How the Lumenos Georgia Health Insurance Plan Works

The Lumenos plan is an innovative approach to health benefits that puts you in charge of the money you spend for health care services and helps you get the most out of your company- sponsored health coverage. With the Lumenos plan, you have flexibility and control in choosing the health care services you and your family members receive - and in determining how the cost of these services is paid.

Health Reimbursement Account (HRA)

Through the Lumenos plan, the company makes an annual allocation to a Health Reimbursement Account (HRA) for you and your covered dependents (the HRA is a bookkeeping account, and not a trust of any sort). You can use your HRA to pay for Covered Services not otherwise covered by the Traditional Health Coverage such as the cost of routine medical expenses like office visits and lab tests, as well as preventive care - including health screenings, physicals and other covered services, for you and your eligible dependents.

In addition, you can use your HRA to cover other Lumenos plan costs including: any covered services above the Reasonable and Customary amount, services beyond the annual benefit maximums and coinsurance you incur in your Traditional Health Coverage.

The HRA is only available for IRC Section 213(d) Qualified Medical Expenses, and even these are subject to the terms of the benefit plan; you can never take amounts out of the HRA in cash for other than the reimbursement of expenses covered under the Lumenos plan.

IMPORTANT! Any HRA amounts that you use to cover expenses above the Reasonable and Customary amount or for services beyond the annual benefit maximums will not count toward your annual out-of-pocket maximum.

The annual company allocation to your HRA is:

• $500 - single coverage
• $1,000 - family coverage (combined family limit)

NOTE: If you join the Lumenos plan at any time other than at the beginning of the Plan year (January 1, 2006), the initial amount allocated to your HRA will be prorated based on the number of months left in the Plan year.

The HRA approach gives you the opportunity to build your available health care dollars over time. If you don't use the full amount of your HRA each Plan year, the remaining amount can be rolled over and used the next Plan year.

NOTE: If you experience a change in family status during the Plan year that results in a reduction in coverage (i.e. from family to single), your allocation will not change until the beginning of the next Plan year. If the change in family status results in an increase from in coverage (i.e. from single to family, you will receive an additional allocation equal to the difference between the levels (i.e. single to family) allocation. If your participation in the Lumenos plan ends for any reason, any balance in your account will be forfeited back to the company.

Bridge

If you use your annual company allocation to your account and you need additional services from the Traditional Health Coverage, you will have to pay a specified out-of-pocket amount before the Traditional Health Coverage begins. This is called your Bridge.

Your Bridge is:

• $500 -single coverage
• $1,000 - family coverage

If you have been in the Lumenos plan for more than a year, you may have money saved up in your account from previous years. If so, you may have enough to cover your Bridge - and therefore not pay anything out of your pocket before the Traditional Health Coverage begins.