Health savings accounts (HSAs) (non-Medicare)

Health savings accounts (HSAs) are only available to subscribers enrolled in a PEBB consumer-directed health plan (CDHP). You can use your HSA to pay for IRS-qualified, out-of-pocket medical expenses.

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Need to manage your HSA?

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What is a health savings account (HSA)?

An HSA is a tax-advantaged account, which means money you contribute is not taxed. When you enroll in a CDHP, you are automatically enrolled in an HSA. The PEBB Program also contributes to your HSA each month.

With an HSA you can pay for:

  • IRS qualified out-of-pocket medical expenses (like deductibles, copays, and coinsurance) including some expenses and services that your health plans may not cover.
  • Qualified expenses for your spouse or other tax dependents, even if they aren't covered on your medical, dental, and vision plans.

Your HSA balance can grow over the years, earn interest, and build savings that you can use to pay for health care as needed. The money is yours, even if you change health plans.

After you’re 65, you can withdraw HSA dollars for any expense – you’ll just need to pay income taxes.

What is a consumer-directed health plan (CDHP)?

A CDHP is a high-deductible health plan (HDHP), with a health savings account (HSA). CDHPs offer lower premiums, a higher medical deductible, and a higher medical out-of-pocket limit than most traditional health plans.

Other features

  • If you cover yourself and one or more dependents, you must pay the entire family medical deductible before the plan begins paying benefits.
  • Your medical and prescription drug costs count toward the annual deductible and out-of-pocket maximum.

Kaiser Permanente NW, Kaiser Permanente WA, and Uniform Medical Plan offer CDHPs. Visit benefits and coverage by plan for coverage details.

Is a CDHP right for me?

Generally, CDHPs work well for people who:

  • Can meet the eligibility requirements.
  • Prefer a lower monthly premium.
  • Want to save on taxes by contributing to an HSA through pretax payroll deductions.
  • Are willing to check which services and supplies are qualified HSA expenses.
  • Can keep track of HSA expenses in case of an IRS audit.

CDHPs can encourage you to make informed decisions about your health care and spend HSA funds wisely. Those who enroll in a CDHP should prepare to invest time and energy in seeking qualified HSA expenses from network providers.

Who is eligible?

You must meet certain eligibility requirements to enroll in a CDHP with an HSA. If you (the subscriber) are not eligible and enroll, you may be liable for tax penalties.

To be eligible to enroll in a CDHP, you cannot be enrolled in:

  • Medicare Part A or Part B or Medicaid.
  • Another health plan that is not an IRS-qualified high-deductible health plan — for example, on a spouse’s or state-registered domestic partner’s plan — unless the health plan coverage is limited coverage, such as dental, vision, or disability coverage.
  • A Voluntary Employee Beneficiary Association Medical Expense Plan (VEBA MEP), unless you convert it to a limited health reimbursement account (HRA) coverage. (This includes you or your spouse or state-registered domestic partner.)
  • A CHAMPVA or TRICARE plan.
  • A fully claims-eligible health reimbursement arrangement (HRA), such as a Voluntary Employees' Beneficiary Association (VEBA) plan. However, you may enroll in a CDHP if you convert your HRA to "limited HRA" coverage by submitting a Limited HRA Coverage Election form to your VEBA plan.
  • An Flexible Spending Arrangement (FSA). This also applies if your spouse has an FSA, even if you are not covering your spouse on your CDHP. This does not apply if the FSA is a limited purpose account or a post deductible FSA.
  • You also cannot be claimed as a dependent on someone else’s tax return.

Other exclusions apply. Check IRS Publication 969—Health Savings Accounts and Other Tax-Favored Health Plans, contact your tax advisor, or call HealthEquity toll-free at 1-877-873-8823(for Kaiser members) or 1-844-351-6853 (for UMP members) to verify whether you qualify. See The Complete HSA Guidebook for full details.

Can I enroll in a CDHP and Medicare?

No. If you are enrolled in a CDHP with an HSA when you or a covered dependent become entitled to Medicare Part A and Part B, you must choose a new medical plan that is not a CDHP. The PEBB Program must receive your request no later than 60 days after the Medicare enrollment date.

If your covered dependents become entitled to Medicare Part A and Part B, you must either:

  • Choose a medical plan that is not a CDHP and keep your Medicare dependent enrolled in PEBB coverage. Your annual deductible and annual out-of-pocket maximum will restart with your new plan.
  • Remove your dependent from your PEBB coverage before they enroll in Medicare Part A and Part B. The dependent will not qualify for COBRA or other continuation coverage through the PEBB Program.

What contributions are allowed?

PEBB Program contributions

After your HSA is established with HealthEquity, you can start to receive contributions.

The contribution goes into your HSA in monthly installments over the year on the last day of each month (the entire HSA amount is not available on January 1).

The PEBB Program will contribute the following amounts to your HSA:

People covered on CDHP Monthly deposit into HSA Total deposited by the end of the year
Just you $58.34 x 12 (months) $700.08

You and your family

If you have at least one other family member on your CDHP, then you qualify for the family contribution.

 $116.67 x 12 (months) $1,400.04

You will receive an additional $125 in your HSA (deposited at the end of January in the following calendar year) if you qualify for the SmartHealth wellness incentive.

Your contributions

The IRS has annual limits for contributions from all sources into an HSA.

  • For 2025, the contribution limit for an HSA is $4,330 (subscriber only) and $8,550 (subscriber and one or more dependents).
  • Members ages 55 or older, you may contribute up to $1,000 more annually in addition to these limits.

How do I contribute?

