Glossary

  • Coinsurance: How you and your medical plan share costs after you meet the plan’s annual deductible. For example, your plan may cover 80% of charges for a covered hospitalization, leaving you responsible for the other 20%. This 20% is your coinsurance.

  • Deductible: The amount you pay for health care services each year before your plan begins to pay benefits. For example, if your annual deductible is $2,850, your plan won’t pay anything until you’ve paid that amount in out-of-pocket expenses first. The exception is in-network preventive care, which is fully covered, with no deductible.

  • Dependent Care Flexible Spending Account (FSA): You may choose to enroll in this account to pay for eligible dependent care expenses — including child and elder care — with pre-tax dollars. You contribute to your FSA through automatic, pre-tax payroll deductions. The Dependent Care FSA has a “use it or lose it” rule, meaning that any money left in your account at year-end is forfeited. In addition, the Dependent Care FSA requires you to incur the expense first and then file a claim for reimbursement after services have been provided. For a full list of eligible expenses, refer to IRS Publication 503.

  • Health Care Flexible Spending Account (FSA): You may choose to enroll in this account to pay for eligible health care expenses — including deductibles and coinsurance for medical, dental and vision care — with pre-tax dollars. You contribute to your FSA through automatic, pre-tax payroll deductions. Up to $500 of unused money may be carried over to the next year; amounts above $500 will be forfeited. By law, you cannot participate in a Health Care FSA and a Health Savings Account (HSA) at the same time, but you can contribute to both an HSA and a Combination FSA. For a full list of eligible expenses, refer to IRS Publication 502.

  • Health Savings Account (HSA): A tax-advantaged savings account that is only available to participants in a qualified high deductible health plan, such as the $4,500, $2,850 and $1,850 Deductible Plans. You contribute to your HSA through pre-tax payroll contributions and can use the money to pay for eligible medical expenses — including deductibles and coinsurance for medical, dental and vision care. In addition, Transamerica will contribute money to your account in 2020 as a reward for completing certain wellness activities — up to $500 for Self Only coverage and $800 if you cover a spouse and/or child(ren) on your medical plan.

    In 2020, the total amount that you and Transamerica contribute to your HSA cannot exceed $3,550 for Self Only coverage or $7,100 if you cover a spouse and/or child(ren) on your medical plan. You can change your contribution amount during the year for any reason. To make a change to your HSA contributions, visit the Mercer Marketplace website — learn how to access the site. (Please note that while your medical plan premiums are also deducted from your paycheck, they are separate from your HSA/FSA contributions and are paid to the insurance carrier providing your coverage — only the amounts you specifically elect to contribute to an HSA or FSA go into those accounts.)

    All of the money in your HSA rolls over from year to year and is always yours to keep. For example, you may use the money in your HSA to pay for eligible health expenses in retirement. For a full list of eligible expenses, refer to IRS Publication 502.

    In order to establish and contribute to an HSA, you:

    • Must be enrolled in an HSA-eligible high deductible health plan, like the $4,500, $2,850 or $1,850 Deductible Plans
    • Cannot simultaneously participate in the Health Care FS (but participation in a Combination FSA is allowed)
    • Cannot be enrolled in any other medical coverage, including a spouse’s plan, Medicare or Tricare
    • Cannot be claimed as a dependent on someone else’s tax return

    You should review IRS rules for making HSA contributions if you will turn age 65 during the year. For more information, see IRS Publication 969.


  • Combination Flexible Spending Account (FSA): Available only to employees who enroll in an HSA, this FSA is designed to provide additional tax-saving opportunities. This type of spending account is a Limited Purpose Health Care plan that is converted to a general purpose Health Care FSA once you meet the IRS-required medical deductible of $1,350/Self Only and $2,700/Spouse and/or Child(ren). Initially, only dental and vision expenses are eligible for reimbursement in a Limited Purpose Health Care FSA; then, once you’ve met the required IRS medical deductible amount, you can also reimburse yourself for eligible medical expenses. When you meet the IRS-required medical deductible, you must submit the Deductible Verification Form (available on the Mercer Marketplace 365+ website — learn how to access the site) to Mercer Marketplace. This document serves as a one-time notification that the deductible was met. You may use funds in your HSA while you are in the process of meeting this deductible requirement.

  • Out-of-pocket maximum: This limit protects you financially by capping the amount you’ll pay in a plan year for covered health expenses. If you reach your medical plan’s out-of-pocket maximum, your plan pays 100% of covered services for the rest of the year. Your deductible and coinsurance count toward your out-of-pocket maximum.

  • Premiums: A fixed amount that is deducted from each of your paychecks to pay for coverage under a medical plan. Premiums can vary widely by the type of plan you choose and are paid to the insurance carriers who provide coverage. To see what the premiums are for each plan, visit the Mercer Marketplace 365+ website — learn how to access the site. Please note that while your HSA and FSA contributions are also deducted from your paycheck, they are separate from your premiums — only the amounts you specifically elect to contribute to an HSA or FSA go into those accounts.

  • Preventive care: In-network preventive care is fully covered under all of Transamerica’s medical plans, with no deductible. Preventive care includes routine care designed to prevent illness or disease, including annual physicals, recommended immunizations and routine cancer screenings. If the same tests are done to diagnose an illness or treat a known condition, they are not considered preventive care and your plan’s normal charges will apply.