HSA -- Advice Needed

AprilZ81 · October 2015

DH came home with his open enrollment package and his company is now offering an HSA (YEAH!!!). The cost is the same and by joining the HSA he gets a one time rollover from his HRA plus funds from the company. DH rarely needs to go to the doctor so his HRA has been building up the last 2 1/2 years until I started using it for fertility treatments this summer (I was added to his plan after I was laid off this spring).

1) The rollover amount won't be able to be used until after he meets his deductible, which sounds shady to me. Is that normal?

2) Does the medical expense have to be his to be reimbursed? If we have a baby and the baby gets added to his plan would either of them be able to draw from it? Could I?

hoffse · October 2015

1) Since it's a rollover it might have special rules. I don't know about that. Any contributions he makes going forward should be able to be withdrawn immediately though.

2) Yes, a spouse and dependent can use the other spouses's HSA. Actually, even if he moves plans or the HSA option is eliminated in the future, it should be his to keep for any of you to use going forward as long as it's a qualifying medical expense. I've been stashing money away in my HSA for a couple of years with the intention of moving to H's family insurance if/when we have kids. We'll have several thousand available to us in the HSA for L&D expenses even though I will no longer be on my employer's health plan.

jtmh2012 · October 2015

#1 sounds weird to me, but I've never been in that situation.

As for #2, at least with our HSA anybody on the plan can use the HSA funds. Not sure if others work differently.

AprilZ81 · October 2015

hoffse said:

1) Since it's a rollover it might have special rules. I don't know about that. Any contributions he makes going forward should be able to be withdrawn immediately though.

2) Yes, a spouse and dependent can use the other spouses's HSA. Actually, even if he moves plans or the HSA option is eliminated in the future, it should be his to keep for any of you to use going forward as long as it's a qualifying medical expense. I've been stashing money away in my HSA for a couple of years with the intention of moving to H's family insurance if/when we have kids. We'll have several thousand available to us in the HSA for L&D expenses even though I will no longer be on my employer's health plan.

What if DH doesn't meet the deductible? He doesn't go to the doctor (never since we met in December 2011) so the odds of him using his health plan, let alone meeting the deductible ($1,750) are slim unless we do have a baby next year and put the baby on his plan. It seems really strange that he wouldn't be able to use it.

This might be a little long winded and not well explained, but let me see if I understand this.

DH enrolls in his HSA, gets the rollover and his company puts in $750 over the course of the year.

I'm on my own plan (no open enrollment yet but currently no HSA only HRA) and continue my infertility treatments and hopefully get pregnant. After I empty my $200 HRA I'm out of pocket until I meet my deductible.

I should be able to use DH's HSA to pay for my out of pocket expenses for doctors visits, ultra sounds, blood work and all that jazz, right?

hoffse · October 2015

AprilZ81 said:

hoffse said:

1) Since it's a rollover it might have special rules. I don't know about that. Any contributions he makes going forward should be able to be withdrawn immediately though.

2) Yes, a spouse and dependent can use the other spouses's HSA. Actually, even if he moves plans or the HSA option is eliminated in the future, it should be his to keep for any of you to use going forward as long as it's a qualifying medical expense. I've been stashing money away in my HSA for a couple of years with the intention of moving to H's family insurance if/when we have kids. We'll have several thousand available to us in the HSA for L&D expenses even though I will no longer be on my employer's health plan.

What if DH doesn't meet the deductible? He doesn't go to the doctor (never since we met in December 2011) so the odds of him using his health plan, let alone meeting the deductible ($1,750) are slim unless we do have a baby next year and put the baby on his plan. It seems really strange that he wouldn't be able to use it.

This might be a little long winded and not well explained, but let me see if I understand this.

DH enrolls in his HSA, gets the rollover and his company puts in $750 over the course of the year.

I'm on my own plan (no open enrollment yet but currently no HSA only HRA) and continue my infertility treatments and hopefully get pregnant. After I empty my $200 HRA I'm out of pocket until I meet my deductible.

I should be able to use DH's HSA to pay for my out of pocket expenses for doctors visits, ultra sounds, blood work and all that jazz, right?

In theory, yes. It's essentially an account where you can reimburse yourself for OOP expenses. Hitting the deductible first though is strange, and I would have him clarify that point with his HR people. It could be a weird rule, it could be that they don't really understand it correctly since it's new.

AprilZ81 · October 2015

hoffse said:

AprilZ81 said:

hoffse said:

1) Since it's a rollover it might have special rules. I don't know about that. Any contributions he makes going forward should be able to be withdrawn immediately though.

2) Yes, a spouse and dependent can use the other spouses's HSA. Actually, even if he moves plans or the HSA option is eliminated in the future, it should be his to keep for any of you to use going forward as long as it's a qualifying medical expense. I've been stashing money away in my HSA for a couple of years with the intention of moving to H's family insurance if/when we have kids. We'll have several thousand available to us in the HSA for L&D expenses even though I will no longer be on my employer's health plan.

