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How are non-preventive services covered, like a doctor visit when I’m sick, or surgery in a hospital?

The deductible applies to all other services that are not preventive. You must meet the annual deductible in full before benefits are payable. Once you meet your deductible, the Hess Medical Plan pays 85 percent for in-network services and 65 percent for out-of-network services.

What are some examples of preventive services?

Preventive services include routine annual exams, cancer screenings (such as mammography and colonoscopy), immunizations, blood pressure screening, cholesterol screening, alcohol misuse screening, type 2 diabetes screening and diet counseling, as well as similar services.

How are preventive services paid?

You don’t have to meet a deductible for most preventive services. The medical plan pays 100 percent. You also don’t have to meet a deductible for preventive prescription drugs. The plan pays 100 percent for generic preventive prescription drugs, and it pays 85 percent for brand-name preventive drugs.

Does the family deductible have to be met in full by each individual?

No. The family deductible is “aggregate,” which means all of your family’s expenses are added together to reach the deductible. Once the deductible is met, the plan will start sharing the cost for all of your family members. If only one family member has medical expenses, however, that one family member must satisfy the full family deductible before the plan pays benefits.

How does a high deductible plan provide value?

A high deductible plan provides value through:

Lower premiums compared to traditional medical plans
Preferred provider networks with discounted pricing
A before-tax savings opportunity called a Health Savings Account (HSA)

For more information about HSAs, please see the Health Savings Account section of this FAQ.

Is the Hess Medical Plan a high deductible plan?

Yes. The Hess Medical Plan is a qualified high deductible plan, which means it meets IRS requirements and can be paired with a Health Savings Account (HSA). A high deductible plan is a cost-effective medical plan with a deductible that is higher than traditional medical plans, such as a Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO). Usually your share of the cost of coverage (the monthly contribution cost or premium) is lower, but you have to pay more health care costs yourself (your deductible) before the plan starts to pay its share (co-insurance) — except for preventive services. A high deductible plan can be combined with an HSA, which allows you to pay for certain medical expenses with tax-free dollars.

Can people age 65 or older withdraw funds for any reason without a penalty?

Yes, but any withdrawals that are not for medical expenses are considered taxable income.

What’s an example of how I can use my HSA to pay for a dependent’s health care even if I’m no longer covered by a qualifying high deductible health plan?

Say you accumulated $5,000 in an HSA, but now you are not eligible to contribute to one. Say, too, that you are married and your spouse has a big, unreimbursed medical expense. You could withdraw money from your HSA tax-free to pay your spouse’s eligible medical expenses that aren’t reimbursed by a health plan. You could also do this for any tax dependent at any time, regardless of whether the person is enrolled in a high deductible plan.

What happens to my HSA if I terminate employment with Hess?

All funds in your HSA are yours to keep, whether you terminate employment or retire. You can:

Keep your HSA with Hess and pay the monthly maintenance fees as an individual account; or
Transfer your funds to another qualifying HSA.

What happens to the money in my HSA if I waive medical coverage?

You still own your HSA and you can continue to use it to pay for qualified medical expenses. But you will not be able to make new contributions to your HSA. Please note if there is no activity on the account, funds could be turned over to the state after a number of years of inactivity (this varies by state). If there are no funds in the account, the account could be closed after a certain amount of time of inactivity. Contact the Hess Benefits Center at Fidelity to see what could happen under any of these scenarios.