Terms to Know

Our Healthcare Strategy

Shared Responsibility

Our medical plans are "self-insured," so the Company and all covered associates share the costs. Sharing responsibility means:

  • Understanding what healthcare costs,
  • Partnering with H&R Block in managing costs, and
  • Living a healthy lifestyle to control costs.

Consumerism

Being a good healthcare consumer means:

  • Taking an active role in healthcare decisions,
  • Knowing how your benefits work, and
  • Using benefits wisely.

BlockStrong

BlockStrong–building a better you is our way of thinking about total well-being–physical, financial and personal–and our commitment to helping you balance it all.

Outcomes-Based Healthcare

An approach to healthcare where associates meet specific health targets; for example, blood pressure and BMI, or make progress toward a goal. Maintain or improve your numbers within the healthy ranges, and you'll be eligible for StayWell Point$ to earn cash incentives.


Benefits 101

Deductible

It's the amount you are responsible for paying out of your own pocket before the plan starts paying for most services. For in-network coverage, you're responsible for paying:

  • $1,250 (associate coverage) or $2,500 (family coverage) for the Consumer Choice Plan
  • $2,700 (associate coverage) or $5,400 (family coverage) for the Max Consumer Choice Plan

You pay the full cost of all expenses, including prescription drugs, until you meet the deductible. However, preventive care is covered at 100% in-network, and preventive maintenance prescriptions are covered at 85% with no deductible. All expenses you pay count toward the out-of-pocket maximum.

Coinsurance

It's the cost-sharing between you and the plan for healthcare services after you meet the annual deductible. Once you meet the deductible (if required), the plan pays a percentage of your covered expenses. For in-network services, the plan pays 85% and you pay 15%; for out-of-network service, the plan pays 50% and you pay 50%.

Cost-Sharing

As part of our consumerism and shared responsibility strategy, H&R Block shares the cost of the premium with associates. For example, for 2014, H&R Block will pay 80% of the medical premium for individual coverage; you pay 20%. You'll pay slightly more than 20% of the medical premium for dependent coverage.

In-Network

Doctors and facilities that participate in the Anthem BCBS network provide services at a discounted rate. So when you use in-network providers, you and H&R Block can save money. For services received in-network in 2014, the plan pays 85% of expenses and you pay 15%, after you meet your deductible. Your out-of-pocket maximum is also lower when you visit in-network providers.

Out-of-Network

Out-of-network providers do not participate in the Anthem BCBS network. If you use out-of-network providers, your costs are higher and the plan pays less of the expenses (50%).

Out-of-Pocket Maximum

It's the most you'll have to pay out of your pocket in a plan (calendar) year for covered services. If you reach your out-of-pocket maximum, the play pays 100% of eligible expenses.

  • Consumer Choice Plan
    • In-Network: $3,450 associate/$6,900 family
    • Out-of-Network: $6,900 associate/$13,800 family
  • Max Consumer Choice Plan
    • In-Network: $5,500 associate/$11,000 family
    • Out-of-Network: $11,000 associate/$22,000 family

Preventive Care

Preventive care is covered at 100% when you visit an in-network provider. Preventive maintenance drugs are covered at 85% and certain prescription contraceptives for women are covered at 100%. You do not pay a deductible when you receive preventive care services in-network.


Healthcare Reform

Affordable Care Act (ACA)

Also known as "healthcare reform" or "Obamacare," it's the 2010 law focused on extending medical coverage to more people, offering more protections to people covered and controlling health costs.

Health Insurance Marketplace (Exchange)

Online public shopping sites where people and small businesses can buy health insurance that meets ACA requirements.

Individual Mandate

ACA's requirement that virtually all Americans have medical coverage by January 1, 2014, or pay a penalty. Associates enrolled in the medical plan offered by H&R Block will have met the Individual Mandate.

Individual Penalty

What you'll pay when you file your federal taxes for 2014 (and beyond) if you don't buy medical coverage when the ACA requires it. The federal 2014 medical coverage penalties are:

  • For Adults
    • 1% of annual income per individual (minimum of $95/year)
    • $2,085 per family, maximum
  • Children under 18 (each) are penalized half of the adult amounts

Penalties will increase each year.

Premium Subsidy

Dollar amount that helps eligible people buy health insurance coverage through the marketplace. Eligibility depends on household income and available employer medical plans.