Cdhp Guide

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Take Control
with a Consumer-Driven
Health Plan
myChoice. myBenefits. myLife.

Kohl’s supports pursuing good health so you can do the things you love—at home and on the job.
HEALTH

It’s More Than
Meets the Eye
with a Consumer-Driven Health
Plan
LOOK NO FURTHER. UNLIKE OTHER
MEDICAL PLAN OPTIONS, A MEDICAL
PLAN PAIRED WITH A HEALTH SAVINGS
ACCOUNT (HSA)—LIKE THE SAVERS AND
BASIC PLANS—GIVES YOU CONTROL OF
YOUR HEALTH AND YOUR HEALTH CARE
SPENDING. ALONG WITH MEDICAL AND
PRESCRIPTION DRUG BENEFITS, THESE
PLANS INCLUDE AN HSA THAT LETS YOU
SAVE PRE-TAX DOLLARS THAT YOU CAN
USE TO PAY FOR QUALIFIED HEALTH
CARE EXPENSES.
CHECK OUT THIS GUIDE TO LEARN HOW
YOU CAN TAKE CHARGE OF YOUR PLAN,
YOUR HEALTH AND YOUR WALLET.

01

About Medical Coverage
At its core, a CDHP works just like a Preferred Provider Organization (PPO) Plan. It provides coverage
for both in-network and out-of-network care—which gives you the freedom to see any provider you
like (although you’ll receive higher benefits when you stay in-network). The main difference is that a
CDHP features a higher annual deductible—which is why these plans are sometimes called High
Deductible Health Plans or HDHPs. When you choose a CDHP, you’re eligible to set up a taxadvantaged savings account—called a Health Savings Account (HSA)—that you can use to pay your
eligible out-of-pocket expenses.
Think a CDHP sounds like a plan for those who don’t use many medical services? Think again! CDHPs
are a great choice for many associates. Read on to learn how a CDHP might work for you.

The Savers Plan—Kohl’s Core Medical Plan
If you enroll in the Savers Plan, Kohl’s contributes to your HSA (up to $500 annually for single
coverage; up to $1,000 annually if you cover a spouse and/or dependents). You can use this
contribution to help pay for eligible medical expenses until you meet the deductible and the plan
starts paying. Or you can pay your expenses yourself and save your Kohl’s contribution for future
health care needs. It’s your choice.

Want a Lower Premium? Try the Basic Plan.
The Basic Plan works just like the Savers Plan, but it has a higher deductible and annual out-of-pocket
maximum and lower paycheck contributions. There are some differences with prescription drug
coverage as well. If that’s okay with you, consider choosing the Basic Plan.

04
05
07
09
10
11
12

Your Health
Savings Account

Seeing a Doctor

Prescription
Drug Coverage

Smart Moves

Keep in Mind

Tools and Resources

Glossary

You’re still eligible for an HSA with the Basic Plan, but Kohl’s does not contribute to it. However, if you
elect to contribute your own pre-tax dollars, Kohl’s will open an HSA for you. The account can be used
to cover your eligible out-of-pocket expenses, build a reserve for medical emergencies or even save for
retirement.
Under all Kohl’s medical coverage, you’ll also receive free in-network preventive care and have the
flexibility to choose any doctor. But if you’re covered through Anthem, you’ll receive higher benefits for
using Anthem’s network of top-rated facilities for certain very specialized procedures.

02

The Savers Plan and the Basic Plan
Insurance
Carrier Network:
UnitedHealthcare or Anthem
(depending on where you work)

IN-NETWORK
PREVENTIVE CARE
Services like annual
physical exams,
well-child care and
immunizations
Savers Plan and Basic Plan
(In-Network):
Plan pays 100%

Services:

Costs:

You’re covered if you go to the doctor,
hospital or emergency room or receive
prescription drugs. And remember,
you get free preventive care.

You pay less from your paycheck
and more when you see a doctor
or fill a prescription.

