Frequently Asked Questions

 
 

Healthy Focus

Frequently Asked Questions

Frequently Asked Questions

Dependent eligibility

Although domestic partners may not satisfy federal or IRS dependent definitions, they are included in the Leidos' definition of dependent. Note that certain fully-insured plans (TRICARE Supplement) do not permit domestic partners to be covered under their plans.

An eligible dependent is defined as:

  • Your legal spouse or domestic partner
  • Dependent children up to the end of the month in which they turn 26, regardless of student status
    • Children include your natural child, legally adopted child, children placed with you for adoption, stepchildren, children of your domestic partner or any other child who depends on you for support and lives with you in a parent-child relationship and provide proof of legal guardianship. A complete description of the Leidos eligible dependent guidelines is available on the Summary Plan Description (SPD) web site.
  • Unmarried children beyond the age of 26 who are incapable of self-support due to physical or mental disability

After you enroll, our vendor, Budco, will ask that you provide documentation for newly added dependents that you are covering. You may also be asked to verify dependent eligibility as part of our ongoing audit of a random 10 percent of our employee population.

You should prepare to provide the following types of documentation once requested by Leidos' vendor, Budco:

  • Proof of Marital Status — Redacted tax return, Marriage Certificate and Joint Ownership Document (current utility bill, marriage statement, etc.)
  • Proof of Domestic Partnership — Residency Document and Joint Ownership Document (current utility bill, marriage statement, etc.)
  • Proof of Parent/Child Relationship — Birth Certificate, Hospital Record, Adoption Paperwork, Report of Birth Abroad, Legal Guardianship Document

Tools and resources

This site includes an interactive benefits decision guide and other tools and resources to help you choose and use your benefits. You have the support of Leidos Employee Services by calling 1-855-553-4367, select #3 or email at AskHR@leidos.com to help you understand and navigate the changes.

Health Advocate is a terrific resource for our U.S. benefits-eligible employees. Health Advocate is an outside third party — they are not connected to our plan administrators. They can offer objective advice and guidance and help you navigate the sometimes challenging landscape of health and health care. Assistance in finding the right doctor, transferring of your medical records, and helping to resolve insurance claims are just a few of the services they offer.

Your first choice can always be Leidos Employee Services. They are equipped to answer most of your coverage questions, and they can help direct you to Health Advocate or other resource, when appropriate.

The healthy focus advantage and healthy focus essential plan options

You and your dependents have to meet the entire family deductible before the plan begins paying benefits for any covered individual for non-preventive care. The out-of-pocket maximum works similar to the deductible and provides protection, limiting your total out-of-pocket costs for a given year. The individual out-of-pocket maximum applies to employee-only coverage for both the Advantage and Essential plans. If you enroll one or more dependents into the Advantage, the family out-of-pocket maximum must be met before the plan begins paying 100% for any individual. However, if you elect the Essential plan and enroll one or more dependents, there is an embedded out-of-pocket maximum of $7,150 for each individual covered by the plan. This means that if one family member reaches the embedded maximum, the plan will begin paying 100% for that individual only. Remember — preventive care is covered at 100% and is not subject to the deductible.

Under both Healthy Focus plan options, preventive care, such as physicals, mammograms and prostate exams, is covered at 100%.

After you meet the annual deductible for non-preventative care, the plans pay the majority of the cost of a doctor visit. Upon visiting your in-network provider for a non-preventative office visit, your doctor’s office should take your card and bill the insurance company prior to billing you for anything. Your in-network cost share or coinsurance is 20% under Healthy Focus Advantage and 35% under Healthy Focus Essential. Keep in mind that you have the Health Savings Account (HSA) option to help budget and save for out-of-pocket health care expenses, including the deductible. Review this site for more information on the plans and how they pay for covered care.

You can access the network directories via the links below:

You can contact the Leidos Employee Services if you have questions. Certificates of coverage and Benefit Summaries are available on the Benefits Summary Plan Description (SPD) web site.

You will need to refer to the fully-insured plan’s benefit summary to obtain that information. The benefit summaries are currently available on the Benefits Summary Plan Description (SPD) web site.

