Transcript Slide 1

2013 Employee Benefits Presentation
Annual Enrollment
Plan Year: January 1, 2013 – December 31, 2013
Our insurance plans are designed to help you attain the health and
dental services you need on a regular basis as well as to protect
you against a catastrophic financial loss in the event of a serious
health condition, disability or death. They represent a significant
part of the total compensation package you have with Hoffman &
Hoffman, Inc. Please review the employee benefits package
carefully, and don’t hesitate to ask questions.
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Overview
● Introduction
● Medical Plan
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Payroll Deductions
Medical Benefits/Features
Claims Examples
HSA’s
● Other Benefits
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Consult-A-Doctor
Health Advocate
Dental
Life
Disability
Flexible Spending
● Things to Remember
● What’s Next
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Introductions – H&H & Senn Dunn
Three ways to get help when you need it:
1. Human Resources
2. Senn Dunn Insurance
3. HealthAdvocate (24/7 - starting 1/1/2013)
Teresa Long
Account Manager
Direct: 336-544-6829
[email protected]
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Annual Open Enrollment
 Benefits start over January 1, 2013
 This is the time of year to make changes
 Everyone enrolled in either Medical plan and/or
either Dental plan, will get new ID Cards
 If your change requires any additional information,
HR will let you know.
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Medical Payroll Deductions
Monthly Rates
HSA Plan
Traditional Plan
Employee Only
$ 45.00
$ 76.30
Employee + Spouse
$ 425.00
$ 654.00
Employee/ Child(ren)
$ 350.00
$ 545.00
Family
$ 575.00
$ 880.72
Tax-Advantaged Options
Hoffman & Hoffman,
Inc. HSA Contribution
Employee Can
Participate in FSA
$160 in Jan and then
$40.00/mo Feb-Dec =
$600/yr
You can set aside up to
$2,500 pre-tax to save
for out of pocket
medical costs
You can also set aside more
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Medical Plan Benefits
Benefit Overview
HSA Plan
Traditional Plan
$1,500*
$3,000*
20%
$3,000
$6,000
$4,500
$9,000
Unlimited
$1,000
$3,000
20%
$3,000
$9,000
$4,000
$12,000
Unlimited
Ded then 20% Coinsurance
Ded then 20% Coinsurance
$25 Copay
$40 Copay
100% Covered
100% Covered
100% Covered
100% Covered
100% Covered
100% Covered
100% Covered
100% Covered
100% Covered
100% Covered
Medical
Individual Deductible
Family Deductible
Coinsurance
Individual Coinsurance Maximum
Family Coinsurance Maximum
Individual Out-of-Pocket Maximum
Family Out-of-Pocket Maximum
Lifetime Maximum
Physician Services
Primary Care Office Visits
Specialist Office Visits
Wellness & Preventive
Routine Physical Exams
Routine Eye Exams
Pap/ Mammograms/ PSA
Immunizations
Colonoscopies (Preventive Only)
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*On HSA Plan, Family Deductible is Non-Embedded.
Medical Plan Benefits
Benefit Overview
HSA Plan
Traditional Plan
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
$25 / $40 Copay
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
Ded then 20% Coinsurance
$150 Copay
$ 40 Copay
$ 40 Copay
Lab and X-Ray
In Office
Out of Office
MRI, CAT & PET
Inpatient Services
Physician
Hospital
Outpatient Services
Physician
Hospital
Other Services
Emergency Room Services
Urgent Care Co-pay
Chiropractic Care
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Prescription Drug Benefits
Benefit Overview
HSA Plan
Traditonal Plan
Many Covered 100%
Many Covered 100%
Tier 1 (Generic)
Ded then 20% Coinsurance
$ 4 Copay
Tier 2 (Preferred Brand)
Ded then 20% Coinsurance
$ 25 Copay
Tier 3 (Non-Preferred Brand)
Ded then 20% Coinsurance
$ 40 Copay
Tier 4 (Specialty Rx)
Ded then 20% Coinsurance
$250 Copay
Tier 1 (Generic)
Ded then 20% Coinsurance
$ 8 Copay
Tier 2 (Preferred Brand)
Ded then 20% Coinsurance
$50 Copay
Tier 3 (Non-Preferred Brand)
Ded then 20% Coinsurance
$80 Copay
Tier 4 (Specialty Rx)
Ded then 20% Coinsurance
$500 Copay
Prescription Drugs (30-day supply)
Many Preventive Generics
Mail Order (90-day supply)
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Health Savings Account
● Who can have an HSA?