ANNUAL DEDUCTIBLE

COINSURANCE

The amount you pay
before the plan covers
your medical services

The percentage the plan
pays for your medical
services after deductible

Savers Plan
(In-Network):
$1,500 single
$3,000 family*

Savers Plan and Basic Plan
(In-Network):
Plan pays 80%

Basic Plan
(In-Network):
$2,000 single
$4,000 family*

ANNUAL
OUT-OF-POCKET
MAXIMUM
The most you’ll pay in a
single calendar year
for services
Savers Plan
(In-Network):
$5,000 single
$10,000 family**
Basic Plan
(In-Network):
$6,000 single
$12,000 family**

Copay: A flat dollar amount you pay for health care. For care received through the Savers and Basic Plans, you pay deductible and coinsurance only.
Note: These plan details reflect in-network coverage.
*Due to IRS limitations, if you elect family coverage in the Savers Plan or the Basic Plan, the entire family annual deductible must be met before
any copays or coinsurance is applied for any individual family member.
**If you elect family coverage, there is a per-person out-of-pocket maximum of $7,300 for the Basic Plan and $6,850 for the Savers Plan.
Once someone reaches the per-person maximum in a year, the plan pays 100% of that person’s remaining eligible expenses for the year.

03

Your Health Savings Account
THE HEALTH SAVINGS ACCOUNT, OR HSA, ALLOWS YOU TO SAVE TAX-FREE
MONEY FROM YOUR PAYCHECK TO PAY FOR CURRENT OR FUTURE HEALTH
EXPENSES. YOU’RE IN CHARGE: YOU DECIDE HOW AND WHEN TO SPEND OR
SAVE YOUR HEALTH CARE DOLLARS.
Keep in mind that unexpected medical expenses can pop up at any time, so you may want to
have some HSA funds available as a safety net…just in case. It’s really up to you. Think about how
you want to manage your money, based on your health care needs and financial situation.
IT’S EASY. When you choose the Savers Plan
(or elect to contribute to an HSA under the
Basic Plan), Kohl’s opens an HSA for you with
HealthEquity. If you choose the Savers Plan,
Kohl’s contributes to your HSA (even if you
don’t contribute your own money). You can
access your HSA dollars via a debit card.
YOU’LL SAVE ON TAXES. You can contribute
up to $3,450 for single coverage and $6,850
if you cover a spouse and/or dependents.
(These annual limits are for 2018 and include
Kohl’s contribution, if you choose the
Savers Plan.)
The money you contribute lowers your taxable
income and therefore the current income taxes
you pay.
YOU DECIDE: SPEND NOW OR SAVE FOR
LATER. You can use your HSA funds now to
pay expenses like office visits, prescription
drugs and dental or vision costs. Or save your

funds for later to pay deductibles and other
eligible expenses in future years. You can even
keep your money in your HSA for use in your
retirement years. It’s up to you how you want
to manage your HSA dollars.
For a full list of eligible expenses, go to
IRS.gov.
YOUR HSA BALANCE GROWS. Once you save
at least $1,000 in your HSA you can invest
your money and it can grow tax-free, just like a
retirement savings account. In fact, many
people use their HSAs as another type of
retirement savings account, paying as many
eligible expenses out of pocket as they can
while they’re working, then claiming
reimbursement for health care expenses
during retirement.
YOURS TO KEEP. Your unused HSA money
rolls over each year. And, if you leave Kohl’s,
you take your HSA with you.

Important Notes:
• Unlike a flexible spending account, your full HSA contribution is not available right away; your HSA contributions are split
evenly across your paychecks throughout the year.
• If you enroll in the Savers Plan, Kohl’s contributes money to your HSA each quarter to help you pay for your expenses too:
– Up to $500 annually for single coverage ($125/quarter)
– Up to $1,000 annually if you cover a spouse and/or dependents ($250/quarter)

04

Need to Go to the Doctor?
YOU’LL PROBABLY NEED TO SEE A DOCTOR DURING THE YEAR. DON’T WORRY—
YOU’RE COVERED. HERE’S WHAT TO EXPECT.
SEE ANY DOCTOR. You can see any doctor you
choose. But you’ll save when you use:
YOU’RE COVERED
• Free preventive care
(in-network)
• Office visits
• Hospitalization
• Emergency room care
• Prescription drugs

• A UHC Tier 1 primary or specialty doctor; or
•A
 n Anthem Blue Distinction Center + or Blue
Distinction Center facility for certain medical
conditions.
Why? Because UnitedHealthcare and Anthem
have recognized them as top-rated for both
quality and cost-effectiveness.
Look for their designations when you search
for in-network providers at myuhc.com or
anthem.com.

