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The Palmetto Health Savings Account medical plan is a consumer-driven health plan that maximizes your benefits when using Palmetto Health facilities and Palmetto Health Quality Collaborative physicians. The plan’s provider network consists of two tiers: a primary tier and a secondary tier. The primary tier consists mostly of Palmetto Health facilities and Quality Collaborative physicians. The secondary network tier consists of all providers in BCBS’ national network that haven’t been included in the primary tier. Please click here for a list of primary tier (Palmetto Health Quality Collaborative) providers. Please click here for a list of secondary tier (BCBS) providers.

The Palmetto Health Savings Account medical plan is intended for relatively healthy individuals and families who anticipate needing only routine preventive and minor sick care in the year ahead. There are no out-of-pocket costs for preventive services. Preventive services include annual physicals, screening services, well-child care and child/adult immunizations.

A health savings account will automatically be opened for you when you enroll in the Palmetto Health Savings Account medical plan. The account will be administered by BCBS’ partner HSA Bank and can assist you with qualified out-of-pocket health care expenses. Palmetto Health will make quarterly contributions to HSA Bank health savings account on January 20, April 14, July 7 and October 13, as long as you are enrolled in the Palmetto Health Savings Account medical plan on the first day of the corresponding month. These contributions are very important as they can help pay for health care expenses before you meet your Deductible.

What is an HSA? (Video information from HSA Bank)

Want to check your HSA balance? Contact HSA Bank at 800-357-6246 or visit www.HSABank.com/HSABank/Accountholders.

Please note the following recent changes to health plan eligibility:

  • Working Spouse Eligibility – Team members may only cover a spouse if the spouse does not have access to medical insurance through his or her employer.
  • Same-sex Domestic Partner Eligibilty - Palmetto Health offers benefits coverage to same-sex domestic partners of our team members. Please click here to review the tax implications of covering a domestic partner.

Schedule of Benefits

The following chart is only an overview. You should refer to your Summary Plan Description for any exclusions or limitations that may apply to the specific benefits.

Deductibles and Out-of-Pockets Maximums

 

Primary (Palmetto Health/PHQC) Tier  Secondary (BCBS) Tier

Out-of-Network

Individual Deductible

$2,000

$3,125

$4,000

Family Deductible

$4,000

$6,250

$8,000

Individual Out-of-Pocket Max

$4,000

$6,250

none

Family Out-of-Pocket Max

$8,000

$12,500

none

2018 Palmetto Health HSA Contributions

 

Full-time

Part-time

Individual

$282 per quarter; $1,128 per year

$160 per quarter; $640 per year

Family

$562.50 per quarter; $2,250 per year

$320 per quarter; $1280 per year

Physician Office Visits

 

Primary (Palmetto Health/PHQC) Tier 

Secondary (BCBS) Tier

Out-of-Network

Primary Care Preventive 2

100%, no deductible

100%, no deductible

50%, after deductible

Primary Care Sick

100%, after deductible

100%, after deductible

50%, after deductible

Specialists

100%, after deductible

100%, after deductible

50%, after deductible

Physician Office Services

 

Primary (Palmetto Healt/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Lab Tests and X-rays

100%, after deductible

100%, after deductible

50%, after deductible

Reading of Labs Preventive

100%, no deductible

100%, no deductible

50%, after deductible

Reading of Labs Sick and X-rays

90%, after deductible

100%, after deductible

50%, after deductible

Other Physician Office Services

90%, after deductible

100%, after deductible

50%, after deductible

Outpatient Hospital Charges

 

Primary (Palmetto Health/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Surgery – Facility Charge

90% after deductible

70% after deductible

50% after deductible;

Surgery – Physician/Anesthesiologist

90% after deductible

70% after deductible

50% after deductible

Labs – Test

90% after deductible

70% after deductible

50% after deductible

Labs – Reading of Labs

90% after deductible

70% after deductible

50% after deductible

X-rays – Facility

90% after deductible

70% after deductible

50% after deductible

X-rays – Physician

90% after deductible

70% after deductible

50% after deductible

MRI/CAT/PET/Nuc Scans – Facility

90% after deductible

70% after deductible

50% after deductible

MRI/CAT/PET/Nuc Scans – Physician

90% after deductible

70% after deductible

50% after deductible

Occupational, Physical and Speech Therapy and Cardiac Rehab

90% after deductible

70% after deductible

50% after deductible

Inpatient Hospital Charges

 

