Insurance

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PerfectHealth EPO Platinum (HSA)


The PerfectHealth EPO Platinum (HSA) plan features the following:
  • A high-deductible, in-network-only EPO Plan
  • Discounts on in-network care before meeting your deductible
  • A Health Savings Account (HSA)


About the Plan
The PerfectHealth EPO Platinum plan is a high-deductible health insurance plan linked with an HSA through FlexRight. With this plan, you pay discounted rates out-of-pocket for all of your in-network medical expenses up to $5,000 per year for an individual ($10,000 for families). You can pay for these expenses tax-free from your HSA. Once you have met the $5,000 deductible, all in-network expenses are covered 100% for the remainder of the year. Well Child Care - regular check ups and immunizations for your children - is covered 100% and is not subject to the deductible. Prescription drug expenses will be applied toward your deductible; once your deductible is met, they will be covered at 70%. See the monthly premium rates below.


VIEW THE SUMMARY OF BENEFITS »


About the Provider Network
PerfectHealth uses the MultiPlan Inc. doctor network and both the MultiPlan and HIP Health Plan of New York hospital networks depending on where you live. You must see a MultiPlan doctor (even in the hospital) for your expenses to count toward your deductible or be covered once you've met your deductible.

Since this is an EPO plan, you do not need to choose a primary care physician, and you do not need referrals to see specialists. In addition, this plan has no lifetime maximum.


Residency Restrictions:

Doctor Network: You may only use MultiPlan doctors in your state of residency. Visits to doctors in another state will not be covered or applied toward your deductible.

Hospital Network*: If you reside in New York State, you may only use the HIP hospital network (with MultiPlan doctors). If you reside outside New York State, you may only use MultiPlan hospitals (with MultiPlan doctors) in your state of residency.

*This does not apply to emergency visits. In the event of an emergency, you should visit the closest hospital and follow the procedures listed on your insurance card.

About the Discounts
Before you reach your deductible you are eligible for discounted rates for in-network medical expenses. If you visit a MultiPlan doctor you will be charged a negotiated discount rate. You pay nothing at the time of the visit, and shortly after, both you and your doctor will receive an Explanation of Benefits from PerfectHealth. Your doctor will then send you an adjusted bill and you will pay your doctor. After you pay the doctor, you will submit a claim to PerfectHealth so that your medical expenses are applied to your deductible.

Read the Summary of Benefits.

About our HSA
A Health Savings Account is a tax-advantaged banking or investment account that you may use to pay your qualified medical expenses. Contributions to your HSA account are tax deductible and you do not have to pay taxes on the interest or dividends it earns. You can withdraw money from your account for medical expenses and any money you don't use will accumulate from year to year as tax-free savings. There are restrictions on how much money you deposit in your HSA, how you spend it, and how you invest it.

Learn more about Health Savings Accounts.

A few things you should know about the FlexRight Health Savings Account:

  • When your eligibility has been approved for insurance, you will be able to enroll in both the HSA and the EPO plan simultaneously. (You cannot enroll in one without the other.)
  • The interest rate on the FlexRight HSA is 3%, guaranteed through December 31, 2008, and there is no minimum deposit.
  • All banking functions, including account setup, funding, withdrawals and account maintenance can be processed electronically and will be available 24 hours a day via a web interface.
  • Coming soon: a debit card for paying qualifying medical expenses directly out of your HSA account.
  • Coming soon: additional investment options.

Monthly HSA Fees*
There are no setup, transaction (for electronic banking) or debit card fees.
Monthly administration fee
$3.50 per month


Additional & Optional Fees
Fee for additional investment options
$2.00 per month
Paper check fee
(transaction fee for non-electronic banking)
Waived until debit card is available;
$1 per check thereafter
Insufficient funds fee $25.00


* All of your fees will be deducted directly from your HSA account.

PerfectHealth EPO Platinum (HSA) monthly premium rates*:
Individual $202.66
Individual & Child $390.84
Individual & Spouse
$460.33
Family $651.07

*These rates are guaranteed until December 31, 2008.
*These rates do not include any fees associated with the HSA.

IMPORTANT: The "monthly fees" and "premium rates" listed above will NOT be deposited as contributions to your Health Savings Account. Any contributions you make will be in addition to the above fees and premiums.