For more information, refer to the HSA PPO summary of benefits [PDF].
Q: The HSA PPO is a “consumer-directed” plan. What does that mean?
A: It is a benefits plan that gives you more purchasing power. You have the freedom to seek care from any licensed provider, and Health Savings Account (HSA) to help pay for services covered under the plan.
Q: How do I benefit from the HSA PPO?
A: The HSA, is an account that you own and control and may contribute to, is partially funded by VMware, earns interest, rolls over annually, offers certain tax advantages and is yours to keep if you leave VMware. Other benefits include the freedom to seek care from any licensed provider without a referral, and a wide range of tools and programs to help you get the information you need and to be proactive about managing your health.
Q: Do I need to select a primary care physician?
A: Some people like to have a primary doctor who can get to know and coordinate care for all of their health care needs. However, you are not required to choose a primary care physician and having one does not impact your coverage levels.
Q: Do I need to get a referral for specialty care?
A: You never need a referral.
Q: What happens to my HSA balance if I leave the HSA PPO?
A: Any remaining funds you and VMware contributed to your HSA account through HealthEquity (HSA administrator) Is fully vested and you own this account. It is yours to use for your lifetime for medical expenses tax free.
Q: What happens if one of my dependents leaves the HSA PPO?
A: The dependent will no longer be eligible for coverage by the plan. Under certain circumstances, the dependent may be eligible for COBRA continuation of benefits. Call Aetna Member Services at 1-877-204-9186 for additional help and information. (VMware’s employer contributions to the plan including any contributions you made pre-tax to this account remain and are not forfeited.
Q: How do prescription drugs benefits work under the HSA PPO?
A: When you have an eligible prescription drug expense, these expenses are part of your HSA PPO deductible and coinsurance. You may use your HSA debit card to pay for your prescriptions. Please refer to the chart below for the coverage levels of prescription drugs.
Coinsurance for Retail (30 day) and Mail Order (90 day) prescription drugs
|Generic||The Plan pays:||You pay:|
|In-network||90% after the deductible||10% after the deductible|
|Out-of-network1||50% after the deductible||50% after the deductible|
|Brand||The Plan pays:||You pay:|
|In-network||85% after the deductible||15% after the deductible|
|Out-of-network1||50% after the deductible||50% after the deductible|
|Non Formulary||The Plan pays:||You pay:|
|In-network||80% after the deductible||20% after the deductible|
|Out-of-network1||50% after the deductible||50% after the deductible|
1Mail order prescriptions are not covered when out-of-network.
As a way to help you take care of yourself, the plan waives the deductible for applicable preventive care prescription drugs. The plan will pay 90% of the cost after you have paid the member coinsurance.
Q: What is a preventive medication?
A: A preventive medication is used to prevent a disease from occurring in an individual who has risk factors but is not yet experiencing symptoms, prevent a complication of a disease, or prevent the reoccurrence of a disease from which an individual has recovered.
Click here for more information and a list of Aetna's preventive medications.
Q: What expenses will be paid from my HSA PPO plan?
A: When you receive care, all eligible medical and prescription expenses are covered under the plan based on the plan summary description. You are subject to the deductible and coinsurance for these expenses but you are able to pay for these expenses if you elect to contribute to a Health Savings Account. For more details go to www.healthequity.com/vmware.
Q: If care is received from an out-of-network provider, is that cost applied to my plan?
A: All covered portions of provider services in-network and out-of-network are paid and you will be subject to the plan same plan deductible. However coinsurance limits are lower than in network and you may have to pay the balance requested by your provider after any allowed amount out of network by Aetna. You may have to file a claim form for out-of-network services. Check your plan documents for specific details.
Q: Do each of my dependents have their own HSA account?
A: Your HSA account is based on your coverage level and you own the account. You may elect to use it to cover out of pocket medical expenses at any time while you are a member of the HSA PPO plan.
Q: Can I choose to pay an expense out of pocket in order to preserve the HSA for later?
A: Yes, the HSA account is yours. You decide if you wish to pay for eligible expenses from the fund (see www.healthequity.com/vmware) or save it for future retirement medical expenses.
Q: If I have a Health Savings Account (HSA), can I still sign up for a Flexible Spending Account (FSA)? If yes, how would the accounts work together?
A: Yes you are able to sign up for a Limited Purpose FSA (LPFSA). This account only covers dental and vision expenses – not Medical since the HSA PPO plan allows you to open an HSA to pay for these medical expenses.
