Human Resources / HSA Plan

HSA Plans

Click on these links to view a schedule of benefits covered by the Medical HSA Plan:

HSA Medical Plan - UMR Benefit Summary

HSA - Summary of Benefits and Coverage - Health Care Reform Document

Health Savings Account Contributions

Need to change the amount of your monthly health savings account contribution? Simply login to Bswift then click the link in the red box to submit your change request

Calendar year maximum health savings account contributions for 2025:

Individual: $4,300
Family: $8,550
Catch-Up for age 55 or over: $1,000

Qualified Healthcare Expenses

The Internal Revenue Service determines what expenses can be reimbursed and what cannot. View the IRS publication for a full list of qualified and nonqualified healthcare expenses: View IRS Publication 502 for a full list

Plan Design

Benefit Design

$1600 HSA Plan

Deductible (Plan Year):

$1,600

Individual

Family

$3,200

Coinsurance:

100%

Total Out of Pocket Max:

$3,200

Individual

Family

$6,400

Physician Office Visit:

$25 after Deductible

Specialist Office Visit:

$35 after Deductible

Teladoc Visit:

$15 after Deductible

Emergency Room:

$100 after Deductible

Urgent Care:

$50 after Deductible

Inpatient Hospital:

$100 after Deductible

Outpatient Surgery:

Deductible

Prescription:

Deductible then $10/30/50 Specialty: $75 or $125

Employee Monthly Premiums:

Monthly Medical Premiums	HSA Plan
Monthly Medical Premiums	w/o Wellness w/Wellness
Employee only	$5 $0 **
Employee & spouse	$450 $420
Employee & children	$315 $285
Family	$755 $725

**The Board will contribute $25 per month into your HSA account.

Teladoc services include general medicine, dermatology and behavioral health:

call 800-TELADOC (800-835-2362) or visit Teladoc.com
Teladoc health benefits summary
Teladoc: How to set up your Teladoc Health account

Other helpful links:

Jefferson City School District

Human Resources

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