● Who contributes to my HSA?
Hoffman & Hoffman, Inc.
will contribute $600/yr
● How much can I contribute?
● How is an HSA like an FSA? How is it different?
● Are their fees associated with an HSA?
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Claims Example: Preventive Exam
Employee Only Coverage
● Fairly healthy individual
whose only medical care for
the year was a preventive
exam with a primary care
physician
Office Visits
● $750 annual exam
Final Annual EE
out-of-pocket
TOTAL Cost = $750
HSA annual contribution
Spends out-of-pocket
Annual payroll deduction
HSA Plan
Traditional Plan
100% paid
100% paid
$600
N/A
$0
$0
$540
$915.60
$540, and you
have $600 in your
Health Savings
(total paid for care & premium)
Account
$915.60
Could have
saved $375.60
and still have
$600 in HSA
Account
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Claims Example: Common Illness
HSA Plan
Traditional Plan
Deductible
$205
N/A
Coinsurance
N/A
N/A
Office Visits
$160
$50 copays
Rx
$45
$12 copays
Spends Out-of-pocket
$205
$62 copays
- HSA annual contribution
-$600
N/A
$0
($205 from HSA)
$62
$540
$915.60
$540
($395 left in
HSA)
$977.60
Employee Only Coverage
● Overall healthy individual with
a couple sick care office visits and
prescriptions throughout
the year (e.g., sinus infection,
strep throat)
● $160 annually in office visits
– Estimated 2 office visits (not
preventive) at contracted rate
of $80 each
● $45 annually in Rx
– Estimated 3 generic medications
at $15 each
TOTAL Cost= $205
Total paid for Care
Annual payroll deduction
Final Annual EE
out-of-pocket
(total paid for care & premium)
Could have
saved $437.60
and still have
$395 in HSA
Account
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Claims Example: Common Illness
Family Coverage
Deductible
● Overall healthy family with a
Coinsurance
few sick care office visits and
prescriptions throughout the year
Office Visits
(e.g., sinus infection, strep throat)
Rx
● $480 annually in office visits
– Estimated 6 office visits
Spends Out-of-pocket
(not preventive) at contracted rate
of $80 each
- HSA annual contribution
● $270 annually for Rx
Total paid for care
– Estimated 6 generic medications
at $15 each
– Estimated 3 preferred brand name Annual payroll deduction
medications at $60 each
Final Annual EE
out-of-pocket
TOTAL Cost = $750
HSA Plan
Traditional Plan
$750
N/A
N/A
N/A
$480
$150 copays
$270
$99 copays
$750
$249 copays
-$600
N/A
$150
($600 from HSA)
$249
$6,900.00
$10,568.64
$7,050.00
$10,817.64
(total paid for care & premium)
Could have
saved
$3,767.64
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Claims Example: Chronic Condition
Employee Only Coverage
HSA Plan
Traditional Plan
$1,500
N/A
N/A
N/A
$1,360
$290 copays
$928 ($140 remaining
Ded then $788 Coins)
$1,680 copays
Spends out-of-pocket
$2,288
$1,970 copays
- HSA annual contribution
-$600
N/A
$1,688
($600 from HSA)
$1,970
$540
$915.60
$2,228.00
$2,885.60
Deductible
● Chronic condition such as high
Coinsurance
blood pressure or diabetes that
Office Visits
requires several office visits and
medications throughout the year
Rx
● $1360 annually for office visits
– Estimated 8 office visits (2 PCP
average $80 each & 6 specialist
average $200 each
● $4080 annually for Rx
– Estimated 4 monthly preferred
brand average $60 each & 1
monthly non-preferred brand
average $100 each
TOTAL Cost = $5,440
Total paid for care
Annual payroll deduction
Final Annual EE
out-of-pocket
(total paid for care &
premium)
Could have
saved
$657.60
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Claims Example: Chronic Condition
