Before-tax Contributions — HCSA, DCSA, LPSA and HSA

Before-tax contributions to your heath savings and spending accounts are deducted from your pay before federal taxes (and in many cases, state and local income taxes) are withheld.

Centers of Excellence (COEs)

COEs are top-rated facilities that deliver high quality medical care for complex specialties like bariatric, orthopedic, and transplant services. Depending on the medical plan you have, you may need to be treated at a COE to receive full in-network coverage for certain procedures. (This requirement doesn’t apply to the In-network Only Plan.)

Choice Plan

The Choice Plan has higher paycheck deductions than Citi’s other medical plans and a lower annual deductible than the High Deductible Plan with HSA. It shares the cost of covered services after you meet the annual deductible. Both in-network and out-of-network services will apply to meeting the deductible. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

Coinsurance

The portion of a covered expense that you pay after satisfying the deductible. For example, if the Plan pays 80% of certain covered expenses, you will pay the remaining 20%, which is your share of the costs.

Copay

A flat fee you pay for medical care. In some cases, the deductible does not apply. For example, if you are enrolled in the In-network Only Plan and need to go to the doctor to address a health concern, you’ll pay either $25 for a primary care visit or $45 for a specialist visit. You do not need to satisfy a deductible first. When you go to the hospital for treatment with this same plan, you must first meet the medical deductible, then you pay the applicable copay for the type of treatment you need (emergency room, outpatient or inpatient care).

Covered Expenses

Covered expenses are medical and related costs that qualify for reimbursement under your medical plan.

Deductible

The amount of eligible expenses you and each covered dependent must pay each calendar year before the Plan begins to pay benefits.

Dependent

Eligible dependents include your legal spouse, your eligible children, your partner (which includes a civil union partner), and your partner’s eligible children.

Evidence of Insurability (EOI)

Evidence of Insurability, or proof of good health, is a statement of medical history and related information which is used to determine whether you (or a dependent) will be approved for certain types of coverage, such as life insurance.

Family Coverage

All coverage levels other than individual are considered family coverage for purposes of the High Deductible Plan with HSA. These include employee + spouse, employee + children and family.

High Deductible Plan with HSA

The High Deductible Plan with HSA has lower paycheck deductions and higher annual deductibles than Citi’s other medical plans. It shares the cost of covered services after you meet the annual deductible. There are different annual deductibles for in-network and out-of-network care that accumulate separately. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

Health Savings Account (HSA)

An HSA is available to employees who participate in the High Deductible Plan with HSA. It is designed to be used in conjunction with the High Deductible Plan with HSA to pay for eligible health care expenses until you satisfy your deductible and thereafter, with tax-free dollars.

HSA funds can also be saved for future health care expenses. If you open an account, Citi will contribute money into your HSA each year that you are enrolled in the High Deductible Plan with HSA, even if you do not contribute to your HSA.

Health Maintenance Organization (HMO)

HMOs are only available to employees in specific locations. You must use in-network doctors and hospitals. If you do not use in-network doctors and hospitals — except in an emergency — the HMO will not cover that care. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

In-network

In-network doctors and hospitals have agreed to a discounted rate negotiated by the insurer. If you enroll in the Choice Plan or High Deductible Plan with HSA, this means you can typically save money by using in-network services. If you enroll in the In-network Only Plan or an HMO, you must stay in-network or your medical care won’t be covered, except in an emergency.

In-network Only Plan

The In-network Only Plan provides coverage only when you receive care from a smaller network of doctors and hospitals who consistently deliver high-quality care at lower costs. If you do not use doctors and hospitals in the smaller network — except in an emergency — the cost of your care will not be covered.

The plan has a lower annual deductible than Citi’s other medical plans. The deductible only applies for some services, such as care provided at a hospital. For doctor visits and prescriptions, you’ll pay a flat copay. Like all Citi plans, 100% of the cost for recommended in-network preventive care is covered.

Out-of-network

Out-of-network doctors and hospitals are not part of the insurer network. If you enroll in the Choice Plan or High Deductible Plan with HSA, this means you’ll typically pay higher costs for care (deductible, coinsurance, and amounts billed over the allowed amount). When you see an out-of-network doctor, you’re responsible for filing a claim for reimbursement. If you enroll in the In-network Only Plan or an HMO, the cost of care you receive from out-of-network doctors or hospitals won’t be covered, except in an emergency.

Out-of-pocket Maximum

The out-of-pocket maximum is the maximum amount you’ll pay in the plan year for eligible expenses—including copays, deductibles, and coinsurance—for yourself and your covered dependents. Once you meet your out-of-pocket maximum, the Plan pays 100% for in-network services.

Paycheck Deductions

The amount you pay for plan coverage out of your paycheck.

Preventive Care

In-network preventive care is covered free of charge regardless of which plan you choose. Preventive care services include routine physical exams and diagnostic tests, immunizations, well-child and well-woman exams.

Spending Accounts

Spending accounts allow you to pay for certain health care, dependent day care, transportation, and parking expenses with before-tax payroll contributions.