The Coming 2023 Plan Year
The upcoming 2023 plan year does not include any major benefit changes.
The University is pleased to announce that 2023 will be the sixth consecutive benefit renewal where there will be no premium rate increases for faculty and staff! This is great news and says something significant about the health and wellness of our SPU population; as well as careful ongoing plan management.
Open Enrollment is an important window - it is the one time each year where benefit-eligible employees may: 1) add or drop coverage, 2) move between plan options, and/or 3) add or drop dependents from plan coverage. Outside of Open Enrollment, one must experience a 'qualifying life event' in order to make similar changes (various deadlines also apply). Please review the following:
- The complete 2023 SPU Benefits Guide.
- The 2023 High Deductible Health Plan Benefit Summary
- The 2023 Summary of Benefits and Coverage (SBC)
- The 2023 Your Rights Notices.
Do you have questions about specifics of the medical plan benefits, provider networks, or prescription drug plan? If so, please contact the Aetna Health Concierge line at 1 (833) 735-0680.
Table of Contents
Seventh Consecutive Benefit Plan-year with No Increases to Your Monthly Insurance Premiums!
There will be no premium rate increase for the 2023 benefits plan year. This is the case for the sixth consecutive plan-year. Given the state of employer-based benefits nationwide, this is an exceptional feat. This kind of stability results from the way we all care for ourselves and our families, not having as many large claims over the last few years, and by maintaining a sustainable medical plan design. It may not always be like this in the future, but let us be thankful to the Lord for it and continue to do our part in staying healthy.
Medical Plan
COVERAGE | Full-time | Part-Time |
|---|---|---|
| Employee Only | $0 | $220 |
Employee + Spouse | $414 | $634 |
| Employee + Child(ren) | $136 | $356 |
| Employee + Family | $640 | $860 |
Dental Plan
COVERAGE | Full-time | Part-time |
|---|---|---|
Employee Only | $0 | $22 |
| Employee + Spouse | $58 | $80 |
| Employee + Child(ren) | $56 | $78 |
| Employee + Family | $114 | $136 |
Vision Plan
COVERAGE | Full-time & Part-time |
|---|---|
Employee Only | $0 |
| Employee + Spouse | $10 |
| Employee + Child(ren) | $12 |
| Employee + Family | $24 |
What is a Deductible?
A deductible is the amount you pay each year for eligible health care expenses before your insurance plan will begin to pay for covered expenses.
For example, if you are enrolled in individual medical coverage, you have a $2,000 annual deductible. You will be responsible to pay for all of your covered health care services until you have paid $2,000 that year.
Once you have paid $2,000, Aetna will start to pay their share of the following costs (this is called 'coinsurance') at a rate of paying 90% if using an In-Network service provider and 60% if you use an Out-of-Network provider until you reach your annual out-of-pocket maximum. After that, the plan will pay for 100% of the covered medical expenses.
If you have family coverage, meaning you cover at least one dependent on your medical plan, then a family deductible of $4,000 applies to everyone taken together.
Why are HSAs So Powerful?
- It's your money! You own it, the HSA is portable; even if you change SPU plan options, leave SPU, or retire.
- It's very tax-favored! HSAs enjoy what we call a 'triple tax advantage': the contributions are pre-tax, you can get tax-free growth on those funds while you hold them, and distributions that cover eligible health expenses are also tax-free.
- The HSA funds can grow! Once you have a minimum amount, you can invest in a selection of funds through HSA Bank's investment options. But be cautious, these funds are intended for your health expenses.
- HSAs are also retirement accounts! Because you keep the funds, you can take your HSA into retirement and use the funds tax-free for health expenses then. Further, once you are 65, you can withdrawal funds like any other retirement account and only pay regular income tax on it (no penalty is assessed, like prior to age 65).
- HSA are flexible! You are in control of your funds and can contribute up to IRS limits and spend on health costs for any of your tax-dependents, even if they are not enrolled in the SPU medical plans.
What is an Annual Maximum?
Each year that you are covered on the plan (our 'plan year' follows the calendar year), Aetna will keep track of all the covered medical and prescription expenses you have to pay for. These might be in the form of deductible expenses, coinsurance (where you pay a percentage of costs after the deductible is covered), or prescription costs.
This is very important because it puts a limit on what you could owe if you or a covered family member needs high cost medical care; or if several people in your family do.
If you have Employee Only coverage, your annual out-of-pocket maximum is $3,425 per year. If you cover a family member on your medical plan, the maximum increases to $6,850 with all family members taken together. (There is an exception for those with family coverage that have only one person with high costs: a separate limit of $4,000 is applied to that individual's costs so that one person cannot make a family owe the entire family maximum.)
How Does SPU Help Offset Deductible Expenses?
