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HDHP Federal Guidelines

Personal Choice® High Deductible Health Plans

To be an HSA-qualified high deductible health plan, certain federal guidelines must be followed:

  • All covered benefits (except preventive care) apply to the deductible, including prescription drugs.
  • Preventive services are not subject to deductible (can apply copayments to preventive care services.)
  • One deductible and out-of-pocket maximum apply to family coverage – the entire family deductible must be met before benefits are paid.
  • New deductibles apply at the beginning of each benefit year. Fourth quarter deductible carryover does not apply.
  • The out-of-pocket maximum includes deductible, coinsurance, and copayments.
  • HDHP requirements are updated annually to account for inflation. The federal HDHP requirements for 2008 and 2009 are:

    Requirements for 2008:
    • A minimum deductible of $1,100 single coverage; $2,200 family coverage
    • A maximum out-of-pocket of $5,600 single coverage; $11,200 family coverage
    Requirements for 2009:
    • A minimum deductible of $1,150 single coverage; $2,300 family coverage
    • A maximum out-of-pocket of $5,800 single coverage; $11,600 family coverage

Maximum deductible and/or out-of-pocket amounts are updated each year based on a cost-of-living adjustment.