| 5 | Health Insurance Key Health Care Terms We’ve compiled this list of health care terms to help you navigate this section of the enrollment guide: › Deductible: Dollar amount you must pay for covered care each calendar year before the medical plan pays benefits for services. The deductible doesn’t apply to every service so be sure to check out the summary schedule of benefits. Under the Network plan, the family must collectively satisfy the family deductible. Additionally, each family member has an individual deductible in addition to the overall family deductible. Meaning if an individual in the family reaches his or her deductible before the family deductible is reached, his or her services will be paid by the insurance company. Under the Health Savings plan (HSA), the family deductible must be reached, either by an individual or by the family, before services will be paid by the insurance company. There is no individual deductible under the HSA plan. › Coinsurance: Percentage of the cost for eligible medical expenses that you pay after you meet the deductible. For example, under the Health Savings Plan, after you meet the deductible, the plan will pay 80% of covered costs and you pay the remaining 20% up to the plan’s out-of-pocket maximum limit. The 20% is your coinsurance. › Copayment (or copay): A fixed amount that you must pay for a service. Copays can vary depending on the service you receive. › Network Providers: Providers who have agreed to lower rates for services. The UnityPoint Health medical plans provide benefits for covered services provided by network providers. › Out-of-Pocket Maximum (OOPM): Maximum dollar amount that you pay for eligible expenses in a calendar year. The plan pays 100% of eligible expenses for the rest of the calendar year after the out-of-pocket maximum is reached - providing financial protection for you by limiting your out-of-pocket expenses in a given calendar year. The out-of-pocket limit is a combined amount for both medical and prescription coverage under each medical plan. Which Medical Plan is the Best Choice for Me? You will have the choice to waive medical coverage or select coverage from one of two HealthPartners medical plans. Both medical plans: › Cover the same basic medical services › Cover the same network of doctors, hospitals and health care specialists who deliver quality care according to network standards and have agreed to lower, preferred rates for covered services. However, depending on the plan selected, your share of the cost of the medical services you receive differs. NETWORK PLAN › Higher biweekly premium cost for coverage › Cost of care (deductible amounts and out-of pocket limit) lower than the Health Savings Plan HEALTH SAVINGS PLAN (HSA) › Pay less in biweekly premium cost for coverage › Cost of care (deductible amounts and out-of-pocket limit) will be higher than the Network Plan › UnityPoint Health contributes to your Health Savings Account to help offset out-of- pocket costs