2016 Grandfathered Rate Sheet
2015 Grandfathered Rate Sheet
Our qualified high deductible health plan with HSA offers your clients great basic coverage and a chance to save money and invest it for future healthcare expenses. It also allows your clients to reduce their taxable income.
We make it easy to enroll in and to manage both the health plan and the savings account.
HSAs offer a triple tax advantage:
They also enjoy:
We offer integrated banking through ConnectYourCare, so that your clients who enroll in an individual HSA-qualified health plan can make the most of their HSA accounts. An account offers:
HSA accounts set up through ConnectYourCare give your clients the ability to maintain records either through our mobile app or by scanning documents to the ConnectYourCare website. This makes it easier to store their records in one place for future reference, such as filing taxes or responding to an IRS audit. In addition, the ConnectYourCare site gives them access to tips for making the best use of their accounts for investments, contributions, and paying for expenses.
*UMB Bank n.a., is a member of the FDIC. Founded in 1913, UMB Bank is one of the largest independent banks in America.
Health, Allergy & Medication Questionnaire
Express Scripts Home Delivery Mail-Order Form
Prescription Drug Reimbursement Form
Authorization for Release of Psychotherapy Notes
Disclosure Accounting Request
Information Release Form - Give someone permission to obtain and discuss your personal and health information, including sensitive information such as substance abuse, reproductive health, and mental health. You can also authorize members on your plan to see your sensitive information on LifeWiseOR.com or ConnectYourCare (medical funding account).
Request for Amendment of Records
Request for Inspection of Records
HSA Authorization Form for UMB Bank
Producer of Record Change Form
Want products and services that save you money and support your healthy lifestyle?
We offer member-only discounts on gym memberships, travel, and more.
We also offer benefits for wellness related classes offered through local hospitals with topics like:
Log in to see these member discounts and more.
Save on alternative care services such as chiropractic, licensed acupuncturists, licensed massage therapists, naturopathic physicians, dietetic and nutrition services.
Special low prices on weight-loss programs including Jenny Craig, and Bestlife, the award-winning diet and fitness plan from Oprah's trainer, Bob Greene.
Receive special savings on your next eye exam and on name brand vision hardware and contact lenses.
LifeWise offers discounted membership and waived initiation fees at LA Fitness.
Save money on hearing aids and screening exams.
Save on umbilical cord blood banking and safety products for your child and home.