HP High Deductible PPO Plus HSA Information

Emerson College also offers the Harvard Pilgrim High Deductible PPO Health Plan (HDHP). This plan is designed to provide comprehensive coverage with in-network and out-of-network benefits. This plan has higher deductibles ($1,600 for individual coverage and $3,200 for family coverage in 2024), and higher out of pocket maximums than the other plans offered (HMO or PPO), but the premiums/deductions from your paychecks are significantly less than the PPO plan, and just slightly higher than the HMO plan.

To help offset the cost of higher plan deductibles, the College provides funding through a Health Savings Account (HSA). For 2024 the College contribution towards this fund will be $800 for an employee enrolled with individual coverage; and $1,600 for an employee enrolled with family coverage (if joining the plan later than January 1, the College contributions are pro-rated). Employees who participate in the HSA plan may also make additional contributions to the HSA on a pre-tax basis.

Funds in the HSA can be used to pay for eligible medical, dental, and vision expenses, and long-term care insurance premiums.   

For 2024, the annual maximum allowed contributions (including the employer contributions) are $4,150 for individual coverage; $8,300 for family coverage. This means that the maximum annual employee contributions (after subtracting the employer contributions) are $3,350 for individual coverage and $6,700 for family coverage. Employees age 55 and over can contribute an additional $1000 annually to these accounts ($4,350 and $7,700).

Participants in the High Deductible PPO Health Plan may also participate in a Limited Purpose FSA plan. These accounts may be used for dental and vision expenses. After meeting the deductible in the health plan, they may also be used for medical expenses. The maximum annual contribution to these plans in 2024 is $3200.

Please note: you cannot be enrolled with a regular Healthcare FSA plan while enrolled with the High Deductible Medical Plan (and the accompanying HSA plan).  If enrolled in an FSA prior to starting in the High Deductible plan, make sure to use up your Healthcare FSA money before your start date in the High Deductible plan. You will lose any remaining FSA money not refunded prior to your start in the High Deductible plan.

Also - note that contributions cannot be made to an HSA plan (by either employee or employer) if you are enrolled with Medicare; therefore you cannot enroll in the High Deductible Health Plan if you are already enrolled with Medicare.   See this webpage for more information, including issues related to receiving HSA contributions (yours or the employer's) after turning age 65.

Additional Information concerning the High Deductible PPO Plan:

Please use the benefit summaries, schedule of benefits, or Harvard Pilgrim's website to find information on specific benefit coverage.  This could include things such as chiropractor, acupuncture, therapy, counseling, etc. 

The HDHP PPO Plan Handbook (very detailed benefits coverage information) can be accessed through your online account with Harvard Pilgrim.

Additional Information regarding the HSA and Limited FSA Accounts:

On-Demand Webinars

Find In-Network providers in the PPO plan

1. Go to the Harvard Pilgrim home page (www.harvardpilgrim.org)

2. Select "Find a Provider" at the top right-hand side of the page

3. For Plan Type select "PPO." For Plan Category select "Standard Plans." Under Standard Plans, select "PPO".

4. The Provider Search tool allows you to search by name, or by a number of different criteria including by specialty, by location, hospital affiliations, gender, etc.

For employees living outside New England - see read HP PPO - Receiving Care Outside New England.

On Harvard Pilgrim’s website, you can create an account where you can access detailed information about your plan. Included is information on your claims activity, a deductible tracker, a benefits summary, and an option to order ID cards.

For more information about the High Deductible Plan, call Harvard Pilgrim at 1-866-623-0184.

For more information about the Health Savings Account (HSA), call Health Equity at 1-844-341-6998.

 

Other Information:

Doctor on Demand - Telehealth

Whole Person Care: Integrated Approach to Behavioral Health

Was this article helpful?
0 out of 1 found this helpful
Have more questions? Submit a ticket