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Blue Options HSA^®

MORE THAN A PPO
Blue Options HSA uses our most popular health plan design, the PPO,¹ and pairs it with a health savings account (HSA).² It’s a tax-free way to help pay for current or future out-of-pocket health care expenses. To be eligible to open an HSA and begin saving money for medical expenses tax-free, you must be covered by an IRS-qualifi ed high-deductible health plan (HDHP), such as Blue Options HSA. High-deductible health plans have lower premiums than traditional plans, so you’ll save money immediately.

A TAX-FREE SAVINGS ACCOUNT FOR MEDICAL EXPENSES
With Blue Options HSA, we automatically include a tax-free savings account for medical expenses.² You can make tax-deductible contributions to your HSA (in one lump sum or throughout the year) up to the allowable limits.³ And, individuals who enroll mid-year can still contribute up to the annual contribution limit at any time during the year.⁴ Each year, as your HSA balance grows, it accrues interest tax-free, and any qualified payments made from it are also tax-free.⁵

ACCOUNT BALANCE ROLLS OVER AND CAN BE INVESTED
Funds that are not used in a given year roll over into the next year and belong to you. Additionally, HSA funds can be invested to save for future medical expenses or even retirement.⁶

ONE-TIME ROLL-OVER CONTRIBUTIONS ALLOWED
Individuals can make a one-time roll-over contribution from an individual retirement account (IRA) into an HSA.⁷

BEFORE MEETING YOUR DEDUCTIBLE
You can start using your HSA funds immediately – even before you meet your deductible! Until you reach your deductible, you'll be responsible for the total cost of any care you receive; however, you'll still receive a discounted rate when you visit a participating provider. You can choose to use your HSA debit card or checkbook to pay the provider directly. Or, you can save your HSA money for future medical expenses. You can also use your HSA to pay for qualified medical expenses not covered by your health plan like over-the-counter medications or LASIK eye surgery. For a complete list of covered expenses, visit us online at bcbsnc.com.

AFTER MEETING YOUR DEDUCTIBLE
Once you've met your deductible, your health care benefits begin. You can still use any remaining HSA funds to pay your share of expenses (coinsurance) for covered benefits. And you'll still receive our discounted rate when you visit participating providers.

ENHANCED PREVENTIVE CARE
With Blue Options HSA, you’re covered for certain preventive care services before you’ve met your deductible.8 Just visit your provider as you normally would and show your BCBSNC ID card. You can keep yourself healthy through a variety of preventive procedures including:

• Annual routine physical exam
• OB/GYN exam
• Annual Pap smear
• Prostate screenings
• Standard immunizations
• Well-baby and well-child care

SAVE NOW. SAVE LATER.
Each year as your HSA balance grows, it accrues interest tax-free and any qualifi ed payments made from it are also tax-free.⁵ You can put aside funds for long-term care, future medical expenses, or even retirement. Additionally, whenever the balance in your account exceeds a specifi c amount, you may elect to invest contributions in a selection of Dreyfus mutual funds, subject to any minimum investment required by such funds.⁹

• Save up to 50% on premiums¹⁰
• Tax-deductible HSA contributions
• Tax-free HSA payments and interest
• Long-term investment options

LARGE NETWORK WITH PROVIDER DISCOUNTS
Blue Options HSA offers our largest network of doctors, specialists and hospitals (and the freedom to go outside the network for care). And, we've negotiated discounted rates with our providers to ensure savings for you. Even if you haven't met your deductible, you will still save money just by visiting providers in our large network. With a high-deductible health plan, our provider discounts matter now more than ever.

• In- and out-of-network benefits
• Our largest network
• Access to specialists without referrals¹¹
• Worldwide coverage¹²
• Discounts for covered services in-network

A HEALTH PLAN AND AN HSA ALL IN ONE
With our online application process, you get a health plan and an HSA.² You don't have to worry about separate applications. Plus, we've made it simple to manage your account online:

• One online application process
• HSA automatically included
• My HSA Account – online account management
• Multiple HSA funding options
• Contribution tracking and monthly statements
• Distribution of all required IRS reporting

HSA FUNDS ARE EASY TO ACCESS
With Blue Options HSA, contributions are placed into a FDIC-insured checking account through the Mellon HSA Solution.SM² You'll receive an HSA checkbook and debit card so you don't have to pay up front, submit a claim and be reimbursed. You can also write your debit card number on the bill that you return to your provider.