What if DH doesn't meet the deductible? He doesn't go to the doctor (never since we met in December 2011) so the odds of him using his health plan, let alone meeting the deductible ($1,750) are slim unless we do have a baby next year and put the baby on his plan. It seems really strange that he wouldn't be able to use it.

This might be a little long winded and not well explained, but let me see if I understand this.

DH enrolls in his HSA, gets the rollover and his company puts in $750 over the course of the year.

I'm on my own plan (no open enrollment yet but currently no HSA only HRA) and continue my infertility treatments and hopefully get pregnant. After I empty my $200 HRA I'm out of pocket until I meet my deductible.

I should be able to use DH's HSA to pay for my out of pocket expenses for doctors visits, ultra sounds, blood work and all that jazz, right?

In theory, yes. It's essentially an account where you can reimburse yourself for OOP expenses. Hitting the deductible first though is strange, and I would have him clarify that point with his HR people. It could be a weird rule, it could be that they don't really understand it correctly since it's new.

I'm going to ask if there are any Open Enrollment Conference calls and just ask him to provide me the dial in number. lol

Since DH doesn't use health insurance he always gets the cheapest plan. Now that we have to think strategically about which plan is best to minimize our out of pocket costs to get pregnant and to actually have the baby I need to take over. He would never be able to get the questions I have answered and remember what they said or ask the proper follow up questions. He has other strengths.

If my employer's plan doesn't change it is better for us to be on our respective employer's plan (lower premiums and I would have a much lower OOP Max for labor and delivery costs). Once we have a baby it looks like it would be best to be on one joint plan until we try for baby #2.

I'm all for capitalism and private markets, but the idea of a single payor health system is appealing. I don't think the executiion ever works out like the "experts" say they will but the idea is appealing.

cbee817 · October 2015

Just as a FYI, since you are planning on TTC #1, it might be a good idea for DH to get a physical and some standard bloodwork just to see how he's doing. DH did that for me and it helped me feel like we were both on the same page about making sure we were healthy. It also gave us a head's up on numbers for DH's life insurance policy that we got when DD#1 was born. Also, if you are sending any little ones to day care, be prepared for a lot of sick visits and not just for them (I had strep throat twice 2 years ago from DD#1- it was way worse than I remember as a kid!).

This and DD#1's 2 hospital stays with ER/Ambulance (happened about 3 years ago within 6 months of each other) is why we won't go to a HSA plan anytime soon. My OOP for the copay plan at work isn't bad at all for a family of 4 and the HSA is just not worth the risk at this point.

cupcait927 · October 2015

It sounds like what your H's employer is setting up is a post-deductible HRA, in order to make the plan HSA-compliant. There's a whole bunch of rules that govern an HDHP plan with an HSA, in order to make them compliant. So it's not uncommon and it sounds like what your H's employer is trying to do is get rid of the HRA but not screw over employees that have been banking that money, hence the one-time rollover. So yes, totally normal, just a little funky.

And yes, your husband can most definitely use his HSA for your expenses and the baby. You are both tax-qualified dependents of his and you do not not have to be on the same health plan in order for him to use his funds for you and the baby.

smerka · October 2015

My husband is the same way. I was able to call his HR department and ask general questions. They would not be able to tell things like how much money comes out of his paycheck, etc. but we did talk about the specifica of the HSA. We just made the switch to a HDHP/HSA. Mathmatically it is better, but will present a cash flow problem. My kids are in speech, OT, ABA therapy. So come January we will be paying around $300 a week until we reach the $2600 deductible for one kid.

formerlyGDaisy09 · October 2015

#1 Sounds weird, but there could be a reason for it (does the transfered amount count towards your annual cap of HSA contributions?)

for #2 and HSA can be used for spouses and dependents.

outside that, I'd recommend doing some hard math out for if it's really better for you to be on the same or seperate plans, keeping in mind that since you are TTC #1 there could be a 3rd party involved next year. for example: H and I both had HDHPs available to us this year, his company uses and HRA mine sets up an HSA. 3 people on his plan gets his company to contribute a total of $600 to the HRA, 2+ people on mine puts $1000 into my HSA.

I did out the math for premiums, employer contributions and worst case scenarios (something truely catastrophic like a major car accident that might have us meeting our In-network Max OOPs and potentially out-of network too). To put H and the baby on his plan and me on mine would cost us -$578 (we'd actually come out ahead with HRA/HSA contributions exceeding our premium costs) but in the event of something terrible we'd be liable for $13,100 in-network and $46,000 out-of network. That's potentially $59,100 in medical expenses we would be responsible for! and contrubutions to my HSA would be capped at $3250.