To help with the deductible, which resets back to zero each January, SPU contributes the amounts in the table below into an HSA based on your plan choice for 2023. These figures assume that your participate in the plan for all 12 months and make enough employee HSA contributions (from your own payroll deductions) to trigger the SPU match up to the annual cap that applies to you based on your plan enrollment.
An equivalent annual contribution is made into the Health Reimbursement Account (HRA) for those who choose to enroll in that plan. The HRA allows all of these funds to be available right away but there are no employee contributions allowed, by IRS regulations. While unused HRA funds rollover from year-to-year; if you leave HRA plan enrollment, SPU retains the unused funds at that time.
Health Savings Accounts (HSA)
If you are enrolled in a Health Savings Account (HSA), SPU will contribute monthly to an HSA on your behalf plus a dollar-for-dollar match of your HSA contributions, up to the annual maximum.
| HDHP Coverage Level | SPU Monthly Contributions | SPU Match of Employee HSA Contributions | Total Possible SPU HSA Contributions per Year |
|---|---|---|---|
| Individual | $84 | Up to $400 per plan year* | $1,408 in 2023 |
| Family | $168 | Up to $800 per plan year** | $2,816 in 2023 |
*If you have Individual coverage and contribute by payroll deduction to your HSA during 2023, SPU will match your HSA contributions dollar-for dollar, up to $400 for the year.
**If you have Family coverage and contribute by payroll deduction to your HRA during 2023, SPU will match your HSA contributions dollar-for-dollar, up to $800 for the year.
Tip: For those who participate in the HSA, with SPU’s additional contributions, be sure to review your contribution plan to ensure that all HSA contributions will not exceed the annual IRS maximums. You may change your HSA pre-tax contribution amounts once per pay period. Please take advantage of your personalized HSA Calculator to help you plan appropriately.
HSA funds belong to the account holder and are portable: unused funds do rollover to the next plan year. If you change coverage to the HRA plan or otherwise lose eligibility to this plan, contributions to the HSA are no longer allowed but you do keep current funds in the HSA to be used for qualifying health expenses in the future.
Health Reimbursement Accounts (HRA)
If you are enrolled in a Health Reimbursement Account (HRA), SPU will fund the below amounts to a HRA setup on your behalf, based on your HDHP enrollment.
| Coverage Level | SPU Contributions for 2023 |
|---|---|
| Individual | $1,008 |
| Family | $2,016 |
Eligible reimbursements through the HRA are for the employee and also eligible dependents that are enrolled on the HDHP plan as a dependent under the employee's medical coverage. If an otherwise qualified dependent is not enrolled on the HDHP medical plan, their expenses are not eligible for reimbursement from this HRA plan.
If a participant remains covered on this HRA plan from year-to-year and does not use up all the funds available, the unused HRA funds from the prior year will rollover and be added to the funding available in subsequent plan years.
However, once coverage under this HRA plan is ended, either because of moving over to the HSA plan or because of changing employment (or losing benefit eligibility), the funds remaining in the HRA are returned back to the plan at that time. Thus, HRA funds are not portable.
HRA contributions are pro-rated on a monthly basis for those with midyear changes.
Flexible Spending Accounts - FSAs Require Annual Re-enrollment
If you participate in our Flexible Spending Accounts (FSA), please review the contribution limits for 2023 as they have been adjusted for the new plan year. There is a small increase that the IRS announced for the Health FSA, based on cost of living changes (the Dependent Care FSA is, by law, not similarly indexed and continues to remain the same amount). If there are multiple adults in a household with access to a Health FSA, both may use this benefit through their employer in the same tax year; they may be 'stacked'.
If you are considering using the Dependent Care FSA, please note that each household may only use this tax-favored vehicle once per tax year, you cannot have two spouses both using this from their own employer. Further, you may only use the Dependent Care FSA or the Dependent Care tax credit in a given tax year, not both.
FSA Contribution Limits for 2023*
Health FSA | Limited-Purpose FSA** (Dental & Vision Only) | Dependent Care FSA |
|---|---|---|
| $3,050 | $3,050 | $5,000 |
**A Limited-purpose FSA is designed to be paired with someone that has a HSA. Remember, if you enroll on a basic Health FSA, that makes you ineligible to make or receive any HSA contributions. But for those on the HSA plan, they are only allowed to use the Limited-Purpose FSA without becoming ineligible for HSA contributions. That is because the Limited-Purpose FSA is only allowed to be used for dental and vision expenses. A very common use of the Limited-Purpose FSA is to cover the costs of orthodontia. Orthodontia is a large, known expense and if you want to preserve your HSA funds, you may then use the Limited-Purpose FSA to pay for the orthodontia to help retain your HSA funds.
Dates to keep in mind
March 15th, 2024: The deadline to incur expenses for FSA reimbursement based on the 2023 plan year.
March 31st, 2024: All 2023 FSA claims must be submitted to HSA Bank for reimbursement, otherwise they will be forfeit.