health plans may not cover. You can spend HSA funds on qualified expenses for your spouse or other tax dependents, even if they aren't covered on your plan. In addition, your HSA balance can grow over the years, earn interest, and build savings that you can use to pay for health care as needed and/or pay for Medicare Part B premiums.
What are the HSA contributions from the PEBB Program?
When you enroll in a CDHP, the PEBB Program contributes $700.08 for you, or $1,400.04 for your family* in your HSA.
The contribution goes into your HSA in monthly installments over the year on the last day of each month (the entire HSA amount is not available on January 1):
|People covered on CDHP
||Monthly deposit into HSA
||Total deposited by the end of the year
||$58.34 x 12 (months)
|You and your family*
||$116.67 x 12 (months)
*If you have at least one other family member on your CDHP, then you qualify for the family contribution.
You will receive an additional $125 in your HSA (deposited at the end of January in the following calendar year) if you qualify for a SmartHealth wellness incentive from the PEBB Program.
What are the HSA contributions I can make?
You can choose to contribute to your HSA through direct deposits to HealthEquity, and you may be able to deduct your HSA contributions from your federal income taxes.
The IRS has annual limits for contributions from all sources into an HSA.
- For 2021, the limit is $3,600 for single subscribers, and $7,200 for families
- For 2020, the limit is $3,550 for single subscribers, and $7,100 for families.
- Members ages 55 and up can contribute up to $1,000 more per year. You must turn age 55 by the end of the taxable year to qualify.
It is your responsibility not to exceed the maximum annual contributions allowed under IRS rules. Before you make your own contributions, make sure to calculate both the PEBB Program's contribution amount(s) for the year, the SmartHealth wellness incentive in January (if eligible), and any amount you contribute. If contributions from all sources are more than the maximum amount allowed, you may be subject to IRS penalties and/or fees from HealthEquity.
What happens to my HSA when I leave the CDHP?
If you choose a medical plan that is not a CDHP you should know:
- You won’t forfeit any unspent funds in your HSA after enrolling in a different plan. You can spend your HSA funds on qualified medical expenses in the future. However, you and the PEBB Program can no longer contribute to your HSA.
- HealthEquity will charge you a monthly fee if you have less than $2,500 in your HSA after December 31. You can avoid this charge by either ensuring you have at least $2,500 in your HSA or by spending all of your HSA funds by December 31. Other fees may apply. Contact HealthEquity for details.
- If you set up automatic contributions to your HSA through HealthEquity, you must contact them to stop the deductions.
Can I enroll in a CDHP and Medicare?
No. If you are enrolled in a CDHP with an HSA when you or a covered dependent become entitled to Medicare Part A and Part B, you must choose a new medical plan that is not a CDHP. The PEBB Program must receive your request no later than 60 days after the Medicare enrollment date.
If your covered dependents become entitled to Medicare Part A and Part B, you must either:
- Choose a medical plan that is not a CDHP and keep your Medicare dependent enrolled in PEBB coverage. Your annual deductible and annual out-of-pocket maximum will restart with your new plan.
- Remove your dependent from your PEBB coverage before they enrolls in Medicare Part A and Part B. The dependent will not qualify for COBRA or other continuation coverage through the PEBB Program.