A publication for HNE providers and their staff
January/February 2006
Consumer Driven Health Plans

Consumer-Driven health care is a concept that began evolving in the past 5 years to address the rising cost of healthcare. All of the different products behind this concept focus on making health care consumers more aware of the cost of healthcare, while empowering them with tools, data and information.

Consumer Driven Health Plans combine a high-deductible health insurance policy (HDHP) and a tax-favored savings account.  Together they cover the member against catastrophic medical expenses and save the money that is not spent paying for healthcare.

On January 1, 2006, HNE launched the HDHP HMO and HDHP PPO in conjunction with a Bank of America Health Savings Account (HSA).

  • HNE's High Deductible HMO: A $2,000 Individual/$4,000 Family integrated medical and pharmacy deductible applies to services other than preventive care as defined by the IRS. The Plan includes first dollar coverage for these preventive care services and no additional medical copayments after the deductible has been satisfied.
  • HNE's High Deductible PPO: The PPO version of the above High Deductible Health Plan is available only to groups with 51 or more eligible employees.  It includes a $2,000 Individual / $4,000 Family integrated medical (in- and Out-of-Network)and pharmacy deductible. There is an In-Network coinsurance maximum of $5,100 per Individual and $10,200 per family which includes deductible and copayment amounts.  The Out-of-Network coinsurance maximum is $7,500 per Individual and $15,000 per Family and includes coinsurance only.  The out of pocket maximums accumulate separately for In- and Out-of-Network services.  The IRS defines the In-Network maximums, and they are subject to change based on inflation indexing. 

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