Regence HSA Healthplan 2.0 “At a Glance”

• Regence HSA Healthplan 2.0 Product Page
• Summary of Benefits
• Benefit Summary Effective Date 10/15/09 to 12/31/09
• Traditional HSA 1500/2500/3500 Ded. (PDF)
• Embedded HSA 3000 Ded. (PDF)
• HSA 100% Coins. 5000 Ded (PDF)
• Benefit Summary Effective Date 01/01/10 and Beyond
• Traditional HSA 1500/2500/3500 Ded. (PDF)
• Embedded HSA 3000 Ded. (PDF)
• HSA 100% Coins. 5000 Ded (PDF)

Training Programs

Agent training slides and answers to common questions.

• Regence HSA Healthplan 2.0 Medical & Rx product (PDF) Overview slides.
• Regence HSA Healthplan 2.0 FAQ (Frequently Asked Questions) (PDF)

How Regence HSA Healthplan 2.0 Works with an HSA

• Calculate Your Savings
• IRS Qualified Medical Expenses

Regence HSA Healthplan 2.0 Banking Partners

Preferred bank partners have dedicated HSA customer service and performance agreements to ensure a good member experience.

• Comparison of Regence HSA Partner Banks (PDF)
• Contact Information for Regence HSA Partner Banks (PDF)

HSA Bank

• HSA Bank Website
• Employer Overview:
• Macromedia flash overview of the choices, steps & options with HSA Bank and HSA Bank products
• Schedule of costs & fees

US Bank

• US Bank Website
• Broker Sales Presentation
• Link to Powerpoint presentation with HSA account overview, how to enroll in the US Bank HSA product, How to make contributions, Using HSA funds
• Schedule of costs & fees

Wells Fargo Bank

• Wells Fargo Bank Website
• Broker Step-by-Step Guide
• Link to Wells Fargo Step-by-Step
• Monthly Administration Fee: $3.75

Product Comparison

• Compare Regence HSA Healthplan 2.0 benefit features to other Regence products
• Rate differentials
• Save comparison online or export as an Excel file
• New and renewing groups

Open comparison tool

Cross-Selling

Bundle Regence HSA Healthplan 2.0 with these products for potential benefit savings:

• Innova^SM Medical Plan
• Engage^SM Medical Plan
• Vitality Wellness Product (groups 100+)
• Dental Plans: Encore^SM, Expressions^SM & Radiance^SM
• Vision Plans
• See Vision under the Optional Benefits section of the Regence HSA Healthplan 2.0 Product Page
• Life & Disability: Regence Life & Health
• Employee Assistance Program - To learn more please contact us.
• Voluntary Critical Illness Protection
• Provides a lump sum cash payment upon diagnosis of a critical illness to pay for expenses the beneficiary chooses; including the full or partial HSA deductible and expenses not covered by medical plans.
• Voluntary Dental
  • Employer Collateral

Dual Options & Guidelines (7/1/09 and beyond)

Effective 07/01/09 to 12/31/09

• Innova/Engage/HSA 2.0 Dual Option Guidelines (groups 10-50) (PDF)
• Innova/Engage/HSA 2.0 Dual Option Guidelines (groups 51+) (PDF)

Effective 01/01/10 and beyond

• Innova/Engage/HSA 2.0 Dual Option Guidelines (groups 10-50) (PDF)

Your Presentation

• Product Collateral
  Use this collateral with an employer.
  • Employer Collateral List
  • Order from your Sales representative
• Summary of Benefits
• Benefit Summary Effective Date 10/15/09 to 12/31/09
• Traditional HSA 1500/2500/3500 Ded. (PDF)
• Embedded HSA 3000 Ded. (PDF)
• HSA 100% Coins. 5000 Ded (PDF)
• Benefit Summary Effective Date 01/01/10 and Beyond
• Traditional HSA 1500/2500/3500 Ded. (PDF)
• Embedded HSA 3000 Ded. (PDF)
• HSA 100% Coins. 5000 Ded (PDF)

Forms

Group Forms

• Group Master Applications
  • Groups 2-99 Employees
  • Groups 100+ Employees
• Spreadsheet Enrollment Procedure and Template (Groups 51-99 and 100+)

Employee Forms

• Utah Small Employer Health Insurance Application (Groups 2-50)
• Authorization for Use and Disclosure of Personal Protected Health Information
  (Must accompany Small Employer Health Insurance Application)
• Application for Enrollment/Change (Groups 51+)
• Application for Enrollment/Change (Spanish)
• Short Form Health Questionnaire and Medical History Statement for groups 51-99 (PDF)
• Short Form Health Questionnaire and Medical History Statement for groups 51-99 (Spanish) (PDF)

Guides, Checklists & Forms

• Online Enrollment Set-Up Checklist Groups 51+ (PDF)
  Get your employees set up on Employer Center so they can use Online Enrollment and eBilling
• Note: Online Enrollment and Spreadsheet Enrollment are not available to those groups using the Short Form Health Questionnaire.
• Group Master Applications
  • Groups 2-99 Employees
  • Groups 100+ Employees
• SurePay Authorization Form (PDF)

Member Materials

• HSA 2.0 Card Carrier
• Summary of Benefits
• Benefit Summary Effective Date 10/15/09 to 12/31/09
• Traditional HSA 1500/2500/3500 Ded. (PDF)
• Embedded HSA 3000 Ded. (PDF)
• HSA 100% Coins. 5000 Ded (PDF)
• Benefit Summary Effective Date 01/01/10 and Beyond
• Traditional HSA 1500/2500/3500 Ded. (PDF)
• Embedded HSA 3000 Ded. (PDF)
• HSA 100% Coins. 5000 Ded (PDF)

Employee Forms

• Utah Small Employer Health Insurance Application
• Authorization for Use and Disclosure of Personal Protected Health Information
• Short Form Health Questionnaire and Medical History Statement for groups 51-99 (PDF)
• Short Form Health Questionnaire and Medical History Statement for groups 51-99 (Spanish) (PDF)
• Affidavit of Qualifying Domestic Partnership (PDF)
• Affidavit of Qualifying Incapacitated Dependent Eligibility (PDF)

Waiver Forms

• Waiver Form
• Spanish Waiver Form (PDF)

Bank Materials

HSA Bank

Find member applications in the Employer/Employer Forms section of this site.

• HSA Bank Website
• Investment Options: Overviews investment options available through HSA Bank

US Bank

Find a member enrollment guide and account applications in Employer/Communication Tools.

• US Bank Website
• Investment Guide: Investment education and guide to US Bank's options

Wells Fargo Bank

Find employee enrollment brochures in the Employer Tab and online member applications in the Participants Tab on the main landing page.

• Wells Fargo Bank Website
• Investment Fund Information