If you elect a Limited Purpose FSA you should use this account first for your dental and vision expenses before using your HSA as this is a “use it or lose it” account which means any expenses that exceed a balance of $500 at the end of the year will be forfeited. Your HSA is never forfeited —it’s yours to use for your lifetime.
Q: What expenses will be counted toward my deductible?
A: Eligible medical and prescription expenses covered by your plan count toward your deductible. Exception: Deductible is waived for certain in-network preventive care.
Q: Is there a separate deductible for each covered dependent?
A: No. Your deductible amount depends on whether you choose the Employee only, Employee + Spouse, Employee + Child(ren), or Employee + Family plan design. The covered expenses for you and your dependents are combined to apply toward the deductible amount, known as an aggregate deductible.
Members with an Employee + Spouse, Employee + Child(ren) or Family design do not have an Individual deductible to satisfy. Once the Family deductible is met, all family members will be considered as having met the deductible for the remainder of the calendar year.
Also, the HSA PPO waives the deductible for applicable preventive prescription drugs. The plan will pay applicable coinsurance depending on the drug tier.
Q: What is the Out-of-pocket Maximum (OOPM)?
A: This is the total amount you will have to pay out of your pocket for covered services in a calendar year.
Q: Is there a separate out of pocket maximum for each covered dependent?
A: No. Members with an Employee, Employee + Spouse, Employee + Child(ren) or Family design do not have an individual out-of-pocket limit. Once the Family maximum out-of-pocket limit is met, all family members will be considered as having met the OOPM for the remainder of the calendar year.
Q: What happens when I reach my Out-of-pocket Maximum?
A: Eligible in-network medical expenses including prescription drugs are covered by the plan at 100% for the remainder of the calendar year. If you use out-of-network services, there is a separate OOPM, the plan will pay the reasonable and customary cost for the services. If the costs are more than the reasonable and customary cost for services in your area, you may be responsible for paying the balance.
Q: What is an HSA?
A: The Health Savings Account (HSA) is a personal savings account that you use for health care. You may contribute pre-tax* monies towards this account to pay for out of pocket medical expenses such as the deductible under the HSA PPO plan and or coinsurance, dental and/or vision expenses.
VMware will also fund monies for you based on coverage levels which can reduce the amount of the deductible under the HSA PPO plan. These funds are yours to keep and are portable if you leave VMware.
You can decide to use the HSA account to pay for medical, dental or vision care out of pocket expenses—such as office visits, lab work, X-rays and prescriptions—now or in the future. It’s only available if you enroll in the HSA PPO medical plan or you may decide to save these monies for future medical expenses in retirement and use post tax monies from your personal account. The choice is yours.
*In CA, AL and NJ, the HSA is subject to state tax.
Q: Isn’t the Health Savings Account (HSA) basically the same as the Health Reimbursement Account (HRA)?
A: No. They work differently. The HSA is an account that you own and control and may contribute to, earns interest and offers certain tax advantages, and provides other advantages that the HRA does not.
Q: Who can have an HSA?
A: You can elect an HSA if you: (1) are enrolled in an IRS-qualified plan, like the HSA PPO Plan, (2) are not enrolled in Medicare, (3) are not covered by a low-deductible medical plan or Flexible Spending Plan through your spouse’s employer even if they cover themselves, and (4) are not able to be claimed as a dependent on someone else’s tax return.
Q: How do I establish my HSA?
A: If you elect the HSA PPO plan for your medical coverage during open or new hire enrollment, your HSA account will be set up as part of your enrollment process. Your account will be held with HealthEquity, VMware’s HSA vendor. You receive a Welcome Kit, which includes a debit card, as soon as you are enrolled with detailed instructions on how to use the plan, review your account online, pay provider bills directly, save receipts online.
Q: How much does VMware contribute towards my HSA account?
A: Based on a January 1 enrollment date, VMware will contribute to your HSA account as soon as administratively feasible once your account is established at HealthEquity.
|Employee + Family||$1,500|
Q: What expenses can I pay with HSA dollars?
A: You can pay for medical, dental and vision expenses*, plus some expenses that insurance doesn't cover, such as in-home nursing services, smoking cessation programs and medications and LASIK eye surgery. There are restrictions. For example, you can't pay for cosmetic surgery or medical services you haven't received yet. For a complete list of expenses, visit www.irs.gov to download Publication 502. You can also look for IRS Publication 969 for more information on HSAs. Or call the IRS at 1-800-829-3676 for a copy of either of these publications.
