Introduction
Marathon Petroleum provides medical coverage to protect and promote your family’s health through the MPC Health Plan – a qualified plan that meets the standards of the Affordable Care Act and offers you a choice of two Preferred Provider Organization options. The Saver HSA and Classic options are both administered by Anthem BlueCross BlueShield (Anthem BCBS).
Saver HSA Option – Overview
The Saver HSA option is a “pay as you go” Health Plan option, and qualifies as a High Deductible Health Plan (HDHP). It has a lower premium, a higher deductible and the opportunity to open a portable Health Savings Account (HSA) that offers triple-tax advantages.
With this option, your annual deductible includes both medical and prescription drug expenses, and you pay all your medical and prescription drug costs in until you reach that amount (with the exception of preventive care and certain generic preventive medications). After you meet the annual deductible, the Saver HSA option pays 80% of your eligible expenses for care received in-network. If you reach the out-of-pocket maximum, the Health Plan will pay 100% of your medical and prescription drug costs.
To help offset the higher deductibles in the Saver HSA option, the Company will contribute $500 for Employee Only coverage or $1,000 for Employee + Dependents coverage to a Health Savings Account when you enroll in this option and open an account. See the “Health Savings Account (HSA)” section for details.
Employees who enroll in the Saver HSA are eligible to participate in a Limited Purpose Flexible Spending Account. This account is limited to paying for eligible dental and vision expenses. As with the Flexible Spending Account, you can elect from $120 to $2,650 for your anticipated dental and/or vision expenses in 2019. Eligible expenses must be incurred by December 31, 2019 and claims must be summited by May 31, 2020. You may carry over up to $500 into 2020. Once you have met your deductible, it can also be used for medical and prescription drug expenses. But first, make sure you let PayFlex know you met your deductible. You will receive a debit card, pre-loaded with the amount of your annual election. The same Flexible Spending Account expense deadlines apply.
Classic Option – Overview
The Classic option is a “pay up-front” option, with a higher monthly contribution in exchange for lower annual deductibles and out-of-pocket maximums. This option also includes copays instead of coinsurance for certain services such as office visits and prescription drugs.
After the annual deductible is met, the Classic option pays 80% of eligible expenses for health care received in-network. With family coverage, until the family deductible is met, each covered family member must meet the individual deductible before coinsurance begins for his/her medical care. However, regardless of whether you have met your deductible, you will only be responsible for copays for in-network doctor visits. With the Classic option, prescription drugs have copays. Retail drugs are subject to a smaller, separate deductible before copays begin.
If you select the Classic option or waive coverage under the Health Plan, you are also eligible for a Health Care Flexible Spending Account (HCFSA), wherein you can set aside pre-tax dollars from your pay to help cover your family’s health care expenses. See the “Health Care Flexible Spending Account (HCFSA)” section for details.
Health Plan Option Coverage Comparison
Health Plan Summary Comparison (as of January 2019)
| In-network Benefits |
| |
Classic Option |
Saver HSA Option |
| Deductible |
$600 Individual |
$1,400 Employee Only |
| $1,200 Family |
$2,800 Employee + Dependents** |
| Out-of-Pocket (OOP) Maximum* |
$3,500 Individual |
$5,000 Individual |
| $7,000 Family |
$10,000 Family |
| Coinsurance |
You pay 20% after deductible |
You pay 20% after deductible |
| Office Visit |
$20 for primary care;
$50 for specialist and urgent care |
You pay 20% after deductible |
| Preventive Services |
Plan covers at 100% (no deductible) |
Plan covers at 100% (no deductible) |
| ER Charge |
$200 charge, then deductible plus 20% coinsurance |
Deductible, then $200 charge, then 20% coinsurance |
| Out-of-network Benefits |
| |
Classic Option |
Saver HSA Option |
| Deductible |
$1,200 Individual |
$2,800 Employee Only |
| $2,400 Family |
$5,600 Employee + Dependents** |
| Out-of-Pocket (OOP) Maximum* |
$7,000 Individual |
$10,000 Individual |
| $14,000 Family |
$20,000 Family |
| Coinsurance |
You pay 40% after deductible |
You pay 40% after deductible |
| Office Visit |
You pay 40% after deductible |
You pay 40% after deductible |
| Preventive Services |
You pay 40% after deductible |
You pay 40% after deductible |
| ER Charge |
$200 charge, then deductible plus 20% coinsurance |
Deductible, then $200 charge, then 20% coinsurance |
* Medical and prescription drug expenses will apply toward meeting the out-of-pocket maximum.
