Terms to Know

Coinsurance

The percentage you pay for medical care after you’ve satisfied your deductible. In Cargill’s HRA and HSA plans, you pay 20% in-network for covered expenses after meeting the deductible (in other words, “20% coinsurance”). In Cargill’s Primary plan, you pay 30% coinsurance in-network for covered services after meeting the deductible.

Deductible

The amount you pay for medical care each year before the plan pays a benefit (excluding preventive care, which is covered 100% in network).

Health Reimbursement Account (HRA)

If you’re enrolled in the HRA plan, you can use this account to pay for qualified medical expenses, and it helps you satisfy the deductible.

Funded by Cargill contributions.

Any remaining balance at the end of the year rolls over to the next year, as long as you remain in the HRA plan at Cargill. If you have funds in your HRA, they will automatically be used to pay your in-network provider the balance due after Blue Cross and Blue Shield processes the claim.

Health Savings Account (HSA)

If you’re enrolled in the HSA plan, you can use this account to pay for qualified health care expenses, and it helps you satisfy the deductible.

• Cargill contributes to the account, which not all employers choose to do.
• You can contribute pre-tax dollars to the account.
• You can elect how to invest your HSA funds in excess of $1,500 (like you do in your 401(k) account), and any earnings on amounts in your HSA are not taxable to you so long as they are used to pay eligible medical expenses.
• Any remaining balance in your account at the end of the year rolls over to the next year – and it’s yours to keep, even if you leave Cargill or choose a different plan. You also can use amounts in the account for medical expenses in retirement.
• You may choose to open a Health Care Flexible Spending Account (FSA) in addition to your HSA; however, if you do, your Health Care FSA will become limited purpose, which means you can only use your Health Care FSA to pay for dental and vision expenses.

Note: HSA funds cannot be used for someone you do not claim as your tax dependent (e.g., a domestic partner or a child who is working full time and living on his or her own, even if you are covering that child under a medical plan). Check the IRS definition of a tax dependent.

In-network providers

Refers to providers who have agreed to charge plan participants a pre-negotiated, discounted rate for services and treatment. When you go to an in-network provider, the plan will generally pay a higher level of benefits, and you will have lower out-of-pocket costs than you would at an out-of-network provider. Always check before your visit to see whether your doctor is in network.

Monthly contributions

The amount taken out of your paycheck each month, based on the plan and tier you select. Although rates are listed as monthly, they are taken out of your paycheck on a per-pay-period basis.

Out-of-network providers

Refers to providers who have not agreed to charge plan participants a pre-negotiated discounted rate for services and treatment. When you go to an out-of-network provider, you may have to file your own claims, and the plan will generally pay a lower level of benefits. You typically will have higher out-of-pocket costs than you would at an in-network provider, because the provider can “balance bill” you, which means you’re responsible for the difference between what they charged and what the plan says is reasonable and customary to pay for a particular service.

Out-of-pocket cost

Your annual deductible, coinsurance (up to the out-of-pocket maximum), and any prescription coinsurance you might pay.

Out-of-pocket maximum

The most you will have to pay out of your pocket for covered services each year. Once the maximum is reached, the plan covers all remaining eligible expenses for that year.