HEALTH SAVINGS ACCOUNT (HSA) AVAILABLE TO BCBS PPO SAVER PLAN SUBSCRIBERS 2023 Maximum Annual Eligible Expenses Plan Administrator How to Use Funds Account Owner Contribution Medical, Dental, and Vision Health Equity Use your Health Equity card You own this account. The Individuals: $3,850 at the point of sale, or funds remain there until you submit receipts for use or invest them Families: $7,750 reimbursement through the member portal HSA eligibility Watch: 5 Benefits of a Health Savings Account - You must be enrolled in the PPO Saver plan - You cannot be enrolled in another medical plan - You cannot be enrolled in Medicare or Medicaid - You cannot be claimed as a dependent on another person’s tax return - You cannot be enrolled in a general-purpose healthcare FSA plan (including through a spouse) 9 // 2022 Employee Benefit Guide