Wise Max 3000 HDHP
Available to both small and large employer groups, this is a high deductible plan with a $3,000 deductible. Higher deductibles mean lower monthly premiums, and this one is our highest deductible yet. The plan is linked to a Health Savings Account (HSA). Employees can make pre-tax contributions to the HSA, and employers can make tax-deductible contributions. Employees then use the HSA to pay for all qualifying medical costs up to the $3,000 deductible. As with all health plans, preventive care is covered with no member cost-sharing. All other covered benefits, including prescriptions, count toward the deductible. After the deductible is reached, the member will no longer have any cost-sharing for covered benefits. Employees can use their HSA funds to pay for any type of qualifying medical cost, including dental and vision care. If the HSA is not exhausted by the end of the year, it still belongs to the employee and can be used to cover future healthcare needs.

Limitations: Employees must manage paying most medical costs until the deductible is reached, probably earlier in the year. If their families experience high medical needs, the plan may be more expensive than a copay plan, instead of less. Because HSA funds belong to the employee, employers may be continuing to contribute funds that are not needed and not used.
Benefits: If employees and their dependents require little care, they will pay less for healthcare than they would if paying higher monthly premiums. The employer’s share of costs will also be lower.

Essential 3000
Available to only large employer groups, this plan also has a $3,000 deductible, however not all costs go toward the deductible. PCPs, specialists, and prescriptions are not included, but have copays instead. This means it will take longer for an employee to reach the deductible and be free from cost-sharing for healthcare. Medical bills will be less likely to be bunched toward the beginning of the year. It also means that even after the deductible is reached, employees will still pay copays for PCPs, specialists, and prescriptions, which they would not with the Wise Max 3000 HDHP plan. Preventive care will still be without cost-sharing. Instead of an HSA, this plan is linked to a Health Reimbursement Account (HRA), from which the employee draws to pay qualifying medical costs. Unlike an HSA, employees do not contribute to an HRA. Also unlike an HSA, employer contributions are promissory, so funds not needed for medical costs are retained by the employer. Funds do not accrue over years, and the employer’s tax-deductible contribution is up to $1,000 per individual or $2,000 per family.

Limitations: If employees and their dependents require little medical care, this plan will cost more than a high deductible plan like Wise Max 3000. It will take longer to reach the deductible and obtain free care. Employees cannot help contribute to the HRA. Their bills will be more toward the beginning of the year than they would be with a copay plan.
Benefits: For employees with families less in need of medical care, this plan will be cheaper than a copay plan and less risky than a high deductible plan. It will be more expensive than a high deductible plan if medical needs are low, but less expensive if more unexpected medical needs arise. Bills will be less bunched toward the beginning of the year than in the Wise Max 3000. Employers will contribute only needed funds to the HRA.

To learn more about Health New England products, please contact our Sales Department at 413-233-3535 / 800-310.2835 or sales@hne.com. For information on our plans, log into www.hne.com and click Employer.