open enrollment highlights setting the stage for 2012 health care review health plan choices for...

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Page 1: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account
Page 2: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Open Enrollment Highlights

Setting the Stage for 2012 Health Care

Review Health Plan Choices for 2012

Introduce New Flexible Spending Account administrator

Resources for enrollment decision-making

Page 3: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Important to enroll: review changes to plans/premiums; certify tobacco user status for medical and term life insurance

On line enrollment through E-Benefits

October 24 – November 24, 2011 (firm deadline)

Page 4: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Flexible Benefits

Pre-Tax Annual Choice

Making

Core Benefits

No annual election

Benefit provided to all eligible employees

University contributes portion of the cost

Voluntary Benefits

Group rates Payroll

deductions Employee pays

full cost

Page 5: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Core Benefits

Long Term Disability Basic Accidental Death and Dismemberment Basic Employee Term Life Insurance Retirement

Page 6: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Flexible Benefits

Medical Flexible Spending Accounts◦Health Care FSA◦Dependent Care FSA

Short Term Disability Additional Term Life (Employee, Spouse,

Child) Additional Accidental Death &

Dismemberment (Employee, Spouse, Child)

Page 7: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Voluntary Benefits

Accident Insurance Dental Insurance Critical Illness

Insurance Home/Auto Insurance Group Legal Plan Universal Life

Insurance

Page 8: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Voluntary Benefits

Accident Insurance Dental Insurance Critical Illness Insurance Home/Auto Insurance Group Legal Plan Universal Life

Insurance

Annual Dental Rates

Page 9: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Pressure from increasing costs and tight budgets shape 2012 options

Page 10: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

2000 $ 54,010,667 2002 $ 64,393,663 2004 $ 74,964,501 2006 $ 92,429,490 2008 $111,250,048 2010 $140,445,094

Page 11: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

2011 Premiums

Employees◦$14,400,000 (11%)

Purdue◦$120,000,000 (89%)

Page 12: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Legislation passed in 2011◦K-12 school corporations required to maintain

their health care costs within a certain range or they would be required to join the state’s health plans.

◦An amendment to include Higher Education was drafted by lawmakers but never introduced in committees.

Page 13: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Legislation introduced in 2005◦Suggested state institutions join Medco, the

state’s prescription purchasing vendor.

Legislation passed in 2011 ◦All higher education institutions join Medco.◦ Impact on Purdue:

Employee’s on the Choice plan will be migrated to Medco (from CIGNA) effective Jan. 1, 2012.

Page 14: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Type of Plan State of Indiana Premium EE only

Purdue EE Only Low TierBelow $44k

Purdue EE Only Higher Tier$44k or Above

High Deductible 1

$354 Not offered Not offered

Page 15: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Type of Plan State of Indiana Premium EE only

Purdue EE Only Low TierBelow $44k

Purdue EE Only Higher Tier$44k or Above

High Deductible 1

$354 Not offered Not offered

High Deductible 2(Choice)

$524 $155 $515

Page 16: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Type of Plan State of Indiana Premium EE only

Purdue EE Only Low TierBelow $44k

Purdue EE Only Higher Tier$44k or Above

High Deductible 1

$354 Not offered Not offered

High Deductible 2 (Choice)

$524 $155 $515

Traditional PPO(Purdue Incentive)

$2,958 $286 $742

Page 17: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Type of Plan State of Indiana Premium EE only

Purdue EE Only Low TierBelow $44k

Purdue EE Only Higher Tier$44k or Above

High Deductible 1

$354 Not offered Not offered

High Deductible 2 (Choice)

$524 $155 $515

Traditional PPO(Purdue Incentive)

$2,958 $286* $742*

(Copay Plan)Not offered $531 $977* Family $912

$2,159

Page 18: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

No Part-time eligibility.◦Must work 37 ½ hours or more per week

No Same Sex Domestic Partner coverage. No salary tier. The State has just two coverage levels.◦ Employee Only

◦ Family

Page 19: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Try to reduce increases by healthy lifestyles and good consumer habits

Increase Premiums

Plan Design◦Deductibles◦Co insurance or Co pays◦Out of pocket maximums◦Incentives to use lower cost providers

Page 20: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Plan Pays 100%

EE Deductible

EE Co-insurance Share

Plan Co-insurance Share

Out of Pocket Maximum

Premium

Page 21: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Co Pays $15 to 30 per visit in network for office visits

Deductible $250 EE$500 family* Hospital In and Outpatient

Co Insurance 15% in network (30% out)

Out of Pocket Maximum

$1,200 EE$2,400 family* In network

Page 22: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Co Pays $15 to 30 per visit in network for office visits

ER CoPay $200 ($150)MRI, CT $200 ($50)

Deductible $250 EE$500 family* Hospital In and Outpatient

Co Insurance 15% in network (30% out) 20% in network

Out of Pocket Maximum

$1,200 EE$2,400 family* In network

• Premium increase 30%

Tiered lab network•Quest, MidAmerica, LabCorp $0•In Network Lab 30%•Out of Network Lab 50%

Page 23: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

If your doctor does not normally send lab work to a Tier 1 lab, ask the doctor to give you a lab order form, so that you may go to another lab to have the work done.