• Convenient payment options
• No need to file a claim for covered expenses

24/7 ONLINE ACCOUNT MANAGEMENT
Blue Options HSA is easy-to-use. Through our My HSA Account tool, you can manage your health plan and HSA with one easy-to-use online resource. You can view balances and claims status; review payment and claims history, including how much has been met to-date toward your deductible and coinsurance; and learn tips on how to manage your HSA. And, with our new Annual Health Care Summary Report¹³ – in the My Member Services section of bcbsnc.com – you can view, analyze and manage your health care spending 24 hours a day, seven days a week.

• Manage your HSA and health plan in one secure online location
• Easy-to-use, saves time
• Health care summary report for each covered member

DECISION SUPPORT TOOLS¹⁴
Use our online Decision Support Tools as you take a more active role in planning for the cost of your care. They can help you estimate the cost of numerous health care services and prescription drugs. They also enable you to compare hospitals and research valuable health information.

• Health Care Cost EstimatorSM¹ Understand your health care costs
• PharmaAdvisor^TM Compare drug options and costs
• Hospital Comparison Tool¹⁵ Find the hospital that's right for you
• Health Line Blue^SM 24-hour health information resource line
• Online Health Encyclopedia. Search for important health information
• Health Survey. Get a personalized health risk report

Here are a few things to keep in mind before you apply:
To be eligible for Blue Options HSA coverage, you must:

• Be a North Carolina resident between the ages of 18 and 64
• Qualify medically
• Not be covered by another insurance policy
• Not be claimed as a dependent on someone else's tax return
• Not be enrolled in Medicare

¹ Blue Cross Blue Shield of North Carolina (BCBSNC) Internal Data, 2007. ² BCBSNC does not administer your HSA. Your HSA custodian is Mellon Trust of New England, N.A. BCBSNC is not affiliated with your HSA custodian or administrator. ³ These amounts will be updated annually for inflation. For the most up-to-date information visit www.irs.gov. ⁴ The contributions made for the months preceding the individual’s eligibility for the HDHP may be included in gross income and subject to a 10 percent additional tax if the employee loses eligibility for the HDHP before the last day of the 12th month following the last month of the taxable year in which the contribution was made. ⁵ Withdrawals are tax free only if used for qualified medical expenses. See www.irs.gov for specific regulations. ⁶ Availability of The ACS/Mellon HSA Solution investment alternative is subject to HSA account balance minimums. ⁷ A transfer from an IRA to an HSA is subject to the annual contribution limits. The contributions made for the months preceding the individual's eligibility for the HDHP may be included in gross income and subject to a 10 percent additional tax if the employee loses eligibility for the HDHP before the last day of the 12th month following the month of contribution. ⁸ Includes in-network annual routine physical exam, well-baby and well-child care and certain immunizations and screenings. Other covered services may be subject to deductible and coinsurance. ⁹ Dreyfus is made available by Mellon. BCBSNC is not affilitated with your investment fund. ¹⁰ Compared to Blue Advantage Plan A with a $2,500 deductible for a 44-year old male in Raleigh on Preferred Risk Tier based on 2007 rates. ¹¹ Referrals may be needed for mental health and substance abuse services. ¹² You are covered in more than 200 countries and territories worldwide through the BlueCard program; www.bcbs.com/news/press/facts/bluecard.html. ¹³ Amounts listed include out-of-pocket expenses such as copayments, deductible and coinsurance amounts. ¹⁴ BCBSNC offers several Decision Support Tools to aid you in making decisions around your health care experience. These tools are offered for your convenience and should be used only as reference tools. You should consult your own legal counsel, tax advisor, or personal physician as applicable throughout your health care experience. ¹⁵ Brought to you by Subimo, LLC.