2014 open enrollment meetings 2014 open enrollment meetings health, dental, flexible spending,...
TRANSCRIPT
2014 Open Enrollment Meetings
Health, Dental, Flexible Spending, Supplemental Life Insurance
April 2014
Schreiner Health Plan• Schreiner continues to offer Faculty and Staff an excellent benefit
package• Our premiums and coverage are better than other comparable
schools and also compared to local businesses of similar size• Schreiner continues to share the burden of increased costs with
employees; • Schreiner cannot guarantee that we will always have a plan that is
this rich• Health Plan and rate adjustments were looked at from all sides• Compared Employee cost to other tiers• Looked at impact on employees at Schreiner’s entry wage • Actuarial analysis
What’s New?• Premium expenses will increase for both the employer and employee
contributions (except for employee only contributions for medical).• Premiums for the HDHP will not increase quite as much as the 70/30
plan.• 70/30 plan deductibles and out-of-pocket maximums will increase.• HDHP deductibles will increase, but out-of-pocket maximums remain
the same.• Primary PhysicianCare changed names in September to Healthgram.• Our Life, AD&D, Supplemental Life insurance and our EAP is now
provided at the same rates through The Principal.• Flexible Spending Accounts will be have a carryover feature that
allows up to $500 to be used in the following plan year.• The HSA maximums will increase slightly again for this plan year.
Plan Comparison to Local and Peers
SU
KISD ActiveCare
3 PRMC Gold
Austin College Plan
2
Austin College Plan
3
Individual Deductible (in-Network) 500 300 1,000 550 950
Family Deductible 1,000 900 3,000 1,100 1,500
Coinsurance 70% 80% 80% 90% 80%Single out of pocket max (includes deductible) 5,000 1,300 6,350 3,050 5,950
Family out of pocket max 12,500
deductible plus 1,000
per individual 12,700 6,100 11,500
Physician Office Visit
Zero Co-pay; Plan pays 70%
after deductible
$20 co-pay for primary, $30 co-pay
for specialist
$30 co-pay for primary, $30 co-pay
for specialist
$20 co-pay for primary, $40 co-pay
for specialist
$25 co-pay for primary, $50 co-pay
for specialist
ER Visit
Plan pays 70% after deductible
$150 co-pay, then plan pays 80% after deductible
Plan pays 80% after deductible
Monthly Premiums:Employee Only 130.00 796.00 197.54 188.70 116.86Employee + Spouse 260.00 1810.00 325.16 Employee + Child(ren) 247.00 1269.00 297.21 Employee + Family 390.00 1990.00 336.40 632.37 391.65
Annual cost of premium for EE 1560.00 9552.00 2370.48 2264.40 1402.32
70/30 Consumer PlanEffective 06/01/2014
Co-Insurance/no change - SU pays 70%/Employee pays 30% after deductible• Deductibles
o Increase from $250 to $500 individualo Increase from $750 to $1,000 employee plus one or more
• Out-of-Pocket Maximum (includes deductible)o Increase from $3,750 to $5,000 individualo Increase from $7,750 to $12,500 Family
• Flexible Spending Accounts - Optionalo Pre-tax funds, withheld via payroll to pay for medical or dependent care expenses
• Pharmacyo 90 day supply at either the retail location or the mail order
HDHP 2500Effective 06/01/2014
• Co-Insurance/no change - SU pays 90%/Employee pays 10% after deductible• Deductibles
o Increase from $2,000 to $2,500 individualo Increase from $4,000 to $5,000 Employee plus one or moreo The increase to the individual deductible allows for imbedded deductibles for
Employees with dependents• Out-of-Pocket Maximum (includes deductible)
o Remains at $5,000 Individualo Remains at $10,000 Employee plus one or more
• Health Savings Account o Pre-tax funds, withheld via payroll to pay for deductible and out-of-pocket
• Pharmacyo 90 day supply at either the retail location or the mail order
Plan Comparison
70/30 Consumer PlanIn-Network Benefits
HDHPIn-Network Benefits
Deductible Individual Family
$500$1,000
$2,500$5,000
Out-of-Pocket Maximum Individual Family
$5,000$12,500
$5,000$10,000
Primary Care Physician 70% after ded 90% after dedSpecialist Physician 70% after ded 90% after dedRoutine Wellness Schreiner pays 100% ded waivedOutpatient Independent Lab Schreiner pays 100% ded waivedEmergency Care (facility only) 70% after ded 90% after dedUrgent Care 70% after ded 90% after dedInpatient Hospital Services 70% after ded 90% after dedOutpatient Hospital Services 70% after ded 90% after ded
Prescription Drug Benefit* (max 90 day supply) Generic Formulary Non-Formulary Contraceptives (generic only)
70% after ded70% after ded70% after ded
Schreiner pays 100%
90% after ded90% after ded90% after ded
Schreiner pays 100%
Lifetime Maximum Unlimited
Medical Plan Pricingper Month
4-Tier Pricing 70/30 Current 70/30 New HDHP 2000 HDHP 2500
Employee Only $130 $130 $130 $130Employee + Spouse $215 $260 $215 $240Employee +Child(ren) $205 $247 $205 $227Employee + Family $305 $390 $305 $360
Flexible Spending Account• The maximum pledge amount remains at $2,500 for a Health Flexible
Spending Account (FSA) and $5,000 for dependent care FSA. The plan year will be from June 1, 2014 – May 31, 2015.
• Carryover of $500 will be allowed for use into the next plan year. Use-it-or-lose-it for any remaining balance exceeding $500 at the end of the Plan year.
• Please see Human Resources to complete your flex election form by May 16, 2014.
• Flexible Spending Accounts are a great way to pay for anticipated medical expenses with Pre-Tax dollars.
