Human Resources

Human Resources

HSA Blue Plan

Medical Plan Schedule of Benefits
In-Network (Blue Preferred) Out-of-Network
OCCC Health Savings Account Contribution $600 per Plan Year
Annual Deductible

Individual
Family

 $3,000
$6,000		 $6,000
$12,000
Coinsurance 100% after deductible 60% After Deductible
Out of Pocket Maximum

Individual
Family

 $3,000
$6,000		 $8,000
$14,000
Office Visits

Primary Care
Specialist
Telemedicine/Virtual Visit

 Covered at 100% After Deductible 60% After Deductible
Chiropractic Care

Limited to 60 visits per year
 combined with Physical and
 Occupational Therapy

 Covered at 100% After Deductible Covered at 60% After Deductible
Preventive Care Covered at 100%; No copay Covered at 60% After Deductible
Outpatient Physical Therapy/

Occupational Therapy

Limited to 60 visits per year
 combined with Muscle Manipulations

 Covered at 100% After Deductible Covered at 60% After Deductible
Emergency Room

True Emergency
Non-Emergency
Urgent Care

 Covered at 100% After Deductible
Covered at 100% After Deductible
Covered at 100% After Deductible		 Covered at 100% After Deductible
Covered at 100% After Deductible
Covered at 60% After Deductible
Lab and X-Ray Covered at 100%; No copay Covered at 60% After Deductible
Inpatient Hospitalization Covered at 100% After Deductible Covered at 60% After Deductible
Outpatient Surgery Covered at 100% After Deductible Covered at 60% After Deductible

Prescription Drugs

30-Day Supply

90-Day Supply (Mail Order)
Generic
Preferred Brand
Non-Preferred Brand
Specialty		 Covered at 100% after deductible Covered at 100% after deductible

Health Savings Accounts (HSAs) are a great way to save money and budget for qualified medical expenses. HSAs are tax-advantaged savings accounts that accompany high deductible health plans (HDHPs). HDHPs offer lower monthly premiums in exchange for a higher deductible (the amount you pay before insurance kicks in).

WHAT ARE THE BENEFITS OF AN HSA?

There are many benefits of using an HSA, including the following:

  • It saves you money. HDHPs have lower monthly premiums, meaning less money is being taken out of your paycheck.
  • It is portable. The money in your HSA is carried over from year to year and is yours to keep, even if you leave the company.
  • It is a tax-saver. HSA contributions are made with pre-tax dollars. Since your taxable income is decreased by your contributions, you’ll pay less in taxes.
  • Additional Retirement Savings. After age 65, funds can be withdrawn for any purpose without penalty (only income tax is assessed).
  • Investment Opportunities. Once you have a balance of $1,000 in your HSA account, you can self-direct investments that can potentially grow your savings for healthcare or retirement.

ANNUAL CONTRIBUTIONS AND LIMITS

Employee Only Family
IRS Annual Max Contribution $3,550 $7,100
Catch-Up Contribution
(Members 55+)		 Additional $1,000 per year

ARE YOU ELIGIBLE FOR AN HSA?

If you enroll in the qualified High Deductible Health Plan (HDHP), you are eligible to participate in the HSA plan, with the exception of the following guidelines:

  • You cannot be covered by any other non-HSAcompatible health plan, including Medicare Parts A and B
  • You cannot be covered by TriCare
  • You cannot have accessed your VA medical benefits in the past 90 days (to contribute to an HSA)
  • You cannot be claimed as a dependent on another person’s tax return

HOW DOES AN HSA PLAN WORK?

The elections you make to the Health Savings Account are automatically taken from each paycheck throughout the year and deposited in your HSA account. You can also contribute to your account anytime throughout the year by completing an online transfer from your bank account in the HSA Bank member portal.

When you have an eligible expense, HSA Bank offers convenient options to pay for current or future healthcare expenses. To pay for a service or make a purchase, you need to have the available funds in your account.

  • Use Your HSA Debit Card
  • Use Online Bill Pay – Pay a provider directly from your HSA account.
  • Write a Check – You can order a book of 50 checks to pay for routine and point-of-sale purchases. claims or file a manual claim.

Access your HSA Account online at www.britulsa.com or download the BRI Tulsa Mobile App from the Apple App Store or Google Plan.


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