The medical plan you choose should reflect the type of care you and your dependents need now and anticipate needing in the coming year. Your choice should also be consistent with your ability to pay. Please take the time to carefully select the plan that is best for you and your family.
Questions to Ask
When choosing your medical plan, consider the following:
What are your anticipated medical expenses for the coming year? How much will you have to pay for these expenses with each option? Do you or your dependents have other coverage? Consider the deductible and maximum out-of-pocket costs you could handle. How well could you meet these medical expenses with each option?
Plan A—Full Plan for Employees and Families
Plan A provides medical, dental, prescription and vision benefits for employees and their families. Of all the options, this Plan costs the most per month. That’s because:
- It generally pays the highest level of medical benefits
- It includes prescription, dental and vision coverage
- It covers you and each eligible family member
If you enroll your spouse in Plan A, you must confirm if your spouse is employed and eligible for employer-sponsored coverage through his/her employer. If your spouse has opted out of employer-sponsored coverage for which he/she is eligible, a $125 monthly surcharge will be added to your payroll deduction.
Plan B—Full Plan for Employees Only
Plan B is identical to Plan A, but costs less per month because it covers only you, not your family.
If you have dependents, you may choose this option only if all of your eligible family members are covered by another health plan—for example, through your spouse’s employer.
Plan C—Supplemental Plan for Employees and Families
Plan C pays a 20% medical plan benefit, as well as prescription, dental and vision benefits. This cost-effective plan is designed to work with most other coverage you and your family have in order to pay up to 100% of covered services.
- Plan C pays 20% of covered medical costs (with no deductible)—whether or not you use a PPO provider
You may choose this option only if you and all of your eligible family members are covered by another health plan—for example, through your spouse’s employer.
Before You Choose Plans B or C:
Check with your other health plan. When you or your dependents are covered by another health plan, and enroll in Plan B or Plan C, the other health plan may reduce its benefits. Before you enroll, call the other health plan’s administrator to find out how the plans will coordinate benefits.
If you or your dependents are covered under the State of Alaska’s Plan for active employees, benefits may be limited or reduced. Please see FAQs on coordination of benefits section including “How does the State of Alaska health coverage coordinate with the ASEA Health Trust coverage".
Other coverage required. If you decide to enroll in Plan B (if you have dependents) or Plan C, you will need to provide information about the other health plan when you enroll.
Plan B and Plan C participants must notify the Health Trust Administrator within 60 days if they gain eligible new family members or if their family members lose their other coverage.
Plan D—Low Option Plan With HRA for Employees and Families
With Plan D, the Health Trust provides a $1,000 (per employee) Health Reimbursement Arrangement (HRA). You can be reimbursed from your HRA for eligible expenses, such as prescription medications or a portion of your deductible. Plan D does not provide dental or vision coverage— but you can use the HRA to pay for dental and vision expenses.
You may use your HRA to pay for any of the eligible expenses allowed with a Health Care Reimbursement Account (HCRA). However, if you have both a HCRA and an HRA, you must use your annual HCRA amount before the HRA reimburses your eligible expenses.
Plan D pays for preventive care that meets standard recommendations, with no deductible required. However, the Plan provides non-preventive medical coverage only after you satisfy a high annual deductible ($5,000 per person and $10,000 per family). After you meet the deductible, Plan D pays 100% of most covered costs or 80% of the contracted price for non-PPO services. Plan D is appropriate if:
- Your estimated annual eligible medical expenses are up to $1,000 (which may be reimbursed by your HRA)
- You are willing to pay for health care costs over $1,000 (and up to the deductible amount) out of your own pocket
- You want protection against the high cost of a serious medical condition
You might also want to consider Plan D if you and your family have other group health care coverage.
If there are unused funds in your HRA at the end of the Plan Year, these funds will be rolled over to the following Plan Year. If you select a different Plan or are no longer eligible for Health Trust benefits, you must forfeit any remaining funds in your HRA.