Employees can find current rates for all medical plans offered on the enrollment web site, WorkDay.​

The health savings account (HSA)

When you enroll in a Healthy Focus medical plan, you have the option to open a Health Savings Account (HSA) through HealthEquity. You can contribute pretax and post tax dollars to the HSA up to the annual IRS contribution limit. You can use the HSA to pay for eligible health care expenses — tax free! You can also grow health care savings in your HSA for future health care expenses. Remember, the limit also includes any contributions that Leidos may make.

You must be enrolled in a Healthy Focus medical plan. You cannot be claimed as a dependent on anyone else's tax return, covered by any other non-CDHP medical insurance or account, such as TRICARE, your spouse's HMO, POS or PPO medical plan, Medicare Parts A or B or a traditional Health Care FSA.

The Company will make an automatic contribution to the HSA for employees enrolled in the Healthy Focus Advantage or Essential plan, and who earn $150,000 or less.

The Company contribution will be deposited to your HSA in equal increments on a biweekly basis.

Use the HSA to pay eligible health care expenses. This includes medical and prescription drug expenses, as well as dental and vision expenses that qualify as tax-deductible through the IRS but aren't paid by the health plan. For a list of eligible HSA expenses, go to healthequity.com/leidos.

HSAs are very unique in that you can set aside money in your HSA on a pretax basis, up to an annual limit. You can grow the money tax free. In fact, when your balance reaches $500, you can invest your HSA dollars to grow the funds for future healthcare expenses. Finally, you can use the HSA dollars for eligible healthcare expenses tax-free. That’s a triple tax advantage! Please note that tax deductibility is for federal taxes and tax treatment varies by state.

For 2017, you can make pretax contributions from your pay up to $3,400 for individual coverage and $6,750 if you enroll your spouse or domestic partner and/or children. For 2018, you can make pretax contributions from your pay up to $3,450 for individual coverage and $6,900 if you enroll your spouse or domestic partner and/or children. Remember, the Company may make an automatic contribution to your HSA and that amount is included in the IRS annual maximum amount you can contribute.

If you are age 55 or older, you can contribute an additional $1,000 in catch-up contributions directly with HealthEquity. For information, contact HealthEquity Member Services as 1-844-373-6981.

The decision to use the account or pay with other money is yours each time you receive care. If you don't use all the funds in your HSA by plan year end, any unused balance rolls over to the next plan year. This means any unused dollars you or the Company contributes can be used for eligible healthcare expenses during the current plan year or future years — even during retirement. Review this site for more information on the Health Savings Account (HSA).

Medical

Each plan has different physical therapy benefits. In the self-insured PPO plans, the combined benefit for therapy treatment (physical, occupational and speech) is 60 visits per calendar year. There is a review for medical necessity that occurs after the twenty-fifth visit so please ensure that your provider is documenting your improvement (maintenance therapy is not covered) and providing documentation to the claims administrator.

It depends on the plan. Under the Healthy Focus Advantage and Healthy Focus Essential plans, colonoscopies are considered preventive exams after age 50. Employees should contact their specific plan's member services department to confirm benefits.

Cigna International services that are obtained overseas are all paid at the "in-network" level of coverage. Therefore, employees and their family members who live and obtain services overseas are covered at the in-network percentage regardless of the physician they use.

Prescription Drugs

Express Scripts manages the prescription drug benefit for the Healthy Focus Essential and Healthy Focus Advantage plans.

As an Express Scripts member, you have access to nearly 60,000 pharmacies nationwide including most major drugstores. Ask your local pharmacy if it is in the Express Scripts network. In addition, you are able to use the Express Scripts mail-order program for all of your ongoing prescriptions such as those you take to control high blood pressure, cholesterol and/or diabetes.

You can call Express Scripts Member Services at 1-877-223-4721 or you can visit their web site, www.express-scripts.com.

The cost of your medications depends on whether you use generics, preferred brand names, or non-preferred brand names. Preferred medications have been selected by the Pharmacy and Therapeutics Committee, an independent committee of practicing physicians and a pharmacist, and Express Scripts. The committee reviews and evaluates medications to ensure they are safe and effective, and that they offer value to the plan and the consumer.

To see if you could save, call Express Scripts Member Services at 1-877-223-4721 or you can visit the Express Scripts web site.

