HSA issue: WWYD?

[madringal]

TLDR: I didn't get an HSA benefit that was implied I would get and I don't think that it is fair.

I recently switched my family to health insurance with my employer (small credit union) over my husbands (large power company).  We had an HDHP plan there that was pretty cheap ($150/month) but with very high deductibles (5000 pp/10000 family). They give us $300 year into an HSA, we never added anything extra.  

The past 2 years DD2 has had some health issues that have caused us to meet her deductible, no one else really has anything other then routine visits. Maybe a lab work here or there.

So we decided to switch to my companies insurance. Credit unions have notoriously good plans.  So for $300/month our insurance has a $1000 pp/3000 family deductible.  So, double the cost monthly, but much lower deductible.  Also, my husband company will pay us $50/month to have insurance elsewhere. 

And then finally, on the list of healthcare options my credit union states that they contribute $1500/year for those on the family plan.  There are two different health options, both are listed as PPOs.  There is no distinction ANYWHERE that says that the HSA is only for one of the two plans.

So, I just find out that my plan does not get the HSA.  My CEO and CFO both agree, that there was no real way for me to know that.  But, guys, its a huge part of the reason I switched.  This plan on paper costs us more, and the HSA offset a huge chunk of the difference.  Do you think they have an obligation to give it to me anyways? I consider myself pretty savvy with this stuff.  I held my states life and health insurance licenses for a few years. I know what to look for when comparing plans and asking questions. I did all my due diligence when researching whether or not to switch plans.  There was no way I could have know this wasn't available to me.

WWYD

Including the information I was given. PDQ the photo, I will DD. I chose the P1000 plan

[ckay]

Looking at the form, i would absolutely think that the HSA benefit applies to either plan. There is nothing to indicate it is only applicable to one plan.

ETA- yes, I think they should give it to you, at least for this plan year.

[AJ]

I think it is crappy that your employer didn't indicate which plan was a high deductible health plan (you can only contribute to an HSA if you have an HDHP). But, the floor for the deductible amount changes each year and is readily available. Those are actually quite low for deductibles. Not that it is at all easy to shell out $,1000 for medical care. I would ask if you can switch to the other plan given they didn't give you all the info. 

[jewel]

That form is definitely misleading! It should be very clear that the one on the left is a regular PPO option, and the one on the right is the HDHP. And there’s nothing on that page that indicates that.

Given that the one on the left is not a HDHP, I’m not sure that they even can contribute to an HSA for you, even if they made an exception for their issue here. I would fight for either a one time regular payout of $1500 for this year or to switch to the other plan in order to get the HSA deposit.

That HDHP is actually a really good one. I know you were counting on the $1500 HSA money with the first, but given the accurate information after the fact, I think the one on the right is a better deal (not better than the first WITH the HSA, though).

Anyway, man that sucks. Hopefully they can do something to make it right this year.

[illgetthere]

My understanding is 1k individual deductible doesn't meet the IRS qualifications for a high deductible health plan, so they couldn't just give you an HSA anyways. I agree the form doesn't explain it as well as it should though

Edit: along with the fact that it has a lower rx deductible and co-pays allowed for different services

[wildrice]

Yeah that's super confusing. i'm surprised nobody else has had this issue - there is nothing to indicate a difference in HSA between plans. Honestly kind of sounds like BS if they can't show you anywhere that states this.

Do they offer a FSA? If so, maybe you can ask them to contribute to that if the deductible makes you ineligible for a HSA.

[Deleted]

I believe the form is misleading also. But as others indicated HSA is for HDHPs and the plan you chose isnt one. I would maybe see if you can negotiate perhaps something in the middle to compensate for the confusion

[TR]

Feb 26, 2020 17:26:17 GMT -5 illgetthere said:

My understanding is 1k individual deductible doesn't meet the IRS qualifications for a high deductible health plan, so they couldn't just give you an HSA anyways. I agree the form doesn't explain it as well as it should though

This. It seems like they were assuming everyone would know what qualifies for an HSA and what doesn’t and that’s not cool. But I don’t think you really have any recourse

For 2020, the IRS defines a high deductible health plan as any plan with a deductible of at least $1,400 for an individual or $2,800 for a family. An HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $6,900 for an individual or $13,800 for a family. (This limit doesn't apply to out-of-network services.)

It meets the family, but not the individual criteria. 

[smock]

I would ask for them to either give you the HSA this year or switch you to the plan with the HSA. Unfortunately, they might not be able to do either.

We were in a similar situation where the company's error left our family uninsured for a month. We asked for them to rush coverage for us or pay for a temporary plan. Ultimately they refused to do either, claiming it was "against policy." This is just another reason having insurance tied to employment stinks – a lot of companies don't seem to feel any urgency to fight for their employees to get coverage.

