Key Terms

  • Coinsurance: The percentage of medical expenses you continue to pay after you’ve met your deductible and before you reach your out-of-pocket maximum.

  • Copay: A flat fee (for example, $25) you pay whenever you use a medical service, like a doctor’s office visit.

  • Deductible: The dollar amount you pay in a calendar year (January 1 to December 31) before your medical or dental insurance begins paying claims. The deductible does not apply to preventive care.

  • Dependent Care Flexible Spending Account (FSA): A tax-advantaged account that allows you to pay for eligible dependent care expenses — including child and elder care — with tax-free dollars. You contribute to your FSA through automatic, pre-tax payroll deductions. The Dependent Care FSA has a “use it or lose it” rule, meaning that any money left in your account at year-end is forfeited. For a full list of eligible expenses, refer to IRS Publication 503.

  • Health Care Flexible Spending Account (FSA): A tax-advantaged account that allows you to pay for eligible health care expenses — including deductibles, coinsurance, and copays for medical, dental, and vision care — with tax-free dollars. You contribute to your FSA through automatic, pre-tax payroll deductions. Up to $500 of unused money may be carried over to the next year; amounts above $500 will be forfeited. By law, you cannot participate in a Health Care FSA and a Health Savings Account (HSA) at the same time. For a full list of eligible expenses, refer to IRS Publication 502.

  • Health Savings Account (HSA): A tax-free savings account that is only available to participants in a qualified high-deductible health plan, such as the PPO HSA Saver Plan. You contribute to your HSA through automatic, pre-tax payroll contributions and can use the money to pay for eligible medical expenses — including deductibles, coinsurance, and copays for medical, dental, and vision care. In addition, WinnCompanies will contribute money to your account in 2019. Unlike a Flexible Spending Account (FSA), all of the money in your HSA rolls over from year to year and is always yours to keep. For example, you may use the money in your HSA to pay for eligible health expenses in retirement. For a full list of eligible expenses, refer to IRS Publication 502.

  • Out-of-pocket maximum: The maximum amount you and your family will pay for medical expenses in a calendar year (January 1 to December 31). After your expenses reach this amount, the plan will pay 100% of all covered services and prescriptions.

  • Premiums: The amount deducted from every paycheck to pay for your share of your insurance coverage.

  • Preventive care: In-network preventive care is fully covered under all of WinnCompanies’ medical plans, so you pay nothing. Preventive care includes routine care designed to prevent illness or disease, including annual physicals, recommended immunizations, and routine cancer screenings. If the same tests are done to diagnose an illness or treat a known condition, they are not considered preventive care and your plan’s normal charges will apply.