Call HealthEquity to set up direct deposits to your HSA. You may be able to deduct your HSA contributions from your federal income taxes.

To make sure you do not go beyond the limit, consider the PEBB Program's contributions, your contributions, and the SmartHealth wellness incentive in January (if you qualify). Use the HSA contribution calculator.

What happens to my HSA when I leave the CDHP?

If you choose a medical plan that is not a CDHP you should know:

  • You won’t forfeit any unspent funds in your HSA after enrolling in a different plan. You can spend your HSA funds on qualified medical expenses in the future. However, you and the PEBB Program can no longer contribute to your HSA.
  • HealthEquity will charge you a monthly fee if you have less than $2,500 in your HSA after December 31. You can avoid this charge by either ensuring you have at least $2,500 in your HSA or by spending all of your HSA funds by December 31. Other fees may apply. Contact HealthEquity for details.
  • If you set up automatic contributions to your HSA through HealthEquity, you must contact them to stop the deductions.

Apple Health (Medicaid) and managed care reports

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Apple Health managed care plans

Apple Health (Medicaid) contracts with five organizations who serve both as Managed Care Organizations (MCO) and Prepaid Inpatient Health Plans (PIHP):

Managed care report cards

Apple Health Plan Report Card

This report card shows how Washington Apple Health managed care plans compare to each other in key performance areas. The report card can be used as a guide to select a health plan for Apple Health coverage.

Performance areas Coordinated Care Community Health Plan of Washington Molina Healthcare of Washington UnitedHealthcare Community Plan Wellpoint Washington (previously Amerigroup)
Getting care ★☆☆ ★★☆ ★★☆ ★★☆ ★☆☆
Keeping kids healthy ★★☆ ★★☆ ★★☆ ★☆☆ ★☆☆
Keeping women and mothers healthy ★★☆ ★★☆ ★★★ ★☆☆ ★☆☆
Preventing and managing illness ★☆☆ ★☆☆ ★★☆ ★★☆ ★★☆
Ensuring appropriate care ★★★ ★★☆ ★☆☆ ★☆☆ ★☆☆
Satisfaction of care provided ★★☆ ★★☆ ★★☆ ★★☆ ★★☆
Satisfaction with plan ★★☆ ★★☆ ★★☆ ★★☆ ★★☆

View the 2024 Apple Health Plan Report Card for more information.

Past Apple Health plan report cards

Value-Based Payment (VBP) Quality Report Card

This report card shows how Apple Health plans preformed in year 2024 and identifies where plans have met the criteria for the return of withhold dollars for the quality performance measure part of the value-based purchasing strategy.

View the 2024 Value-Based Payment Quality Report Card.

Managed care

Value-based payment measure Coordinated Care Community Health Plan of Washington Molina Healthcare of Washington UnitedHealthcare Community Plan Wellpoint Washington (previously Amerigroup)
Total percent achieved 83.3% 100% 83.3% 66.7% 66.7%

Foster care

Apple Health Integrated Foster Care VBP measure Coordinated Care
Total percent achieved 75%
Past value-based payment report cards

National Committee for Quality Assurance (NCQA) accreditation

Washington State Apple Health managed care organizations (MCOs) are required to have and maintain NCQA accreditation. Below is each plan and their NCQA accreditation status.

Additional report information is available using the NCQA Health Plan Report Card search.

NCQA Accreditation Community Health Plan of Washington Coordinated Care Molina Healthcare of Washington UnitedHealthcare Community Plan Wellpoint Washington (previously Amerigroup)
Rating Three and a half stars Three and a half stars Three and a half stars Three and a half stars Three and a half stars
Accreditation Type Health Plan Health Plan Health Plan Health Plan Health Plan
Plan Type Medicaid HMO Medicaid HMO Medicaid HMO Medicaid HMO Medicaid HMO
Status Accredited Accredited Accredited Accredited Accredited
Distinction Electronic Clinical Data
Health Equity Accreditation		 Health Equity Accreditation Electronic Clinical Data
Health Equity Accreditation		 Electronic Clinical Data
Health Equity Accreditation		 Electronic Clinical Data
Health Equity Accreditation
Health Equity Accreditation Plus

Apple Health managed care quality reports

Managed Care Quality Strategy
Annual EQR Technical Report
Annual Comparative Analysis Report
Consumer Assessment of Healthcare Providers and Systems (CAHPS) reports

HCA uses surveys and other data collection to help measure Apple Health clients' experience with their health plans.

Adult

Child

Parity analysis

Managed care plan enrollment

Most Apple Health clients are enrolled in a managed care plan. The following reports are for the Apple Health managed care population:

Managed care program annual reports

Apple Health client eligibility dashboard

The client dashboard is an interactive tool that helps answer questions about Apple Health eligibility.

How to use the dashboard

The following instructions demonstrate several ways to use the dashboard.

How to see people by county

Option 1: From the dropdowns on the left:

  1. Select the month.

  2. Select a program. (All) is the default.

  3. Select a county or leave the selection as default.

The dashboard will automatically refresh with the choices you select. Be sure to click Apply at the bottom of each dropdown to complete the selection.

Option 2:From the tabs at the top of the screen (above the HCA logo):

  1. Select Apple Health Client Map.
  2. Select a month from the dropdown on the left.

How to see a 12-month summary

  1. On the dashboard select month dropdown, choose most recent 12 months.
  2. Select Apply.
  3. Use other available filters to refine data further.

How to see eligible children

In the Select a program dropdown:

  1. Select Apple Health for Kids.
  2. Select Apply.
  3. Use other available filters to refine data further.
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