Out-of-Area Health Savings Account (HSA) Medical Plan
The Health Savings Account (HSA) Medical Plans are qualified high-deductible health plans that come with a tax-advantaged Health Savings Account (HSA). When you enroll in the Out-of-Area HSA Medical Plan, you will receive a Health Savings Account. For information about the Health Savings Account itself, refer to Health Savings Account in the Reimbursement Accounts section.
Under the HSA Medical Plans, Anthem Blue Cross administers medical and mental health/substance abuse treatment benefits while Medco Health administers prescription drug benefits. Like other plans administered by Anthem Blue Cross and Medco Health, the HSA Medical plans are welfare benefit plans subject to the Employee Retirement Income Security Act of 1974 (ERISA). Anthem Blue Cross and Medco Health coordinate benefits so that out-of-pocket costs for both medical and mental health/substance abuse treatment as well as prescription drug out-of-pocket expenses apply to the deductible and the out-of-pocket maximum. The Health Savings Account is administered separately by ConnectYourCare and is not subject to ERISA. When you enroll in the Out-of-Area HSA Medical Plan, PG&E will set up and contribute to an HSA for you. The mechanism for this account is described in "Health Savings Account" in the Reimbursement Accounts section.)
There are two separate HSA Medical plans:
  • the In-Area HSA Medical Plan (a Preferred Provider Organization (PPO) plan) and
  • the Out-of-Area HSA Medical Plan (a fee for service plan).
Your eligibility will depend on your home address and network availability. Unlike the NAP and CAP plans, Anthem Blue Cross administers the mental health and substance abuse care benefits. Medco administers the prescription drug benefit, which is described in this section.
In general, the Out-of-Area HSA Medical Plan is similar to the Comprehensive Access Plan (CAP). The Out-of-Area HSA Medical Plan, however, covers preventive care at 100%. There are, however, different deductibles, calendar year out-of-pocket maximums and coinsurance amounts. The higher HSA deductible is required by federal law in order to allow federally tax-exempt contributions to the HSA, which is an essential part of the HSA Medical Plan