[isabel]

I would not have assumed that the HSA applied to both. For me, there's always been an option for a standard PPO and a HDHP PPO + HSA. I would have looked at that form you posted and assumed the plan on the left was standard PPO, eligible for FSA but not HSA, and the plan on the right was a HDHP, eligible for HSA contributions for both you and the company.

All that said, I do kind of get where you're coming from. I just know that I wouldn't have made the assumption that the HSA contribution applied to both plans.

[sometimesrunner]

They can't put money in a HSA for you since your plan doesn't qualify, but they can pay you $1,500 in wages to compensate since there was no way for you to know your plan didn't qualify.

[isabel]

Feb 26, 2020 17:33:16 GMT -5 wildrice said:

Yeah that's super confusing. i'm surprised nobody else has had this issue - there is nothing to indicate a difference in HSA between plans. Honestly kind of sounds like BS if they can't show you anywhere that states this.

Do they offer a FSA? If so, maybe you can ask them to contribute to that if the deductible makes you ineligible for a HSA.

I agree with asking them to contribute that $1,500 to a FSA or letting you switch to the HDHP plan so that you are eligible for the full $1,500 to your HSA.

They won't be able to put $1,500 into an HSA for you on the plan you're on now. It's not legal.

[madringal]

Thank you for validating that I wasn't crazy. Like I said I consider myself pretty insurance savvy, but I did know know there were minimums for what is considered a HDHP. In my experience, neither of them where high.

My CFO did offer to switch me to the actual HDHP plan, but I asked for the $1500 in cash instead. Figured it can't hurt to ask We will see what he says.

ETA: We do not have a FSA.

[fiddles]

Take this with a grain of salt because I'm in HR and deal a lot with benefits.

The plan you signed up for is not a HDHP because you have a copay, therefore it's not eligible for an HSA. Whoever created that document is an idiot Every time I've seen something like this it is very clear which is an HDHP as it has it in the title. It is eligible for FSA but that is something you would have to put money into. There are strict rules on how much money an employer can contribute to an FSA and it's a super low limit.

It really sucks, I get that. But I doubt there is anything your company can do based on laws and such without qualifying events.

[audry80]

So I was expecting when reading the text that you didn't read it correctly it but after looking at the picture, I 100% agree with you!

[kadams767]

Feb 26, 2020 16:57:22 GMT -5 madringal said:

TLDR: I didn't get an HSA benefit that was implied I would get and I don't think that it is fair.

I recently switched my family to health insurance with my employer (small credit union) over my husbands (large power company).  We had an HDHP plan there that was pretty cheap ($150/month) but with very high deductibles (5000 pp/10000 family). They give us $300 year into an HSA, we never added anything extra.  

The past 2 years DD2 has had some health issues that have caused us to meet her deductible, no one else really has anything other then routine visits. Maybe a lab work here or there.

So we decided to switch to my companies insurance. Credit unions have notoriously good plans.  So for $300/month our insurance has a $1000 pp/3000 family deductible.  So, double the cost monthly, but much lower deductible.  Also, my husband company will pay us $50/month to have insurance elsewhere. 

And then finally, on the list of healthcare options my credit union states that they contribute $1500/year for those on the family plan.  There are two different health options, both are listed as PPOs.  There is no distinction ANYWHERE that says that the HSA is only for one of the two plans.

So, I just find out that my plan does not get the HSA.  My CEO and CFO both agree, that there was no real way for me to know that.  But, guys, its a huge part of the reason I switched.  This plan on paper costs us more, and the HSA offset a huge chunk of the difference.  Do you think they have an obligation to give it to me anyways? I consider myself pretty savvy with this stuff.  I held my states life and health insurance licenses for a few years. I know what to look for when comparing plans and asking questions. I did all my due diligence when researching whether or not to switch plans.  There was no way I could have know this wasn't available to me.

WWYD

Including the information I was given. PDQ the photo, I will DD. I chose the P1000 plan

So, while I agree this form is confusing, the law isn’t and I would assume that if you held a health insurance license and did a ton of research, you should have known that you cannot have an HSA without having an HDHP.  So the fact that they were both labeled PPOs should have triggered the question as to how they were providing funds to an HSA.  That said, I don’t think it hurts to ask that they give you $1,500, but it’s not going to be $1,500 into an HSA, it would likely be taxable income to you.[/quote]

[idahome]

The person who designed the form did not do a good job, but the plan on the right is the HSA plan because everything is subject to the deductible and then co-insurance (hallmark of an HSA plan). Both plans are part of the PPO network —that matters when you’re looking for an in-net work provider.

Sorry they gave you such confusing information!

