We are proud to offer three medical plan options through Scott and White Health Plan. Each plan has the same provider networks, pharmacy formulary and covered services. The main difference is how you pay for care.
This plan is a great option for those who want to take a more active role in managing their care and like getting money from Baylor Scott & White to help. There plan has a higher deductible, but the HRA dollars help offset certain copays and deductible expenses. Your HRA helps you meet your deductible and out-of-pocket maximum. Subtract your HRA from the out-of-pocket maximum to see the most you will pay from your own pocket.
How You Pay for Care: Baylor Scott & White contributes between $1,000-$2,000 to your HRA. This money pays for your care. Once it’s gone, you pay from your pocket until you reach your deductible. Keep in mind that you can’t contribute your own money to the HRA but you can set up an FSA to use once your HRA is depleted.
Deductible: Lab work, imaging, outpatient procedures, etc., count toward your deductible. The money in your HRA helps offset the cost.
Copays: Tier 1 office visit copays are paid from your HRA funds. Tier 2 and Tier 3 office visits to a primary care physician, specialist and urgent care are not eligible for HRA payment.
Prescriptions: You pay copays for prescriptions (as low as $3-$5 for generics). Prescription expenses are not paid by your HRA.
Unused Dollars: Money left in your HRA carries forward to the following year when you stick with the HRA plan. Unused dollars are forfeited upon retirement or termination. A HRA rollover maximum, equal to two times your annual Tier 1 deductible will apply, effective Dec. 31, 2018.
This plan works well for those who want an added way to defer pre-tax dollars for future healthcare expenses (including in retirement). It is also a great plan for those who want to take a more active role in managing their healthcare. When you invest your funds and contribute your own dollars, this plan has real value! Employees with high pharmacy costs or those who are not used to managing a high-deductible plan should carefully research this plan before selecting.
How You Pay for Care: Baylor Scott & White contributes between $500 - $1,000 to help jump start your HSA account. You can contribute your own money to your HSA through pre-tax payroll deductions. Call PeoplePlace at any time during the year to increase or decrease your contribution.
Deductible: You meet your deductible by paying 100% of the contracted rate for office visits, prescriptions, urgent care visits, lab work, imaging, etc.
Copays: Copays are not available with this plan, except for prescriptions after your deductible is met.
Prescriptions: You are responsible for 100% of your prescription costs until your deductible has been met. Once the deductible is met, you will pay copays (as low as $3-$5 for generics).
Unused Dollars: Money left in your HSA carries forward to the following year even if you change plans. Unused dollars go with you upon retirement or termination.
If you elect the HSA medical plan, you can add to the dollars that Baylor Scott & White contributes to your HSA. Keep in mind that the IRS places limits on how much you can set aside each year.
In 2018, you can save up to $3,450 if you have self-only coverage and up to $6,850 if you have family coverage. The Baylor Scott & White contribution counts toward these limits. If you’re 55 or older or turn 55 in 2018, you can make an additional one-time catch-up contribution of $1,000. These accounts have a monthly maintenance fee of $2.15 per month. In addition, any open HSA account that has an available balance of less than $5,000 will be charged a $2 monthly custodian fee.
This plan works well for those who want a lower deductible and the assurance of copays for office visits and most pharmacy costs. Employees who select this plan do not mind a trade-off for higher premiums (paycheck deductions).
How You Pay for Care: You pay for care from your pocket. Baylor Scott & White does not fund an account for this plan.
Deductible: This plan offers a lower deductible than the other two plans. You meet your deductible with lab work, imaging, outpatient procedures, etc.
Copays: You pay copays from your pocket for office visits, prescriptions, urgent care visits and the first visit to the emergency room for you and each of your covered dependents.
Prescriptions: You pay copays for prescriptions (as low as $3-$5 for generics).
Learn more about the HRA, HSA and PPO plans in our Digital Benefits Guide.
Helping to Offset the Cost of Care: FSAs
To help you and your family pay for healthcare services, we offer three types of flexible spending accounts (FSA) administered by WageWorks:
Here’s how it works: The money you contribute to an FSA comes out of your paycheck before taxes are withheld. Since your taxable income is lower all year, you pay fewer taxes on April 15.
The HRA and PPO plans feature embedded deductibles. You receive after-deductible coverage once you have met the individual deductible, even if you haven’t met the family deductible. It’s one of the best things about these plans. This is another way we’ve got you covered! The HSA plan does not include embedded deductibles due to IRS requirements.