Medical

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Health Savings Account

Q. 
How does Healthcare FSA participation affect HSA eligibility?
A. 
Participation in a Healthcare Flexible Spending Account (FSA) makes you ineligible for an HSA. If your spouse is enrolled in Healthcare FSA through his or her employer and that account can be used to pay for your medical expenses, you become ineligible for an HSA.
 
Keep in mind that the money you contribute to your HSA can be used to pay for qualified medical expenses not only for yourself, but also for your spouse and tax dependents, regardless of their insurance coverage.
Q. 
What happens to my HSA Bank Account if I pass away?
A. 
If the spouse is the beneficiary for the HSA Bank Account, upon death of the account holder, HSA funds can continue to be used as an HSA Bank Account with its tax free privileges.
 
If the beneficiary is designated for the HSA Bank Account and is not the spouse, upon death of the account holder, HSA funds can be withdrawn by the beneficiary for non-medical reasons without penalty, but the distributions will be subject to income taxes.
 
If a beneficiary is not designated, or if the total percentage designated for the beneficiaries is less than 100%, the HSA funds will become part of the estate after the account holder's death.
Q. 
Who is eligible to be covered under the Premium HSA, Choice HSA, or Base HSA Medical Plan option?
A. 
Associate:
  • If full-time, regular, benefits eligible
Spouse:
  • If associate’s Legal Spouse
  • If associate’s Common-law spouse who resides in a state that recognizes common-law marriages and the couple meets all state requirements for common-law marriage
  • If qualified Same-sex Domestic Partner as verified by Corporate Benefits
Children:
  • If associate’s natural, adopted, or step-children, under age 26
  • If children for whom the associate has legal guardianship for, under age 26
  • If children over age 26 and have been previously approved for continuous coverage due to permanent disability
  • If children of qualified Same-Sex Domestic Partner as verified by Corporate Benefits
Q. 
Who is eligible to set up an HSA Bank Account through Optum?
A. 
A Shaw associate:
  • If enrolled in the Premium HSA, Choice HSA, or Base HSA Medical Plan
  • If not enrolled in Medicare or Tri-care
  • If not covered under any other non-HSA health plan (even as secondary)
  • If not covered under a spouse's full Healthcare FSA
  • If not a dependent on another person's tax return
  • If  you have not received VA benefits (excluding benefits for service-related disabilities) in the past three months.
     
Q. 
Who is eligible for use of HSA funds for payment of qualified healthcare expenses?
A. 
We are not able to give tax advice related to individual associate situations.  Associates should be encouraged to speak with a tax advisor about their specific situations to verify eligibility.  The following are general guidelines to help associates evaluate their circumstances.

Associate:
  • If enrolled in one of the Shaw HSA Medical Plan options and has an HSA bank account

Spouse:
  • If legally married and filing joint tax return with associate
  • If legally married but filing separately, in general may still be eligible for use of funds depending on the reason they file separate returns.  (NOTE:  If filing separate returns for inappropriate and/or invalid purposes, spouse may be ineligible for use of funds.  For example:  Cannot file separate as “married” and both file “head of household”; cannot file separate as “single” and both file “head of household”; cannot file separate and indicate they are “single” rather than “married”. Associate may want to talk with a tax advisor to verify eligibility.)
  • If Common-Law married and filing joint tax return with associate.  (This is a requirement in most states to qualify for common-law marriage.)
  • If same Sex-Domestic Partner and legally married (in states that recognize) or if claimed as a tax-dependent on the associate’s tax return.

Children (Natural/Adopted/Legal Guardianship):
  • If eligible to be claimed as a tax dependent on the associate’s tax return.

Children of Divorced Parents:
(Special rules apply for use of HSA funds for children of divorced parents that could vary based on the individual circumstances for that associate.)
  • If the child is claimed as a tax-dependent on the associate’s tax return, HSA funds could be used to cover qualified healthcare expenses for that child.
  •  In general, if a child is eligible to be claimed as a tax-dependent on the associate’s tax return, but the associate chooses not to claim, HSA funds could be used to cover qualified healthcare expenses for that child.
  • In general, if the child is not eligible to be claimed as a tax-dependent on the associate’s tax return because they are claimed on the other parent’s tax return, but the child is principally dependent upon the associate for support and maintenance as defined by the IRS, they could be eligible for use of associate’s HSA funds.
  • If the child is covered under a health plan as an adult child (over age 19) and is not eligible to be claimed as a tax-dependent on the associate’s tax return, they are not eligible for use of the associate’s HSA funds.
Q. 
Who is responsible for the HSA Bank Account?
A. 
The individual account holder is responsible for ensuring that the deposits going into the HSA account do not exceed the annual legal limit. The employer, Cigna, and Optum cannot and do not control the bank accounts. The individual account holder is also solely responsible that the use of HSA funds is for qualified medical expenses for themselves and their qualified dependents as recognized by the Federal Government. Associates are responsible for paying all applicable taxes on non qualified fund use, as well as disclosing whether their withdrawals meet the definition of 213(d) expenses on their tax returns.
Q. 
If I enroll in a Shaw Medical Plan option and become age 65 (or otherwise Medicare eligible) mid-year, am I still eligible for the Shaw Medical Plan?
A. 
Yes; when you become Medicare eligible, you continue to be eligible for coverage under the Shaw Medical Plan. However, if you elect Medicare Part D (prescription), you are no longer eligible for the Shaw Medical Plan coverage.
 