And, once you are enrolled, you can explore the My Rx Choices® prescription savings program (also known as Savings Advisor) at Express Scripts. With My Rx Choices, you can see if you have lower-cost alternatives available for the medications you take regularly. This tool allows you to enter or select a drug name and get information such as brand name and generic alternatives, estimated cost, and whether or not the drug is covered under the plan. Simply look up the name of a medication to find lower-cost alternatives and potential savings. Then, print out the list of alternatives and savings and ask your doctor whether a lower-cost generic or preferred brand-name is right for you.

The Plan uses the Preferred Prescription Formulary by Express Scripts. The formulary provides a list of common medications that are typically covered by your plan, including generic and brand-name drugs. Discuss the list of drugs on the formulary with your doctor before your prescription is written. Your doctor may see that there is a preferred drug that is appropriate for you. You can look up the formulary on the Express Scripts web site.

Once you're on the web site click "Formulary — look up drugs by name".

Or, once you are enrolled, you can also log on to Express Scripts to find out which medications are preferred. (If you are a first-time visitor to the web site, please take a moment to register with your member ID number on your pharmacy ID card, and recent prescription number.)

The Express Scripts mail order Pharmacy is a part of the Express Scripts family of pharmacies. The Express Scripts pharmacy is your mail-order service under the Healthy Focus Plans. With the Express Scripts Pharmacy, after your deductible is met, you'll save when you purchase up to a 90-day supply. Just ask your doctor for a new prescription for up to a 90-day supply, plus refills for up to one year (as appropriate). It is good practice to submit refill requests early, when you have a two-week supply on hand, to help avoid any issues should there be an unexpected delay in refilling the prescription by mail.

Another advantage of the Express Scripts Pharmacy is that you'll receive the support of Express Scripts specialist pharmacists who are trained in the medications that treat an ongoing condition such as asthma, heart disease, or diabetes. Specialist pharmacists are available when you need them, 24/7. They can work with you and your doctor to help make sure that your medications work safely together and work well for you.

Getting started is easy. If you use medication on an ongoing basis (such as those used to treat high blood pressure or high cholesterol), you can order up to a 90-day supply and have it delivered right to your home — through the Express Scripts Pharmacy, your mail-order service.

Placing your first order

At the Express Scripts web site, download the mail-order form and Express Scripts Health, Allergy & Medication Questionnaire (HMQ) for your first order. Just complete both forms and indicate your choice for payment. You can register a credit card with the program or ask to be billed for your order. Remember to include your doctor's original written prescription with this first order.

Receiving your medication

You'll receive your medication within eight days after Express Scripts receives your order. You can request express delivery for an additional charge.

Requesting refills

When it's time for a refill, you can:

  • Order online at the Express Scripts prescription drug web site
  • Complete and mail the refill form sent with your medication

The company continually evaluates our health programs to try and enhance our offerings when possible. The company and Express Scripts are faced with some limitations with respect to what medications can be included on the preventive drug list. These limitations are mandated by the IRS. In this case we were able to partner with Express Scripts to expand our preventive drug coverage to include some diabetic medications, which are strictly viewed as "preventive."​

Unfortunately, no. The list of specialty medications administered by Express Scripts' Accredo specialty pharmacy are determined strictly by Express Scripts and apply to all of Express Scripts' 60 million members. They are not client-specific.

No. You would need to utilize the Express Scripts mail-order pharmacy to obtain the 90-day pricing benefit.

If a generic equivalent is available and you choose to purchase the brand, you will pay your generic cost share plus the difference in cost between the brand and the generic.

If you have to pay the difference in cost between the brand and generic drug, this difference will not apply toward your deductible nor out-of-pocket maximum, and you will continue paying the difference even after you have met your out-of-pocket maximum.

If your physician determines that there are clinical reasons you must take the brand versus the generic equivalent, he/she must indicate such by writing "dispense as written" on the prescription.

There may also be generic alternatives available for some brand-name medications (they may be as effective in treating your condition but they are not chemically equivalent). You may wish to discuss generic alternatives with your physician to determine if they are appropriate for your condition.

Dental

Consult the Benefits Summary Plan Description (SPD) web site or contact the carrier directly.

Vision

Yes. Lenses and frames are currently covered every 12 months. This means that employees can receive a "complete" new pair of glasses — lenses and frames — every 12 months.

The plan does provide some coverage for either contacts or frames/lenses — not both.

You are able to get an exam, lenses and frames every year regardless of whether you've had a prescription change.

You are able to use Costco and Eye Care Centers of America as if you were using a VSP approved in-network provider.