To put all three of us on my plan will cost us $690 in premiums (after I subtract the employer HSA contribution). But in the event of something catastrophic we're responsible for $8,200 in-network and $13,100 out-of network...so $21,300 as the maximum we could be liable for. With more than one person on my plan, the contribution cap on my HSA is $6,750, so we can stash aside more money there pre-tax.

short+sassy · November 2015

formerlyGDaisy09 said:

#1 Sounds weird, but there could be a reason for it (does the transfered amount count towards your annual cap of HSA contributions?)

for #2 and HSA can be used for spouses and dependents.

outside that, I'd recommend doing some hard math out for if it's really better for you to be on the same or seperate plans, keeping in mind that since you are TTC #1 there could be a 3rd party involved next year. for example: H and I both had HDHPs available to us this year, his company uses and HRA mine sets up an HSA. 3 people on his plan gets his company to contribute a total of $600 to the HRA, 2+ people on mine puts $1000 into my HSA.

I did out the math for premiums, employer contributions and worst case scenarios (something truely catastrophic like a major car accident that might have us meeting our In-network Max OOPs and potentially out-of network too). To put H and the baby on his plan and me on mine would cost us -$578 (we'd actually come out ahead with HRA/HSA contributions exceeding our premium costs) but in the event of something terrible we'd be liable for $13,100 in-network and $46,000 out-of network. That's potentially $59,100 in medical expenses we would be responsible for! and contrubutions to my HSA would be capped at $3250.

To put all three of us on my plan will cost us $690 in premiums (after I subtract the employer HSA contribution). But in the event of something catastrophic we're responsible for $8,200 in-network and $13,100 out-of network...so $21,300 as the maximum we could be liable for. With more than one person on my plan, the contribution cap on my HSA is $6,750, so we can stash aside more money there pre-tax.

I just got my company's open enrollment plan for next year and also have a high PPO/HSA type of insurance. Unless I am missing something about your situation, the federal government has capped out of pocket medical costs (not including the premiums) for people on insurance plans at $6850 for in-network and $16K out-of-network. For a family plan. For individual plans it is $4K and $8K. I think. Not as sure about this one.

And I'm not sure the max. out of pocket for in/out of network would be combined like that. For example, if someone hit max. out-of-network at $16K, I think they'd be done. It wouldn't make sense for it to then revert to paying more money in deductibles for an in-network doctor/hospital. Otherwise, people would be inclined to just go out-of-network entirely, once they meet that cap. KWIM? But then, logic and insurance companies are rarely friends, so I could be totally wrong.

formerlyGDaisy09 · November 2015

short+sassy said:

formerlyGDaisy09 said:

#1 Sounds weird, but there could be a reason for it (does the transfered amount count towards your annual cap of HSA contributions?)

for #2 and HSA can be used for spouses and dependents.

outside that, I'd recommend doing some hard math out for if it's really better for you to be on the same or seperate plans, keeping in mind that since you are TTC #1 there could be a 3rd party involved next year. for example: H and I both had HDHPs available to us this year, his company uses and HRA mine sets up an HSA. 3 people on his plan gets his company to contribute a total of $600 to the HRA, 2+ people on mine puts $1000 into my HSA.

I did out the math for premiums, employer contributions and worst case scenarios (something truely catastrophic like a major car accident that might have us meeting our In-network Max OOPs and potentially out-of network too). To put H and the baby on his plan and me on mine would cost us -$578 (we'd actually come out ahead with HRA/HSA contributions exceeding our premium costs) but in the event of something terrible we'd be liable for $13,100 in-network and $46,000 out-of network. That's potentially $59,100 in medical expenses we would be responsible for! and contrubutions to my HSA would be capped at $3250.

To put all three of us on my plan will cost us $690 in premiums (after I subtract the employer HSA contribution). But in the event of something catastrophic we're responsible for $8,200 in-network and $13,100 out-of network...so $21,300 as the maximum we could be liable for. With more than one person on my plan, the contribution cap on my HSA is $6,750, so we can stash aside more money there pre-tax.

I just got my company's open enrollment plan for next year and also have a high PPO/HSA type of insurance. Unless I am missing something about your situation, the federal government has capped out of pocket medical costs (not including the premiums) for people on insurance plans at $6850 for in-network and $16K out-of-network. For a family plan. For individual plans it is $4K and $8K. I think. Not as sure about this one.
And I'm not sure the max. out of pocket for in/out of network would be combined like that. For example, if someone hit max. out-of-network at $16K, I think they'd be done. It wouldn't make sense for it to then revert to paying more money in deductibles for an in-network doctor/hospital. Otherwise, people would be inclined to just go out-of-network entirely, once they meet that cap. KWIM? But then, logic and insurance companies are rarely friends, so I could be totally wrong.

I sat down with the Cigna rep at my company and did the math out...some of the math in my above post is a little wrong, but Either way, the benefits sheet from my H's company had the Family OOP Max for out-of-network listed at $40,000...so either way his plan was a lot riskier. H's premiums were so ridiculously low I have a hard time believing that his plan wouldn't screw us over at some point.

The cigna rep explained to me that the in and out of network maxes are seperate buckets and don't count towards each other. To-date I've never used out-of-network care, but every benefits session I've been to they've been explicitly clear that in network and out of network are seperate buckets.

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