Watch for more info Arrangements are

underway to contract with national laboratories:

Quest LabCorp Mid America

(PUSH is a draw site for Mid America Labs)

Page 24: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Under 44,000

Difference Over 44,000

Difference

Employee Only $690 $159 ($3/wk)

$1270 $293 ($6/wk)

Employee & Children

$1201 $277 ($5/wk) $2097 $484 ($9/wk)

Employee & Spouse

$1745 $403 ($8/wk) $3051 $704 ($13/wk)

Family $2113 $488 ($9/wk) $3687 $951 ($18/wk)

Page 25: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Deductible $500 EE$1,000 family* In network

Co Insurance 15% in network (40% out)

Out of Pocket Maximum

$2,000 EE$4,000 family* In network

Page 26: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Deductible $500 EE$1,000 family* In network

Co Insurance 15% in network (40% out) 20% in network

Out of Pocket Maximum

$2,000 EE$4,000 family* In network

$2,200 EE$4,400 Family*in network

• Premium increase 15%

Tiered lab network•Quest, MidAmerica, LabCorp $0•In Network Lab 30%•Out of Network Lab 50%

Page 27: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Under 44,000

Difference Over 44,000

Difference

Employee Only $329 $43 ($<1/wk) $853 $111 ($2/wk)

Employee & Children

$598 $78 ($1.5/wk) $1411 $184 ($3.5/wk)

Employee & Spouse

$869 $113 ($2/wk) $2055 $268 ($5/wk)

Family $1049 $137 ($2.6/wk)

$2483 $324 ($6/wk)

Page 28: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

No deductible Retail: ◦Generic 20% co-insurance◦Preferred Brand 30% co-insurance◦Non-preferred Brand 50% co-

insurance Mail Order: ◦ 15%, 25%, 45%

Out of Pocket Maximums $1300 per person and $2600 per family. • No Change for 2012

Page 29: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Deductible $1,300 EE$2,600 family* In network

Health Savings Account

$650 EE$1,300 family

Co Insurance

20% in network

50% out of network

Out of Pocket Maximum

$3,300 EE$6,600 family* In network

• Premium increase 10%

• Prescription Plan coverage through Medco

Page 30: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Under 44,000

Difference Over 44,000

Difference

Employee Only $171 $16 ($<1/wk)

$567 $52 ($1/wk)

Employee & Children

$308 $28 ($<1/wk) $908 $83 ($1.5/wk)

Employee & Spouse

$407 $37 ($<1/wk) $1419 $129 ($2.5/wk)

Family $512 $47 ($<1/wk) $1700 $155 ($3/wk)

Page 31: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

New Flex Spending Account Administrator Dental Premiums Slight Increase Implement $250 additional premium◦Additional Premium for tobacco users, each for

employee and/or spouse/SSDP◦Everyone MUST go through open enrollment and

certify tobacco user status. If you do not, you will default to tobacco user and you will be assessed the additional premium along with any spouse/SSDP covered on your medical plan!!! Also, if you carry Add’l Term Life Insurance you will be assessed the tobacco user premium!

Page 32: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

E-Benefits Certification I have not used tobacco products in the

past 12 months. I have used tobacco products in the past

12 months, but I have completed an approved tobacco cessation program between Sept. 1- Nov. 23, 2011 to qualify for a waiver of the additional premium for tobacco users.

I have used tobacco products in the past 12 months.

Page 33: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Open Enrollment Guide

Choose Well, Live Well News

Schedule of Activities◦ Voluntary Benefit Fair (10/26)◦ CIGNA medical plan (10/27 and 11/4)◦ Flexible Spending with PayFlex (11/7)◦ Walk In Enrollment Help Sessions

Websites◦ www://purdue.edu/benefits/◦ https://mycigna.com◦ http://www.purduecal.edu/hr

Call Human Resources at x2251

Page 34: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

www.purdue.edu/benefits

Page 35: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Do too many factors and figures get confusing?

Maybe some sample employee stories would help.

www.purdue.edu/benefits

Page 36: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account

Reminders for Enrollment

Tobacco User Status Certification

October 24 – November 24, 2011

Z…Z..Z..Z…

Z..Z.ZZ….Z..Z…

Z..Z

Page 37: Open Enrollment Highlights  Setting the Stage for 2012 Health Care  Review Health Plan Choices for 2012  Introduce New Flexible Spending Account