** Employee + Dependents covers Employee + Spouse, Employee + Child(ren) and Employee + Family.
Company Contribution to Health Savings Account (HSA)
| Company Contribution to Health Savings Account (HSA) |
| |
Classic Option |
Saver HSA Option |
| 2019 HSA Funding |
None |
$500 Employee Only/
$1,000 Employee + Dependents** |
**Employee + Dependents covers Employee + Spouse, Employee + Child(ren) and Employee + Family.
Key Health Plan Option Features
The primary difference between the two options is how you pay for your health care expenses, so the Saver HSA and Classic options will have different premiums, deductibles and out-of-pocket maximum limits. The following chart offers a side-by-side comparison of the Saver HSA and Classic options.
| Comparing the Two Health Plan Options |
| Key Health Plan Option Features |
Classic Option
“Pay up-front” |
Saver HSA Option
“Pay as you go” |
| Premiums and Deductibles |
- Higher monthly premiums, but lower deductibles and out-of-pocket maximums.
- With Family coverage, until the family deductible is met, each covered family member must meet the individual deductible before the Health Plan starts paying coinsurance
|
- Lower monthly premiums, but higher deductibles and out-of-pocket maximums.
- With Employee + Dependents* coverage, once any combination of covered family members reaches the annual deductible, the Health Plan starts paying coinsurance for all family members.
- Qualifies as a High Deductible Health Plan (HDHP).
|
| Copays and Coinsurance |
Includes copays instead of coinsurance for office visits and prescription drugs. |
No copays; only coinsurance. |
| Prescription Drug Coverage |
- Separate deductibles for medical and retail prescription drugs.
- Prescription drugs have copays (retail drugs are subject to a smaller, separate deductible that must be met before copays apply).
|
- Annual deductible includes both medical and prescription drug expenses.
- Certain generic preventive drugs covered at 100%. (The list of these drugs can be found here.)
- You pay all your medical and prescription drug costs in full until you reach your deductible (with the exception of preventive care and certain generic preventive medications).
- You pay 20% after deductible for retail and mail-order drugs.
- Plan pays 100% for medical and prescription drug costs once you reach the out-of-pocket maximum.
|
| Health Savings Account (HSA) Flexible Spending Account (FSA) and (NEW) Limited Purpose Flexible Spending Account (LPFSA) |
- Eligible for a Health Care Flexible Spending Account (FSA), which allows you to set aside pre-tax dollars from your pay to help cover some of your family’s eligible health care expenses.
|
- Offers a portable Health Savings Account (HSA) that includes triple-tax advantages. Company contributes $500 for Employee Only coverage or $1,000 for Employee + Dependents coverage*.
- Eligible for a Limited Purpose FSA that is limited to paying for eligible dental and vision expenses with pre-tax dollars.
|
| Out-of-Pocket Maximums |
Both Health Plan options have in-network out-of-pocket maximums. So whichever option you choose, the most you’ll pay for covered in-network medical (including prescription drug) expenses out of your own pocket in a calendar year is the
out-of-pocket maximum for your selected Health Plan option. With Family coverage, until the family out-of-pocket maximum is met, each covered family member must meet the individual out-of-pocket maximum for the Plan to begin paying at 100% for that individual. |
*Employee + Dependents covers Employee + Spouse, Employee + Child(ren) and Employee + Family.
Health Plan Information for Retirees
Retirees under age 65 are eligible for the same Health Plan options as MPC active employees. Monthly contributions depend on your accrued percentage of the Company subsidy, based on your years of service.
Retirees age 65 and over can receive an annual Company subsidy toward the cost of individual Medicare-related plans available through Towers Watson’s Via Benefits. If you’re eligible for the subsidy, you will receive an enrollment guide from Via Benefits similar to the sample below.
* OneExchange has changed their name to Via Benefits. They still provide the same services to our post-65 retirees and their dependents.
How to Get the Most From Your Medical Coverage
Need to find a doctor?
Using doctors and hospitals within Anthem’s network can result in considerable savings. It’s your responsibility to check if providers are in-network – and it’s easy to do.
Is it time for your preventive exam?
Don’t understand your Explanation of Benefits?
Expecting a baby?
Best Doctors – More Than a Second Opinion
If you’re enrolled in the Health Plan, we provide the added benefit of Best Doctors, a service that gives you access to the best medical minds in the world, with complete confidentiality – at no cost to you. If you have questions about your diagnosis, would like an in-depth review of your treatment plan or want to find the best specialist for your condition, Best Doctors will help you get it right.
LiveHealth Online
Anthem’s LiveHealth Online offers you the opportunity to see a doctor “virtually” anywhere. Whether you are at home, in the middle of a road trip or at the office, you can now speak to a doctor immediately via your smartphone, tablet or computer with a webcam. Anthem’s LiveHealth Online is available for members of the Marathon Petroleum Health Plan.