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Anthem Blue Cross Lumenos PPO/HSA Plan
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Anthem Blue Cross Lumenos PPO/HSA Plan

This Lumenos PPO/HSA Plan offers participants a High Deductible Health Plan plus a Health Savings Account.  You will have the option to set aside pre-tax contributions into a designated HSA bank account.  These funds are intended to be used to pay for out-of-pocket medical expenses like routine medical care, prescription drugs and other qualified medical expenses.  Your HSA bank account is portable and will be available to you even if you leave Metagenics. 

Annually, at the beginning of each plan year (January 1st), Metagenics will fund $500 for individual coverage & $1,000 for family coverage into your HSA bank account.  Employer funding will be calculated on a prorated basis for new hires and qualified status changes throughout the plan year.  Metagenics employer funding is subject to change at each annual plan year renewal. 

Funds that are deposited to the HSA are intended to be used to pay for routine medical care, prescription drugs and other qualified medical expenses.  Unused dollars can be saved from year to year to reduce the amount the insured person may have to pay in the future.

Anthem’s Lumenos PPO/HSA plan allows participants the same freedom to choose their own provider as a traditional PPO plan would.  The difference is that with a High Deductible Health Plan, individuals and/or families must satisfy the deductible prior to benefits being paid under the plan. 

How the PPO/HSA Plan works:

  • You are responsible for paying all eligible medical expenses until you reach your annual deductible.  Your annual deductible is $1,500 for an individual and $3,000 for a family.
  • Once the deductible has been reached, you then pay a coinsurance percentage, to include all prescription costs.  You will be responsible for the full price of all prescription medications until your deductible is met and then you will pay the applicable co-payment. 
  • The HSA funds are used to reimburse you for out-of-pocket expenses
  • Preventive care is covered at 100%.
  • The plan coinsurance is 10% for network services and 30% for non-network services.
  • You have access to your account funds by using your Debit card or Account checks.  Withdrawals for medical expenses and interest earned is all tax-free.

Setting Up Your HSA

During the open enrollment process you will be given instructions on how to open your Health Savings Account with ACS Mellon Bank.  If you choose not to complete the process online when you first enroll, you may open your account at a later time by clicking on the following link:  Mellon HSA Anthem ACS/ Advantage.  Please note, you will not have access to your contributions or your company’s contributions until after your account has been set up. 

ACS Mellon Bank will send out a packet following open enrollment to employees who elect the Lumenos PPO/HSA plan.  This packet will contain bank account information including account details, a list of applicable fees, terms and conditions, and agreements along with the forms necessary to set up an account.