AFTER YOU MEET YOUR DEDUCTIBLE. You’ll
pay a portion of your expenses—called
coinsurance—until you reach your out-of-pocket
maximum.
For most in-network care, the plans pay 80%
after deductible.
IF YOU REACH YOUR OUT-OF-POCKET
MAXIMUM. The out-of-pocket maximum is the
most you’ll pay for care in a plan year. Once you
reach your out-of-pocket maximum, the plan will
pay 100% of your eligible medical expenses for
the rest of the calendar year.

DON’T PAY AT YOUR APPOINTMENT. Show
your medical ID card, so your provider submits
your claim to your insurance carrier first. You’ll
receive a bill later.
BEFORE YOU MEET YOUR DEDUCTIBLE. You
pay the full cost of your care (except in-network
preventive care, which is covered at 100%), until
you meet your deductible.
To save money, visit a doctor’s office or an
urgent care clinic. Only use the emergency room
if it’s a true emergency.
When it’s time to pay your portion of your expenses, you decide whether to use your HSA
funds or pay out of your own pocket and save your HSA funds for the future.

05

Accident Protection Plan
and Critical Illness Plan
Kohl’s offers the Accident Protection Plan as well as the
Critical Illness Plan that are designed to supplement your
Kohl’s medical coverage. These voluntary benefits provide
additional protection to help meet annual deductibles,
copays and out-of-network expenses. The plans pay a
lump-sum amount, based on your accident/condition, and
you choose how to spend it.
Don’t forget to consider this coverage when you enroll.

Telemedicine
If you enroll in Kohl’s medical coverage (excluding Kaiser),
you and your family will have access to a telemedicine
service—the Teladoc® network of physicians—when your
primary doctor is unavailable or if it’s after hours, or on a
weekend. Teladoc is available to you 24/7 with a simple
phone call. And Teladoc visits generally cost less than
in-person appointments—especially emergency room or
urgent care visits.

DEDUCTIBLE? COINSURANCE?
To review key terms, check out the glossary at
the end of this book!

06

Prescription Drug
Coverage
PRESCRIPTION COVERAGE IS A LITTLE
DIFFERENT WITH THE SAVERS AND BASIC
PLANS. SO REVIEW THIS SECTION
CAREFULLY SO YOU’LL UNDERSTAND
HOW IT WORKS.
Ways to Save
GO GENERIC. Ask your doctor if a generic prescription
drug is right for you. Generic prescription drugs are made
of the same active ingredients as their brand-name
counterparts, but they generally cost much less.
USE CVS CAREMARK. You can use any pharmacy, but
you’ll save money by using CVS Caremark, Kohl’s
prescription drug partner. Manage your CVS Caremark
account at caremark.com.
USE MAIL-ORDER. For medications you take on a longterm basis, you can get a three-month supply delivered
right to your door.

07

You pay the full cost of your prescription drugs until you meet your deductible.*
Once you meet your deductible, you’ll pay a percentage of the drug’s cost between a set minimum and maximum.
See the table below for more details.

Generics

BASIC PLAN

Preventive: $10
Non-Preventive: Deductible then $10

Preventive: $10
Non-Preventive: Deductible, then 20%

Preventive: 30% ($40 min, $125 max)

RETAIL Brand
(30-day Formulary
supply)
Brand NonFormulary

Generics

Non-Preventive: Deductible, then 30%
($40 min, $125 max)

Deductible, then 20%

Deductible, then 40% ($60 min, $200 max)

Prior authorization needed

Preventive: $25
Non-Preventive: Deductible then $25

Preventive: $25
Non-Preventive: Deductible, then 20%

Preventive: 30% ($100 min, $312.50 max)

MAIL Brand
(90-day Formulary
supply)
Brand NonFormulary

SAVERS PLAN

Non-Preventive: Deductible, then 30%
($100 min, $312.50 max)

Deductible, then 20%

Deductible, then 40% ($150 min, $500 max)

Prior authorization needed

*If you take generic preventive prescription drugs, you’ll pay a flat $10 copay at retail or a $25 copay through mail—even if you haven’t
met your deductible.