Flexible Spending Accounts - Eligible Expenses

Yes, you can review the list of the eligible expenses for Health Care Flexible Spending Accounts and Dependent (Day) Care Flexible Spending Accounts.

Yes. You will still be able to receive reimbursements for OTC drugs, as long as there is a doctor's prescription. Medical devices and supplies (crutches, blood sugar monitors, etc.) and items such as bandages, contact lens solution or denture bond, will not require a prescription.

Requiring an office visit copay for an OTC drug prescription is determined between the patient and the provider. An office visit co-pay may be required if it is a new illness not previously treated by the doctor. You should contact your healthcare provider to determine what policy the provider has in place to accommodate the prescription requirement for OTC drugs.

Dependents are eligible until age 13, unless they are physically or mentally unable to care for themselves and live in your household for at least 8 hours a day.

Yes. However, you will need to submit a doctor's statement with your reimbursement request verifying that the patient's diagnosis is obesity and that the OTC was prescribed to treat obesity. Keep in mind, an FSA will not pay for the cost of food supported by a weight-loss program.

The IRS requires that medical expenses reimbursed through an FSA must be primarily for the diagnosis, treatment or prevention of disease. For example, your doctor may prescribe a vitamin to treat your medical condition. Because vitamins are generally considered an ineligible expense, you will need a letter from your medical provider detailing the type of service rendered and the treatment necessary.

Flexible Spending Accounts - claim information

For claims, log into your HealthEquity account and click on "Claims and Payments".

Flexible Spending Accounts are plans that are governed by IRS regulations which detail who is eligible to use the account and what, where and how the money can be used. It is your responsibility to:

  • Make sure account funds are only spent on eligible expenses for you and your eligible tax dependents. Leidos provides a list of eligible expenses on the Benefits Summary Plan Description (SPD) web site or view the list of the eligible expenses.
  • Keep your receipts and make sure the service, the amount you paid and the service date (not payment date) is included.
  • Keep track of your FSA balance by watching your online statement. In some cases, you may be required to submit additional information regarding debit card transactions or claims submitted.

The maximum amount you can contribute to your Health Care FSA for the 2017 Plan year is $2,600. For 2018, the maximum amount you can contribute will increase to $2,650.

Flexible Spending Accounts - reimbursements

No reimbursement will not be through Leidos payroll. To receive reimbursements via direct deposit, you must provide your personal banking information on the HealthEquity website. You can also complete the Direct Deposit form and submit it to HealthEquity via U.S. mail or fax.

A Health Care FSA will reimburse you for healthcare expenses incurred by you and your eligible tax dependents, even those not covered under our health and welfare plans. Likewise, if you are covered under a spouse's medical plan rather than the Company's, you can still use the Company's FSA benefit to reimburse you for your tax dependent's healthcare expenses. If your spouse also participates in his/her company's FSA plan, you cannot both be reimbursed for the same eligible expense.

Once your benefits take effect, the Company will fully fund your account with your total election amount. The Company will then deduct the election amount from your paychecks in equal amounts throughout the year.

No, you will only have access to dependent care funds that have been deducted from your paycheck each pay period.

You can submit a reimbursement request at any time during the same plan year when the expense was incurred. Otherwise, you will have a deadline date of four months after the plan year to submit for reimbursement. This date is typically April 30.

There are three options for receiving reimbursement:

Use your healthcare debit card

You can use your HealthEquity debit card at select pharmacies, healthcare providers and general merchandise stores that have an IRS-approved inventory and checkout system. In most instances, the card transaction will be automatically verified at checkout. With this verification, you may have to submit a receipt to HealthEquity after the transaction. Note: Cannot be used for dependent day care expenses.

Pay My Provider

You can request HealthEquity to pay your provider directly by selecting Pay Doctor/Provider in the Claims and Payments drop down menu.

Request Reimbursement

You can request reimbursement from your health care flexible spending account online via the HealthEquity member portal. As part of the online process, you can upload the backup documentation and associate them directly to the claim.

You can sign up for direct deposit on the HealthEquity website. You also have the option of completing the Direct Deposit form and submitting it to HealthEquity via U.S. mail or fax.

 

You can pay many of your eligible healthcare and dependent care expenses directly from your FSA account.

