HSA Comparison

Enter your current health plan amounts and that of an HSA plan that you would like to compare it to. For examples, compare one of the following plans to a copay plan.


HSAs Typically Costs Less
	Current Plan	HSA Plan	Difference
Annual Premium (Monthly x 12)¹	$	$	$


HSAs Makes Quality Coverage Simple
	Current Plan	HSA Plan	Difference
Calendar-Year Deductible per Family	$	$
Out-of-Pocket Expense to Reach 100% Coinsurance (Annual Deductible[s] Plus Annual Coinsurance[s])²	$	$ Only 1 deductible per family!
HSA Annual Deposit Amount (12 Monthly Deposits)³ (Use All or Part of Your Premium Savings to Fund Your HSA)	$	$
Net Amount (Out-of-Pocket Expense² Minus HSA Annual Deposit Amount)³	$	$	$


HSAs Offers Tax-Advantaged Savings
	Current Plan	HSA Plan	Difference
1040 Tax Deduction⁴ (Equal to HSA Annual Deposit Amount)³	$	$	$
Asset Accumulation (Unused HSA Deposits Grow Tax-Deferred)	0%	2% Annually⁵	2% Annually⁵

UnitedHealthOne is a brand name used for products underwritten and/or administered by the following Insurance Companies: American Medical Security Life, Golden Rule, PacifiCare Life and Health, United HealthCare. The brand name may also be used for PacifiCare Life Assurance Company products. In Arizona, the underwriter is Golden Rule Insurance Company. Plans are subject to medical underwriting. Product availability and plan design vary by state. Policy Form numbers: C-006.3 or state variation; GRI-PA-20.1-06; GRI-PA-23.1-10; UHC06-N21M-17; GRI-N21M-07; GRI-N21M-15; GRI-N21M-30; GRI-N21M-40; GRI-N22M-16; GRI-N22M-27-HSA; GRI-N22M-49; GRI-N23M-05; GRI-N23S-05; or MGR03928. In LA, plans are offered by United HealthCare Insurance Company and administered by Golden Rule.

¹ This quote is for an HSA 100®____________ rate, based upon the family status, age(s), and ZIP Code information provided by the client. It may not be the actual premium rate determined after the underwriting review. It does not include any optional benefits or $3 monthly dues to FACT (required in all states except CO, CT, DE, GA, KS, KY, LA, NM, NV, SD, or WY), so the actual cost may be higher. Premiums will increase over time, but HSA 100® rates will not increase during the first 12 months of coverage, subject to benefit, dependent eligibility, or location change. ² Includes only deductible(s) and coinsurance(s) required to be paid each year by an insured before an insurer will pay 100% of covered expenses. ³ You may deposit a different amount, between $300 and $3,000/$3,050 (2009/2010 tax year) for individuals or $5,950/$6,150 (2009/2010 tax year) for families. Unless your current plan is a medical savings account (MSA) plan or a health savings account (HSA) plan, it is probably not designed to have a deposit amount. ⁴ Federal law allows a full deduction up to the amount deposited or legal limits ($3,000/$3,050 for individuals, $5,950/$6,150 for families in 2009/2010). ⁵ Interest rate as of 2/1/09. Subject to change. The purpose of this document is to help explain the concept of health savings accounts (HSAs). It must be accompanied by the HSA 100® product brochure describing the costs, benefits, limitations, exclusions, eligibility, and renewal terms. This form alone cannot fully compare the two plans — both your current plan and HSA 100® have unique attributes not considered here that may be important to you. You should not make a decision about health insurance without complete information. You should read the HSA 100® product brochure and compare it to your current plan documents. Please discuss your needs and the product differences with your broker before making a decision.