A premium is the amount that you pay for your health insurance or plan.

^*The premiums apply only to employees in state agencies, higher-education institutions, and community and technical colleges. School district employees and employees who work for a city, county, port, water district, hospital, etc. need to contact their personnel, payroll, or benefits office for their monthly premiums for 2013.

A deductible is what you pay before the plan begins paying toward covered services. For UMP Classic and UMP CDHP, 2013 plan deductibles are:

Coinsurance is the percentage of the cost of visits and procedures that members pay after they've met their deductible.

For both UMP Classic and UMP CDHP, members pay:

• 15% for preferred providers for most services
• 40% for out-of-network providers for most services
• Most preventive care services are covered 100% with no deductible when you see a preferred provider

A copayment is a fixed dollar amount the member pays the provider when they receive a medical service.

For UMP Classic, members pay:

• $75 for emergency room visits (this copayment is waived if the visit results in a doctor admitting the patient to the hospital). Members also pay 15% of facility and professional fees.
• $200 per day for inpatient stays, up to $600 per calendar year. Medicare retirees pay $200 per day, up to $600 per admission. In addition to the inpatient copayment, members pay 15% for preferred provider professional services.

For UMP CDHP, members pay:

• UMP CDHP does not have emergency room, inpatient, or any other copayments.
• Members generally pay 15% for preferred providers for emergency room visits and inpatient hospital stays once the deductible is met.

The out-of-pocket limit is the maximum amount you will be liable to pay to preferred providers for covered services in any year. Both plans have out-of-pocket limits, but they are calculated differently.

For actively employed subscribers not covered by Medicare, the UMP Classic out-of-pocket limit is $2,000 for individuals, $4,000 for families. For subscribers covered by Medicare, the UMP Classic out-of-pocket limit is $2,500 for individuals, $5,000 for families. Certain costs do not count toward your out-of-pocket limit, including your medical deductible, copayments for ER visits and inpatient hospitalizations, prescription drug costs, and what you pay to out-of-network providers. Note that out-of-network providers are never paid at the 100% level, even if you reach your out-of-pocket limit.

The UMP CDHP out-of-pocket limit, which is the maximum amount you pay to preferred providers for covered services and prescription drugs during a calendar year, is $4,200 for one person on an account or $8,400 for a family of two or more. Unlike UMP Classic, the deductible and prescription drug costs do count toward the out-of-pocket limit. As for UMP Classic, out-of-network providers are never paid at the 100% level, even if you reach your out-of-pocket limit.

A health savings account (HSA) is a tax-free savings account used to pay for health expenses.

The PEBB Program contributes $700 for individuals, or $1,400 for families of two or more, per year into your account. Deposits are prorated and paid on a monthly basis throughout the year. Individuals can contribute up to $2,400 more, or families can contribute up to $4,850 more, to their HSAs per year. Individuals age 55 or older can contribute an additional $1,000 per year.

To open or contribute to an HSA, you must be enrolled in a qualifying health plan, like the UMP Consumer-Directed Health Plan (UMP CDHP). Medicare enrollees are not eligible to open HSAs.