To pay a provider:

  • You must submit a receipt or invoice prior to a payment being issued.
  • Once the receipt is approved, one-time payments will be issued on or after the service start date or service end date for Dependent Day Care (even if provider requires payment prior to service).
  • Participant may schedule recurring payments for any eligible expense — provided there is a contract between patient and provider.

Flexible Spending Accounts - eligibility, enrollment and contact information

Participation in FSA is in no way linked to participation in medical and/or dental plans.

Yes, birth of a child is a life event (also referred to as qualified status change event), and you can enroll at that time.

No. You can only change the amount you are contributing if you have a qualifying life event, such as marriage, divorce or the birth of a child.

You will be reimbursed for any eligible expense incurred before the date you retire or leave the company. Under IRS regulations, any remaining funds in the account must be forfeited. Any expenses you incur after the end of your employment is not eligible for reimbursement unless you are eligible to continue your Health Care FSA via COBRA.

Flexible Spending Account (FSA)

  • FSAs are available to employees only if their employer makes them available
  • Employees elect to set aside a certain amount of money pretax from which they can reimburse themselves for certain out-of-pocket expenses
  • Health premiums cannot be reimbursed
  • Unused funds are subject to "use it or lose it" provisions
  • Employees may not take unused funds to a new employer

Health Savings Account (HSA)

  • HSA is available to employees with high-deductible health plans (i.e. Healthy Focus Advantage and Healthy Focus Essential plans)
  • The account is owned by the employee
  • The account is fully funded and can earn interest
  • Misc. IRC 213(d) expenses can be reimbursed as well as limited health premiums
  • Nonqualified withdrawals can be made, but subject to taxation plus 10 percent penalty. After age 65, death or disability, there’s no penalty
  • Unused funds from the account roll over from year-to-year and are fully portable — employees can take them to new employer

An employee cannot enroll in the Company Health Care Flexible Spending Account if the employee’s spouse is enrolled in a Health Savings Account in the same plan year.

Whether the Dependent Care FSA or the tax credit is more advantageous to you depends on your personal tax situation. Unfortunately, we cannot provide tax advice to you. You should consult your tax advisor. Another resource to check is the IRS Publications.

Flexible Spending Accounts - healthcare debit card

Your healthcare debit card is only for use at select pharmacies, healthcare providers, and general merchandise stores that have an IRS-approved inventory and checkout system (IIAS). In most instances, your card transaction will be automatically verified at checkout, which means you will not have to submit a receipt to the administrator after the transaction.

You are, however, required to keep each receipt for tax purposes, and in the event it is needed for verification. When you go to one of these stores or provider's office and swipe your card, choose "credit," even though it is not a credit card.

No. Debit cards are only issued for the Health Care Flexible Spending Account.

You can use your healthcare debit card at healthcare providers (doctors, dentists, vision providers, etc.). You can also use it at merchants with an IRS-approved Inventory Information Approval System (IIAS) that sell eligible over-the-counter items.

IIAS is the common acronym for the IRS-approved Inventory Information Approval System. IIAS was introduced in 2008 and enables participating merchants to verify card purchases right at the check-out counter. Since all stores (including pharmacies and drug stores) that sell general merchandise along with healthcare items must participate to accept the card, it practically eliminates the need and hassle of having to submit receipts to verify the transaction after the purchase.

Yes, visit the Special Interest Group for IIAS Standard web site for the most up-to-date list of merchants who have an IRS-approved inventory system. The list can be found under the Publication section of the web site.

No, you will not need to submit receipts if the merchant has an IRS-approved system. Only eligible healthcare items can be purchased with the card at the point of sale. The FSA administrator will validate these card transactions; however, you still need to keep the receipts for IRS audit purposes.

Please save all your receipts and monitor your account. When you use your healthcare debit card at a doctor's office, the FSA administrator will attempt to automatically verify your card transactions. If they are not able to do so, you will be asked to submit receipts to verify the transactions.

The IRS approval system will only allow the standard list of eligible OTC items to be purchased via the card. Any items that are not on this list will require a letter of medical necessity and will need to be paid for with another form of payment and you will need to submit a request for reimbursement.

No. You also can file a claim online to request reimbursement for your eligible expenses. Go to HealthyEquity, complete an online claim form and scan/upload your receipts. Most claims are processed within one or two days after received and payments are sent shortly thereafter.