• Check your balances online at https://www.wealthcareadmin.com/default.aspx
• Current participants will have a grace period to use remaining funds until August 15, 2014
Health Savings Account• The annual maximum contribution has increased to $3,300 for a Health
Savings Account (HSA) for an individual and $6,550 for a family. • If you are currently enrolled, you do not need to do anything at this time,
unless you want to increase your monthly.• Reminder: You can change your HSA contribution at anytime by notifying
payroll of the increase or decrease, but always keep in mind the annual maximum allowed by the IRS.
• Your HSA Account is a great way to save for future medical expenses with Pre-Tax dollars.
Pre-certification Example
$0
$1,000
$2,000
$3,000
$4,000
$5,000
Colonoscopy (CPT - 45378,45385, 45380)
Hospital
ASC
Dental• There will be no changes to dental benefits.
• There will be a slight increase in Premium.
• You can go to any dental provider, no network.
• Deductibles and $2,000 plan year maximums restart June 1, 2014.
• You will have one ID card for Medical, Dental, and Prescription.
• You may enroll in Dental coverage without enrolling in Medical coverage.
Dental Plan Pricing4-Tier Pricing Current Employee Contribution New Employee Contribution
Employee Only $10.80 / month $11.34 / monthEmployee + Spouse $34.10 / month $35.82 / monthEmployee +Child(ren) $42.70 / month $44.84 / monthEmployee + Family $73.20 / month $76.86 / month
Changes to monthly premiums only; no changes to plan provisions
$2,000 plan year maximum per person on the plan,With additional $1,000 lifetime orthodontia benefit for covered dependents under 19
The Schreiner portion will continue to be $15 per month per employeeregardless of coverage level
Online Open Enrollment
https://www.healthgram.com/openenrollment.
Healthgram Website• Create/access your own account in order to:
o Complete online enrollmento Access claims activityo View deductibles and out-of-pocket informationo View prescriptionso Print EOB’so Print claim formso Email customer serviceo Wellness toolso And much more!
• If you have any questions or need technical support, please email [email protected].
www.healthgram.com
Vision
• VSP through Assurant Vision Care is our vision provider. In FY 2015 we will continue with the same premium and coverage. To find in-network providers please visit, www.vsp.com.
Coverage Type Monthly Employee ContributionEmployee Only $6.04
Employee + Spouse $12.08
Employee + Child(ren)
$11.09
Employee + Family $18.04
Basic Life and AD&D• Coverage provided by Principal Financial Group (formerly The
Hartford)• Current Benefits Include:
o Basic Life and Accidental Death and Dismemberment (AD&D) insurance is an plan that is 100% Employer paid. The plan covers eligible employees for One times your basic annual earnings to a maximum of $100,000 with a minimum of $25,000.
o Upon termination of employment, life insurance may be converted to an individual policy.
Voluntary Life Coverage
• Coverage provided by Principal Financial Group (formerly The Hartford)
• Current Benefits Include:o Employee coverage - includes $10,000 increments to a maximum
of $500,000, not to exceed 5 times annual earnings. o Spouse coverage - includes $5,000 increments up to a maximum
of $100,000.o Employee must enroll in supplemental life and have 50% more
coverage to allow dependents to be eligible for coverage.o Child coverage - includes $5,000 increments up to $10,000 and
does not require medical evidence. • Child coverage starts on day 1 and ends at age 26.
Voluntary Life Coverage
• During Annual Enrollment – you will now have the opportunity to update or increase Voluntary Life coverage for you and your dependents.
• Employees and Spouses are allowed a 1x increment increase without medical evidence this year as long as it does not exceed the guaranteed issue amount.
• Any increases over 1x increment or over the guarantee issue amount will require medical evidence.
• Guaranteed Issue Amounts at time of employment are:o $200,000 for Employeeo $50,000 for Spouseo $10,000 for Children
• Upon termination of employment, Voluntary life insurance may either be converted or ported to an individual policy.
Voluntary Life and Accidental Coverage
Rates• Supplemental Life Rates• Supplemental AD&D $0.02/$1,000 (for Employee and Dependents)
Employee & Spouse
<25 $0.059/$1,000
50-54 $0.28/$1,000
25-29 $0.059/$1,000
55-59 $0.489/$1,000
30-34 $0.059/$1,000
60-64 $0.681/$1,000
35-39 $0.084/$1,000
65-69 $1.27/$1,000
40-44 $0.117/$1,000
70-74 $2.068/$1,000
45-49 $0.174/$1,000
75> $2.068/$1,000
Child: $0.19/ Per $1,000 Unit
Long Term Disability• 60% of your monthly earnings to a maximum of $7,000 per month • Minimum is the greater of $100 or 10% of monthly income loss• 2 Year Own Occupation with Any Occupation after that• Elimination Period is 90 days• Benefit Duration to Social Security Normal Retirement Age
Discounts and ServicesType How to Access
Travel Assistance • www.principal.com/travelassistance
Will & Legal Document Center
• www.ARAGwills.com/Principal
• Group policy number: 1041923Identity Theft Kit • www.ARAGwills.com/Principal
• Group policy number: 1041923
Beneficiary Support • Communications sent directly to the beneficiaries on how to access
Employee Assistance Program
• www.MagellanHealth.com/member
• 800-588-8412
Discounts and ServicesType How to Access
Laser Vision Correction
• www.principallasik.com• 888-647-3937
Hearing Aid Program
• www.americanhearingbenefits.com
• 866-925-1287Weight Loss • www.principal.com/weightwatch
ers
Oral HealthCare • www.epicdental.com• 866-920-4200• Promo code: PR25FT
Magazine Program
• www.principal.com/diabeticliving