*If you use your HSA to pay for dental and vision expense, note that these do not count toward your medical deductible
Q: Does the HSA pay for expenses automatically, like the HRA?
A: No. You own your account, so you decide how and when to use your account for qualified expenses. You can decide to pay your provider using your debit card or save up your HSA dollars for future expenses during retirement. As long as it is used for qualified medical expenses all contributions including earnings on this account is tax free. You may elect to pay yourself for any unreimbursed medical expenses during any calendar year from first day you established your HSA going forward.
It is important to keep receipts of your expenses in case of an IRS audit. HealthEquity provides an online feature for you to save all your receipts which can help avoid being subject to a taxable distribution if audited.
Q: How do I pay expenses with my account?
A: You can use a number of different payment methods. They include a Health Equity debit card, online withdrawals, bank account links and direct deposit. You can even arrange to have payments made directly to a provider or to you as reimbursement for out-of-pocket expenses.
Q: How do I access account information?
A: The HSA administrator, HealthEquity provides you with a secure website where you can view balances, check on payments, review year-to-date contributions and much more. You can access HealthEquity through Single Sign on the VMware benefits site OR go directly to the HealthEquity website: www.healthequity.com/vmware
Q: Where are my HSA dollars kept?
A: Your HSA contributions and the contribution that VMware makes are deposited in an HSA bank account that is administered by HealthEquity. Download the HealthEquity mobile app to receive alerts on deposits made to your account by VMware and through your paycheck contributions.
Q: How do I contribute to the HSA?
A: You may elect to make pre-tax contributions on the ADP Benefits website. For 2018 enrollment, please make a new 2018 HSA contribution election as 2017 elections are not carried over. You can start, stop or change your contribution at any time by contacting HR Source at 1-888-VMWARE8 and select option "US Benefits". You can also make an after tax contribution after the calendar year and prior to April 15 of the tax filing deadline directly to HealthEquity. This allows you to contribute up to the maximum IRS limit for the year (optional). You choose, which may be tax-deductible to you, but remember you cannot exceed the maximum contribution limit set forth by the IRS. The maximum limit is calculated using both, VMware’s HSA contribution and your contribution during the calendar year.
Q: Are there limits to how much I can contribute to my HSA?
A: Yes. The IRS determines the maximum amount that can be contributed to an HSA for a calendar year. The 2018 limits for all contributions (employee and employer combined) are $3,450 for an individual plan and $6,900 for a family plan. In addition, account holders who will be age 55 or older by December 31 of the calendar year are allowed to make an annual Catch-Up Contribution of up to $1,000 above IRS limits. Those who enroll in Medicare mid-year should pro-rate contributions.
Q: What happens if I don’t contribute to my account?
A: VMware will still make a contribution to your account on a pre-tax basis if you are an active, eligible employee under the HSA PPO, and funds will roll over year to year and earn interest. However, if you don't contribute, your account won't grow as fast and you will have less money available to help pay your eligible medical expenses.
Q: What is the deadline for making contributions for a particular tax year?
A: As indicated by the IRS, contributions may be applied toward a tax year until the tax filing deadline (typically April 15 of the following year).
Q: What happens to my HSA if I leave VMware?
A: The HSA is “portable”—you own your account and keep the full account balance if you leave VMware.
Q: I use a post office box as my primary address, will that be a problem?
A: As part of the Patriot Act, banks and other financial institutions are required to verify the identities of customers wishing to open accounts by using their street addresses. You cannot establish your HSA without providing a street address. When you establish your HSA, you will need to provide a physical mailing address (street address) that is not your PO Box.
Q: Can I have HSA mail sent to my PO Box?
A: When you establish your HSA you will need to provide a physical mailing address (street address) as well as your PO Box. Once you’ve established your account, you may receive HSA-related mail at your PO Box.
Q: Is there a minimum balance to earn interest?
A: There is no minimum balance required to earn interest. The funds in your account will earn interest as long as there is a balance.
Q: Are there any fees for maintaining an HSA?
A: No. As an active employee, there are no administrative fees for maintaining the HSA. However, you may incur fees under certain situations.