Note: If Medicare part A or B is selected in addition to the Shaw Medical Plan, the Shaw Medical Plan continues to be the primary Insurance Carrier (Medicare is the secondary payee) while you are actively employed at Shaw.
 
Note: When any part of Medicare is chosen, there are implications to the HSA Bank Account. You will not be able to make any additional contributions or receive any Company contributions to your HSA Bank Account if you enroll in any part of Medicare. Keep in mind that once you open an HSA Bank Account, the funds are yours. You will still be able to use any funds in your HSA Bank Account for qualified healthcare expenses with tax free privileges.
Q. 
Can I cover a dependent who is over age 65 (or otherwise Medicare eligible) under the Shaw Medical Plan?
A. 
Dependents over age 65 (or otherwise Medicare eligible) may remain enrolled in the Shaw Medical Plan. In addition, if the dependent is claimed on the associate’s federal tax return, then their HSA Bank Account funds would be eligible to be used for the dependent’s eligible healthcare expenses.
 
Q. 
What information will I receive from Optum when I enroll in the Premium HSA or Choice HSA and open an HSA Bank Account?
A. 
There will be a Welcome Packet mailed directly to participants from Optum approximately 14 days before coverage effective date. This packet will include an HSA brochure, deposit slips, HSA debit card, facts on how Optum uses personal information, and debit card terms and conditions.
Q. 
If I use my HSA funds for services incurred prior to the effective date of my HSA Bank account, could this result in a penalty being applied to that withdrawal?
A. 
Yes, expenses incurred prior to the HSA effective date are not eligible to be paid thru HSA funds.
Q. 
Can an associate enroll in one of the HSA Medical Plan options and be eligible to open an HSA bank account if they are covered as secondary under their spouse’s employer’s non-HSA medical plan?
A. 
The associate can enroll in one of the HSA Medical Plan options; but, they would not be eligible to have an HSA bank account if they are covered as secondary under their spouse’s non-HSA medical plan.
Q. 
If I leave the Company, can I continue to contribute to my HSA Bank Account?
A. 
As long as the associate is enrolled in an HSA qualified medical plan, they are able to contribute to their HSA Bank Account.
Q. 
What is the annual maximum amount that an associate can contribute to their HSA bank account each year?
A. 
For 2017, the maximums are:
$6,750 – If you elect Associate and Spouse/Child or Family coverage.
$3,400 – If you elect Associate Only coverage (Associates over age 55 are eligible to contribute an additional $1,000)  NOTE: The annual maximum amounts include both company and associate contributions.
Q. 
What happens if an associate contributes more than the annual maximum HSA contribution limit allowed by the IRS?
A. 
There are tax liabilities and penalties that could apply. There is an excess contribution form and process that can be invoked to return the excess contributions and earnings. The associate would need to contact Optum for assistance with this process.

Health Center

Q. 
Why does Shaw have a Family Health Center?
A. 
Shaw continually strives to enhance wellness benefits for its associates. The Shaw Family Health Center provides high quality, affordable health services that are more accessible and convenient for covered Shaw associates and their dependents.
Q. 
Can anyone use the Shaw Family Health Center?
A. 
No. The Center is only available to Shaw associates and dependents covered by Shaw’s medical insurance plans.
Q. 
What are the benefits of Health Center?
A. 
The Shaw Family Health Center features shorter wait times, online scheduling, more personalized care with the medical staff, and reduced visit costs.
Q. 
Does Shaw have access to my medical records?
A. 
No. Shaw does not have access to associate and dependent medical records. The Health Center is operated by QuadMed, an outside organization that strictly complies with HIPAA privacy-protection laws.
Q. 
What hours is the Health Center open?
A. 
The hours of operation are Monday through Friday from 6 a.m. to 6 p.m.
Q. 
What services are available at the Health Center?
A. 
The Shaw Family Health Center offers a full spectrum of medical care, including routine physicals and immunizations, preventive screenings, lab work, chronic condition management, rehabilitation services, and wellness services.
Q. 
Am I required to use the Shaw Family Health Center?
A. 
No. While Shaw associates are encouraged to use the Health Center, they are not required to use the Health Center.
Q. 
Where is the Shaw Family Health Center located?
A. 
The state of the art Center is conveniently located at 2659 Abutment Road in Dalton, Georgia.
Q. 
Is there a doctor on staff at the Health Center?
A. 
Yes. The Health Center has two physicians on staff as well as registered nurses and nurse practitioners. 
Q. 
Is the Shaw Family Health Center multilingual?
A. 
Yes. The Health Center has Spanish speakers on site.
Q. 
Who is QuadMed?
A. 
QuadMed has more than 20 years of experience in developing and administering employer-sponsored health facilities for manufacturers and other employers. QuadMed will oversee the operations of the facility. Physicians, nurses, and other staff will be employed by QuadMed, not Shaw.