Primary (Palmetto Health/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Facility

90% after deductible

70% after deductible

50% after deductible

Physician/Anesthesiologist

90% after deductible

70% after deductible

50% after deductible

Emergency Dept

 

Primary (Palmetto Health/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Visit

90% after deductible

90% after deductible

90% after deductible

Urgent Care

 

Primary (Palmetto Health/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Visit

100% after deductible

70% after deductible

50% after deductible

Mental Health

 

Primary (Palmetto Health/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Office Visit

100% after deductible

70% after deductible

50% after deductible

ED Visit

90% after deductible

90% after deductible

90% after deductible

Other Ancillary Services

 

Primary (Palmetto Health/PHQC) Tier

Secondary (BCBS) Tier

Out-of-Network

Home Health

100% after deductible

70% after deductible

50% after deductible

DME

90% after deductible

70% after deductible

50% after deductible

Hospice

100% after deductible

70% after deductible

50% after deductible

*For Employee + Spouse, Employee + Child (ren) and Family coverage, the family deductible is satisfied once your total family expenses reach the family deductible. One member cannot meet the family deductible. Only a combination of two or more individuals can meet the family deductible. Individual deductible applies to Employee coverage. In addition, there is an individual deductible within Employee + Spouse, Employee + Child (ren) or Family coverage. When only two individuals are on the medical plan, each member must meet their individual deductible. For plans including three or more members, one member can meet their individual deductible, with the combination of all other members adding up to meet the remainder of the deductible. Or, the combined claims of all members can meet the deductible.
1. Palmetto Health Facilities include: Baptist (Columbia), Baptist Parkridge, Baptist Easley Hospital, Richland, Tuomey, Greenville Hospital System and Parkridge Surgery Center
2. Pap Smear, PSA, Mammogram, Colonoscopy (screening), Bone Density, Physical, Immunizations (includes flu shots), Well-Baby, Well-Child Exam. Covered preventive services are subject to change
3. Click here for a list of Primary Tier (PHQC) providers. Click here to search the BCBS network.

2018 Health Savings Account Team Member Bi-Weekly Contributions

Class

Active, Full-Time

Active, Part-Time

Tier

Under $15.23

$15.23 - $30.45

$30.46 - $50.55

Over $50.55

Under $15.23

$15.23 - $30.45

$30.46 - $50.55

Over $50.55

Bi-Weekly Contributions

 

 

 

 

 

 

 

 

With Discount

Team Member Only

$30.00

$31.00

$32.00

$33.00

$43.00

$46.00

$47.00

$47.00

Team Member+Spouse

$69.00

$72.00

$74.00

$75.00

$106.00

$111.00

$113.00

$117.00

Team Member+Child(ren)

$69.00

$72.00

$74.00

$75.00

$106.00

$111.00

$113.00

$117.00

Team Member+Family

$69.00

$72.00

$74.00

$75.00

$106.00

$111.00

$113.00

$117.00

Without Discount

Team Member Only

$59.00

$62.00

$63.00

$64.00

$80.00

$82.00

$85.00

$86.00

Team Member+Spouse

$104.00

$110.00

$112.00

$114.00

$150.00

$158.00

$162.00

$165.00

Team Member+Child(ren)

$104.00

$110.00

$112.00

$114.00

$150.00

$158.00

$162.00

$165.00

Team Member+Family

$104.00

$110.00

$112.00

$114.00

$150.00

$158.00

$162.00

$165.00

Health Savings Account

HSA Bank

800-357-6246

www.HSABank.com/HSABank/Accountholders

Related Links

Enrollment Information

New Benefits for 2018

Have a Question?
Contact the Total Rewards Benefits Center at 800-963-3456 or 803-296-8893, or email TotalRewards
@PalmettoHealth.org

Note for HSA Plan participants: If you are changing your address, you must notify HSA Bank directly.