[jlt19]

I would be livid if I was you. I've had Union benefits for my entire adult life and that's $0 premiums for my entire family and some copays and co-insurance (which only started with the ACA). I'm now moving positions and have NO clue about HSAs, FSAs, deductibles, etc. I don't think the onus should be on the employee to navigate this stuff. Someone in HR should direct you.

[madringal]

Feb 26, 2020 20:28:32 GMT -5 kadams767 said:

Feb 26, 2020 16:57:22 GMT -5 madringal said:

TLDR: I didn't get an HSA benefit that was implied I would get and I don't think that it is fair.

I recently switched my family to health insurance with my employer (small credit union) over my husbands (large power company).  We had an HDHP plan there that was pretty cheap ($150/month) but with very high deductibles (5000 pp/10000 family). They give us $300 year into an HSA, we never added anything extra.  

The past 2 years DD2 has had some health issues that have caused us to meet her deductible, no one else really has anything other then routine visits. Maybe a lab work here or there.

So we decided to switch to my companies insurance. Credit unions have notoriously good plans.  So for $300/month our insurance has a $1000 pp/3000 family deductible.  So, double the cost monthly, but much lower deductible.  Also, my husband company will pay us $50/month to have insurance elsewhere. 

And then finally, on the list of healthcare options my credit union states that they contribute $1500/year for those on the family plan.  There are two different health options, both are listed as PPOs.  There is no distinction ANYWHERE that says that the HSA is only for one of the two plans.

So, I just find out that my plan does not get the HSA.  My CEO and CFO both agree, that there was no real way for me to know that.  But, guys, its a huge part of the reason I switched.  This plan on paper costs us more, and the HSA offset a huge chunk of the difference.  Do you think they have an obligation to give it to me anyways? I consider myself pretty savvy with this stuff.  I held my states life and health insurance licenses for a few years. I know what to look for when comparing plans and asking questions. I did all my due diligence when researching whether or not to switch plans.  There was no way I could have know this wasn't available to me.

WWYD

Including the information I was given. PDQ the photo, I will DD. I chose the P1000 plan

So, while I agree this form is confusing, the law isn’t and I would assume that if you held a health insurance license and did a ton of research, you should have known that you cannot have an HSA without having an HDHP.  So the fact that they were both labeled PPOs should have triggered the question as to how they were providing funds to an HSA.  That said, I don’t think it hurts to ask that they give you $1,500, but it’s not going to be $1,500 into an HSA, it would likely be taxable income to you.

[/quote]


Well, aren’t you a peach. Yeah, I know it would be taxable income.

[fiddles]

Feb 26, 2020 21:09:16 GMT -5 jlt19 said:

I would be livid if I was you. I've had Union benefits for my entire adult life and that's $0 premiums for my entire family and some copays and co-insurance (which only started with the ACA). I'm now moving positions and have NO clue about HSAs, FSAs, deductibles, etc. I don't think the onus should be on the employee to navigate this stuff. Someone in HR should direct you.

The best place to go would be directly to the benefit company, not HR.  Benefits, like taxes, are so specific to individuals.  HR can give you a high level overview but they can't help you pick out what specific plan you should be on.  

[madringal]

Feb 27, 2020 12:51:24 GMT -5 fiddles said:

Feb 26, 2020 21:09:16 GMT -5 jlt19 said:

I would be livid if I was you. I've had Union benefits for my entire adult life and that's $0 premiums for my entire family and some copays and co-insurance (which only started with the ACA). I'm now moving positions and have NO clue about HSAs, FSAs, deductibles, etc. I don't think the onus should be on the employee to navigate this stuff. Someone in HR should direct you.

The best place to go would be directly to the benefit company, not HR.  Benefits, like taxes, are so specific to individuals.  HR can give you a high level overview but they can't help you pick out what specific plan you should be on.  

Thanks, my CFO (we don’t have HR) did refer me on to our insurance providers rep for our company. I can’t quite get them to understand that I didn’t choose the wrong one, I thought this one had it too!

[sometimesrunner]

Feb 26, 2020 20:28:32 GMT -5 kadams767 said:

Feb 26, 2020 16:57:22 GMT -5 madringal said:

TLDR: I didn't get an HSA benefit that was implied I would get and I don't think that it is fair.

I recently switched my family to health insurance with my employer (small credit union) over my husbands (large power company).  We had an HDHP plan there that was pretty cheap ($150/month) but with very high deductibles (5000 pp/10000 family). They give us $300 year into an HSA, we never added anything extra.  

The past 2 years DD2 has had some health issues that have caused us to meet her deductible, no one else really has anything other then routine visits. Maybe a lab work here or there.

So we decided to switch to my companies insurance. Credit unions have notoriously good plans.  So for $300/month our insurance has a $1000 pp/3000 family deductible.  So, double the cost monthly, but much lower deductible.  Also, my husband company will pay us $50/month to have insurance elsewhere. 