GET THE MOST FROM YOUR RX COVERAGE
1. C
 heck to see if your prescription qualifies as preventive
•S
 avers Plan Preventive Drug List
•B
 asic Plan Preventive Drug List
2. C
 onfirm that your prescription is on the plan’s formulary
• Savers Plan Formulary List
• Basic Plan Formulary List
3. Estimate your prescription drug costs
• Basic Plan Estimator
• Savings Plan Estimator

08

Smart Moves
BUDGET FOR HEALTH CARE AND KEEP THE
CALENDAR IN MIND. Remember that the deductible
and out-of-pocket maximum start again each
January.
CONSIDER CONTRIBUTING UP THE ANNUAL HSA
LIMIT. Or at least up to your annual deductible. You
can always change your HSA contribution election
during the year, especially if your medical expenses
are higher than you’d originally expected.
PLAN ACCORDINGLY. The full amount of your HSA
money—your contributions and what Kohl’s
contributes, if you choose the Savers Plan—is not
available as a lump sum on January 1. The money
must be in your account before you can spend it.
For a full list of eligible expenses, go to IRS.gov.

SAVE YOUR RECEIPTS. They’ll come in handy if
you’re audited by the IRS.
If you decide to pay an expense out of your pocket,
you can reimburse yourself later from your HSA. And
you’ll need your receipt when you submit the claim.
Also, if your HSA balance isn’t enough to pay an
eligible expense now, you can pay it out of pocket
and request reimbursement later. Another option is
to use your HSA as another type of retirement
account, paying eligible expenses out of pocket while
you’re working, then claiming reimbursement of
health care expenses after you retire.
KNOW WHAT’S ELIGIBLE. Only spend your HSA
funds on qualified expenses, such as medical and
prescription drug expenses, radiology services, first
aid supplies, etc.
Go to IRS.gov for a full list of eligible expenses.

09

Keep In Mind
BECAUSE HSAS PROVIDE SOME ATTRACTIVE TAX SAVINGS, THE
INTERNAL REVENUE SERVICE (IRS) HAS A FEW RULES YOU MUST
FOLLOW IN ORDER TO MAKE CONTRIBUTIONS.
You, as the accountholder:
•C
 annot be enrolled in Medicare (for most individuals, this means you will no longer
be eligible to contribute to an HSA when you turn age 65. You lose eligibility as of
the first day of the month you turn age 65; but it’s okay if your dependent is enrolled
in Medicare);
• Cannot be claimed as a dependent on someone else’s tax return; and
• Cannot be covered under any other health insurance plan.
HSA funds can be used to pay for qualified medical expenses of any family member
who qualifies as a dependent on your tax return, including your spouse. Remember, if
the dependent isn’t covered under your plan, his or her expenses won’t be applied
toward your plan’s deductible.
In addition, you cannot participate in both a traditional flexible spending account (like
Kohl’s Health Care FSA) and an HSA at the same time. However, you can participate in
a limited-purpose FSA and use it for dental and vision expenses.

When Is a Limited Purpose FSA the Right Move?
A limited-purpose FSA is the right solution if you want to use a pre-tax savings
account to pay for a specific service—like a major dental procedure—early in the year,
before you’ve contributed enough to your HSA to cover the full cost. That’s because
with a limited-purpose FSA, your full annual contribution is available to you on
January 1 of each year. But with an HSA, you need to have enough in your account to
cover the cost of the expense to request reimbursement.
As you’re considering your options, keep in mind that limited-purpose FSAs are
subject to the “use it or lose it rule,” which means you’ll forfeit unused funds at the end
of each plan year.