Q: Is there a minimum balance I need to have in my HSA before I can begin using the investment options?
A: Yes. You're required to maintain a minimum balance of $1,000 in order to invest. If you maintain this minimum balance, you may choose from several mutual fund investment options. Keep in mind that the money available to invest is the amount over the minimum required balance. Any HSA funds you choose to invest are in an investment account that is not FDIC insured.
Q: Is there a fee for using the investing options?
A: HealthEquity does not charge fees to buy or sell mutual funds known as trading charges. Also, there are no fund minimums. HealthEquity does charge an investment platform admin fee of 0.40% annually. The mutual funds charge their own fund expense fee. To calculate the total expense to invest, add the fund expense fee and the HealthEquity investment administration fee to determine the total expense to invest. For example: The Vanguard Growth Index I (VIGIX) has a fund operating expense ratio of 0.08% annual, combined with the HealthEquity, Inc. Investment Administration Fee of 0.40% annual, represents a total expense to the investor of 0.48% annual to invest in this fund. This equates to $4.80 per year per $1,000 dollars invested in this example.
Q: Can I use my account to pay non-medical expenses?
A: The HSA is designed to help pay qualified medical expenses. You own your account and may, in fact, use it as you choose. However, any withdrawals or payments from your account for non-medical expenses will be included in your gross income and taxed. In addition, if you are under age 65 at the time of the withdrawal or payment, you will be subject to an additional 20% tax penalty that is imposed by the IRS.
Q: Do I have to meet the annual deductible before using the HSA?
A: No. In fact, any HSA funds that are used to pay for plan-eligible expenses under the HSA PPO plan.
Q: I tried to purchase over-the-counter medication at a convenience store. Why was my card declined?
A: Purchases on your HSA card are limited to a list of merchants that typically provide medical products and services. If you are at a convenience store, restaurant or other non-medical-related merchant, your debit card will not work. In the event that you pay for an eligible medical expense with non-HSA funds, there are several options for reimbursing yourself.
Q: Are there limits on how much I can spend on my debit card?
A: Yes. There is a daily limit of $2,500 for point-of-sale purchases.
Q: How can I pay for medical expenses without being charged a transaction fee?
A: Ask the merchant or provider to run your card as they would run a credit card. As long as you do not enter your PIN, you will not be charged a transaction fee.
Q: Can I use my HSA when I retire?
A: Yes. The HSA is yours to keep and use, including the money contributed by VMware. You may continue to use it in retirement to pay qualified medical expenses. Once you are age 65 or older, you may use your HSA to pay for Medicare and other health coverage (other than premiums for a Medicare supplemental policy, such as Medigap), and other non-qualified expenses without penalty—you will just pay income tax on those purchases.
Q: Can I have an HSA and an IRA?
A: Yes, having an HSA in no way restricts your ability to have an IRA. However, an HSA cannot be rolled over into an IRA. HSAs can only be rolled over to another qualified HSA without incurring tax consequences.
Q: How do the HSA and the Limited-Purpose Flexible Spending Account (FSA) work together?
A: Both accounts can be used to reimburse dental and vision expenses. But it's best to use the Limited-Purpose FSA first. The most important reason is the "use it or lose it" provision of the Limited-Purpose FSA. Funds remaining in your account in excess of $500 after the grace period must be forfeited, so it's a good idea to use them before the deadline for reimbursement. If you run out of funds in the Limited-Purpose FSA, you can turn to the HSA to pay vision and dental expenses.
Another consideration is interest. The HSA earns interest, while the Limited-Purpose FSA does not. When you're able to pay dental and vision expenses with the Limited-Purpose FSA, you'll keep more money in your HSA. More money in your account means more interest earned.
Q: What happens to my account if I leave VMware and my HealthEquity account?
A: Since you "own" your HSA, you keep your account and may continue to use the funds in your account to pay for qualified medical expenses. There is no time limit on using the funds. However, you may not actively contribute to your account unless you are enrolled in an IRS-qualified plan, such as the HSA PPO.
Q: How can I find out more about the advantages of owing an HSA with an HSA PPO plan?
A: HealthEquity has lots of online videos, documents webinars. You can also receive information on what tax receipts and reporting you will need to file when filing your income tax in 2019 for 2018 calendar year. Click here to learn more about Health Equity.
Q: Where can I access my HSA information online?
A: Contact Information:
By telephone: 866.296.2857