And then finally, on the list of healthcare options my credit union states that they contribute $1500/year for those on the family plan.  There are two different health options, both are listed as PPOs.  There is no distinction ANYWHERE that says that the HSA is only for one of the two plans.

So, I just find out that my plan does not get the HSA.  My CEO and CFO both agree, that there was no real way for me to know that.  But, guys, its a huge part of the reason I switched.  This plan on paper costs us more, and the HSA offset a huge chunk of the difference.  Do you think they have an obligation to give it to me anyways? I consider myself pretty savvy with this stuff.  I held my states life and health insurance licenses for a few years. I know what to look for when comparing plans and asking questions. I did all my due diligence when researching whether or not to switch plans.  There was no way I could have know this wasn't available to me.

WWYD

Including the information I was given. PDQ the photo, I will DD. I chose the P1000 plan

So, while I agree this form is confusing, the law isn’t and I would assume that if you held a health insurance license and did a ton of research, you should have known that you cannot have an HSA without having an HDHP.  So the fact that they were both labeled PPOs should have triggered the question as to how they were providing funds to an HSA.  That said, I don’t think it hurts to ask that they give you $1,500, but it’s not going to be $1,500 into an HSA, it would likely be taxable income to you.

[/quote]
Except they're both labeled PPOs and one is HSA-compliant and one isn't. If she had left off the part where she mentioned previously having insurance licenses, would you have the same "you should have known" attitude? It is HR's job to accurately state benefits to the employees. This is HR's mistake, and they should compensate her for it. 

[kadams767]

Feb 27, 2020 13:18:27 GMT -5 sometimesrunner said:

Feb 26, 2020 20:28:32 GMT -5 kadams767 said:

So, while I agree this form is confusing, the law isn’t and I would assume that if you held a health insurance license and did a ton of research, you should have known that you cannot have an HSA without having an HDHP.  So the fact that they were both labeled PPOs should have triggered the question as to how they were providing funds to an HSA.  That said, I don’t think it hurts to ask that they give you $1,500, but it’s not going to be $1,500 into an HSA, it would likely be taxable income to you.

Except they're both labeled PPOs and one is HSA-compliant and one isn't. If she had left off the part where she mentioned previously having insurance licenses, would you have the same "you should have known" attitude? It is HR's job to accurately state benefits to the employees. This is HR's mistake, and they should compensate her for it. [/quote]

I'm not trying to be mean about it, and I'm not posting this to try and pile-on the OP, I am just responding to this question.

I responded to the post as I did specifically because OP indicated that she had an HDHP policy for years previously, held a health insurance license (which I assume is some sort of license to sell/broker insurance policies?) and, in her own words, knows what to look for when comparing plans and asking questions.  She isn't an uninformed consumer in this situation.  I said I don't think its unreasonable to ask to be compensated.  But if you had all of this prior knowledge and understood how different plans worked, and looked at these two plans, wouldn't you wonder why anyone would ever choose the second plan if both were getting the same HSA?  It wouldn't make any sense to pick #2, ever, because the difference in premium cost would be more than offset by an HSA contribution, and the coverage on the first one is better.    

[sparkythelawyer]

They cannot do what the plan documents say they cannot do. That may be the issue.

You absolutely need to raise hell with HR and management about this issue, so that it does not happen again.

[madringal]

Just to clarify, I did hold my states license, as in I studied for it because it was necessary to hold along a series 6 license at my former company. But I never sold health insurance, and that was back in 2004 - so a lot has changed. I really meant it to say that I know insurance verbiage - not that I know the ins and outs of the industry. Clearly I missed the part where a HDHP is legally defined as having a minimum deductible of $2800. If I knew that, it would have been much more clear when looking at these options.

Thanks for all the feedback guys, helps a little to know that I wouldn't have been the only one to assume this. Although I am shocked that I am the first one to have made this mistake here? Like I said earlier, there is no HR department. Our CEOs admin just hands out all the benefit information to new hires and then at open enrollment time. We have never had a rep or anyone onsite.

[kadams767]

Feb 27, 2020 14:47:34 GMT -5 madringal said:

Just to clarify, I did hold my states license, as in I studied for it because it was necessary to hold along a series 6 license at my former company. But I never sold health insurance, and that was back in 2004 - so a lot has changed. I really meant it to say that I know insurance verbiage - not that I know the ins and outs of the industry. Clearly I missed the part where a HDHP is legally defined as having a minimum deductible of $2800. If I knew that, it would have been much more clear when looking at these options.

Yea, I definitely read your post to mean you'd held them recently, not prior to HSAs barely even existing, LOL!