Medical

Q. 
Who is eligible to elect benefits with Shaw?
A. 
All regular full-time associates or full-time equivalent associates who have satisfied their 90 day probationary period.
Q. 
Can I make mid-year changes to my benefits?
A. 
Yes, if you have incurred a qualifying Family Status Change event (based on IRS Regulations), you are eligible to request coverage changes. All requests must be received in Corporate Benefits within 31 days of that event. Events include:
  • Loss of or beginning of spouse’s employment  
  • Loss of or beginning of a dependent's employement 
  • Associate’s Marriage or Divorce
  • The death of a spouse or dependent
  • The birth or adoption of a dependent child 
  • Medicare or Medicaid (CHIP) entitlement for associate, spouse or dependent  (60 days to submit on these events) 
  • Change that causes a dependent to become ineligible for coverage or lose eligibility under the Shaw Plan
  • Qualified medical child support order
  • When a spouse participates in a benefit plan which maintains a different Open Enrollment period (effective date) than the associate's plan.
Changes are effective the date that all completed forms and required documentation are received in Corporate Benefits.
Q. 
During Open Enrollment, I elected to contribute a set amount of money to my HSA Bank Account. Can I change my HSA Associate Contribution amount at any time?
A. 
Yes, simply complete the HSA Eligibility Contribution Form and fax into Corporate Benefits or provide to your HR Office.
Q. 
How can I check my HSA Balance?
A. 
You can check your HSA balance by logging into optumhealthfinancial.com.
Q. 
How can I file a medical claim?
A. 
Providers that participate in the Cigna Open Access network should file all medical claims for Shaw Plan participants. However, if for some reason the provider does not file or if they are not a participant with the Cigna network, the CIGNA Medical Claim form  should be completed and submitted by the associate.

Once a claim is filed, the associate will receive an Explanation of Benefits (EOB) listing the charges, payments by the plan, and the patient’s out of pocket amount due. This EOB can also be viewed and printed at mycigna.com. If the associate does not wish to receive the paper EOBs through the mail, they can elect to receive email notification when a new claim is processed.
Note:  All claims must be received within six (6) months from the date services are incurred “Timely Filing Limit” to be considered eligible for processing.  Claims received after 6 months will be denied based on the Timely Filing Limit.
Q. 
How will I know if my enrollment was completed in ShawAndMe?
A. 
You may review your Benefits Summary in ShawAndMe after 24 hours of submittal.  For instructions on reviewing your Benefits Summary, click here.
Q. 
What documentation is required in order for my dependents to be eligible for benefits?
A. 
Relationship Documentation
Legal Spouse Marriage Certificate is required
Common-law Only available in states that recognize (see HR for details)
Natural Child Birth Certificate listing the associate as the parent
Adopted Child  Documentation of Legal Adoption placement letter/order
Step-Child Birth Certificate and Marriage Certificate listing child’s parent and the associate
Foster Child Birth Certificate and Legal Placement letter/order

Note: Other children that the associate and/or spouse have legal custody or guardianship will require an active Legal Custody or Guardianship Order signed by a judge.

Note:  You are required to enter a valid Social Security Number in ShawAndMe for any dependent that you wish to have benefits coverage. Dependents will not be added to coverage(s) if documentation is not provided and/or a valid Social Security number is not entered in ShawAndMe by the associate prior to their probationary period end date.
Q. 
When will my New Hire benefits be effective?
A. 
Benefits will be effective upon completion of your 90 day probationary period.  Enrollment is based on the associate’s completion of benefit elections through ShawAndMe prior to the effective date.  Premium deductions will begin on the first payroll following the effective date.
Q. 
Who is an eligible dependent?
A. 
Legal spouses and children up at age 26 (subject to approval of documentation provided by the associate) - see Covered Dependents and Dependent Verification.  

Note:  During the year, when a dependent turns age 26, benefits coverage ends on their 26th birthday.

Note: Life Insurance is only available for children up to age 24 provided that they are a full-time student.
Forms

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