Partial-year Enrollments Are Prorated

The MSA is based on a full calendar year. The deposit and deductible amounts listed for the Fenyx Health Group MSA plans are for a 12-month enrollment.

For members joining late and/or leaving early, they are subject to prorated deposit and deductible amounts.

Reduced Deposit and Deductible For Joining Late

Joining a Fenyx Health Group MSA plan after January 1 (for coverage the same year):

Deposit and deductible amounts are prorated, or reduced, to reflect the number of months remaining in the calendar/benefit year.

Joining a Fenyx Health Group MSA plan after January 1 (for coverage the same year):

Deposit and deductible amounts are prorated, or reduced, to reflect the number of months remaining in the calendar/benefit year.

Consider this simple example of a member joining the plan on April 1. There are 9 months left of the calendar/benefit year, so they’ll receive 9/12ths of the deposit amount.

Prorated Deposit Repayment For Leaving Early

Leaving a Fenyx Health Group MSA plan before December 31:

A prorated portion of the current year’s deposit amount must be paid back to Fenyx Health, who in turn, repays Medicare.

Leaving a Fenyx Health Group MSA plan before December 31:

A prorated portion of the current year’s deposit amount must be paid back to Fenyx Health, who in turn, repays Medicare.

Consider this simple example of a member leaving the plan on September 30. There are 3 months left of the calendar/benefit year, so they need to repay 3/12ths of the current year’s deposit back to Fenyx Health.

The repayment amount is calculated ONLY on the current year’s deposit amount. The member keeps any leftover deposit funds accumulated from previous years and any investment gains made.

Members Don’t Have to Do the Math

We’ll do all the math for our members as we service their enrollments/disenrollments. We just want to provide the background information on how we’ll calculate those numbers.

Utilize our Enrollment and Disenrollment Guide for more information on how prorating works. The guide also includes easy reference tables with the proration amounts by plan for each month of the year (yes, we’ve done the math for you).

If You Want to Do the Math…

Each plan has a monthly prorated amount. The deposit and deductible are prorated by the same amount for each plan. This means the plan’s out-of-pocket amount remains constant throughout the year.

  • To determine the deposit amount received:

    Monthly prorated amount  multiplied by  Months remaining in the benefit period

  • To determine the deductible amount:

    Annual deductible amount  minus  (Monthly prorated amount
    multiplied by Months already past in the benefit period

  • To determine the deposit repayment amount:

    Monthly prorated amount  multiplied by  Months remaining in the benefit period

Standard Group MSA 1$50/month
Standard Group MSA 2$100/month
Standard Group MSA 3$200/month
Enhanced Group MSA 1$400/month
Enhanced Group MSA 2$500/month

Example 1

A beneficiary joining Standard Group MSA 1 for a March 1 start receives a deposit of $500 ($50 x 10 months remaining) with a deductible amount of $2,700 ($2,800 – ($50 x 2 months already past)).

A beneficiary leaving Enhanced Group MSA 2 at the end of July owes $2,500 ($500 x 5 months remaining) back to Fenyx Health/Medicare.

A beneficiary joins Standard Group MSA 2 for an April 1 start receives a deposit of $900 ($100 x 9 months remaining) with a deductible amount of $3,700 ($4,000 – ($100 x 3 months already past)).

They move out of the Fenyx Health Group MSA service area on September 9; their coverage ends on September 31. They owe $300 ($100 x 3 months remaining) back to Fenyx Health/Medicare.

Prev

Next