10

Tools and Resources
Learn more about CDHPs and HSAs

GET THE MOST FROM YOUR RX COVERAGE

Check out these informational videos:

1. Check to see if your prescription qualifies as preventive

• HSA videos
–
–
–
–

Winning with an HSA
Saving the day with an HSA
Add new horsepower to your financial plan
Save now, cash in later

Know how much to contribute to your HSA
Your financial situation is unique, and so are your health care needs.
Use the HSA contribution calculator for help choosing the right HSA
contribution amount.

Manage your HSA online
Check your balance, update your investment funds, order debit cards
for dependents and more at Learn.HealthEquity.com/Kohls. If you
have questions about your account, call HealthEquity at 877-372-6250.
(Or better yet, download the HealthEquity mobile app!)

Find an in-network provider
You’ll pay less when you receive in-network care and services—
especially when you use a UHC Tier 1 primary or specialty doctor
or an Anthem Blue Distinction Center + or Blue Distinction Center
facility for certain medical conditions.
Search for in-network providers by name, location and/or specialty at:
• Anthem
• UnitedHealthcare
Remember to look for Anthem’s Blue Distinction Center + or
UHC’s Tier 1 designation!
Note: Your carrier depends on where you work.

• Savers Plan Preventive Drug List
• Basic Plan Preventive Drug List
2. Confirm that your prescription is on the plan’s formulary
• Savers Plan Formulary List
• Basic Plan Formulary List
3. Estimate your prescription drug costs
• Basic Plan Estimator
• Savings Plan Estimator

Download these apps for access on the go
HEALTHEQUITY MOBILE
App Store
Google Play
• iOS Touch ID
• Upload receipts
• Enhanced claim payments

UNITEDHEALTHCARE
HEALTH4ME
App Store
Google Play
• Estimate costs
• Get directions to providers

ANTHEM ANYWHERE
App Store
Google Play

Already registered on
myuhc.com? Log in with the
same info.

• Estimate costs
• Get directions to providers
• Chat with a rep

CVS CAREMARK
App Store
Google Play

Already registered on
anthem.com? Log in with the
same info.

• iOS Touch ID
• See costs and in-network
pharmacies
• Order/refill prescriptions
Already registered with
caremark.com? Log in
with the same info.

11

Glossary
BENEFIT TERMS CAN BE CONFUSING. REVIEW
THESE KEY DEFINITIONS.
DEDUCTIBLE: A deductible is the amount of
money you pay each year before your insurance
plan starts paying benefits.
For example, let’s say your deductible is $1,500.
The plan won’t pay anything until you’ve paid the
first $1,500 in medical expenses.
COINSURANCE: Coinsurance is when you share a
percentage of the cost of medical services with
your insurance plan, after you’ve met the
deductible.
For example, your coinsurance is 80% for an
in-network primary doctor visit. The plan will pay
80% of the cost and you’ll pay 20%. Let’s say
your doctor’s visit is $100. In that case, the plan
will pay $80 and you will pay $20.

OUT-OF-POCKET MAXIMUM: The out-of-pocket
maximum is the total amount of money you’ll pay
for your medical care in a year. Once you hit your
out-of-pocket maximum, the plan pays 100% of
your costs for the remainder of the calendar year
(except for copays, if applicable).

SAVERS PLAN SINGLE
COVERAGE EXAMPLE

For example, if you choose the Savers Plan, the
most you’ll pay for single coverage is $5,000. If you
have family coverage, the most you’ll pay is $6,850
for one person or $10,000 in combined family
expenses. This maximum protects you from very
high medical costs.

$1,500

COPAY: A copay is the flat dollar amount you pay
for a covered expense. For example, you’ll pay a
$10 copay for a generic preventive prescription
drug from a retail pharmacy.

PRIMARY
DOCTOR VISIT
Deductible

(you pay)

Coinsurance

80% 20%
(plan pays) (you pay)

Out-of-Pocket Max

$5,000
(most you can pay)

Plan Pays

100%

12

OE_CDHP_0318



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