HSA Plan
Traditional
Plan
Deductible
$3,000
N/A
Coinsurance
N/A
N/A
$2,720
$580 copays
$1856 ($280 remaining
Ded then $1576 Coins)
$3,360 copays
Spends Out-of-pocket
$4,576
$3,940 copays
-HSA annual contribution
-$600
N/A
$3,976
($600 from HSA)
$3,940
$6,900.00
$10,568.64
$10,876
$14,508.64
Family Coverage
● Chronic condition such as high
blood pressure or diabetes that
requires several office visits and
medications throughout the year
● $2,720 annually for office visits
– Estimated 16 office visits (4 PCP,
average $80 each & 12 SPC
average $200 each
● $8,160 annually for Rx
– Estimated 8 monthly preferred
brand average $60 each & 2
monthly Non-preferred brand
average $100 each
TOTAL Cost = $10,880
Office Visits
Rx
Total paid for care
Annual payroll deduction
Final Annual EE
out-of-pocket
(total paid for care &
premium)
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Could have
saved
$3,632.64
Which plan is right for me?
● Consider general health, family history, and
historical utilization
● Consider your monthly prescription costs
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Other Benefits
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Consult-A-Doctor
Health Advocate ** New Benefit
Voluntary Dental – now Reliance Standard, small increase
Life/Disability – now Reliance Standard, Open Enrollment
– Rates will only change if you make a change or move to the next Age Bracket
● FSA – now Stanley Benefits – Lower Healthcare max ($2,500)
– Health Care FSA (cannot be used with HSA Plan)
– Dependent Care FSA (can be used with BOTH plans!)
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Consult-A-Doctor
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24/7 telephonic access to physicians at no cost to you
Available to all employees, enrolled in medical or not
Can cover 5 dependents
When to use:
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Available to those enrolled on either of the 2 medical plans
For non-emergent, common conditions
When you can’t miss work
After hours or on weekends
When you are traveling
When you need a prescription or refill
REGISTER ASAP IF YOU HAVENT ALREADY: then its ready
when you need it
Health Advocate
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Available to those enrolled on either of the 2 medical plans
Dental Plan Benefits: ** Now Reliance Standard
Benefit Overview
Benefit Maximum Per Year
Preventive Care
Routine Exam, 2 Cleanings per Year, Flouride Treatments and
Emergency Pain Relief
Deductible
Basic Services
Diagnostic X-Rays, Fillings, Extractions
Low Plan
$1000 per Member
Covered 100% of Usual & Customary
$50 Individual or $150 Family max
Benefits are paid at 80% of Usual &
Customary Pricing
Major Services
Endodontics, Oral Surgery, Periodontics, Crown, Bridges,
Dentures
Orthodontia
Waiting Period
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High Plan
Not Covered
Benefits are paid at
50% of Usual &
Customary
Not Covered
Covered at 50% up
to a lifetime
Maximum coverage
of $1000
None on any services as long as you enroll
when 1st eligible or at Annual Open
Enrollment
Basic Company Paid Life & AD&D
** now Reliance Standard
1x Salary to $50,000
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Supplemental Life
** now Reliance Standard
Employee Life
You can elect coverage in $25,000
increments up to $100,000, not to exceed
5 x your salary
** New Benefit: Spouse Amount
Spouse can elect $10,000 increments up
to 50% of the employee’s elected amount
to a maximum of $50,000
** New Benefit: Child Amount:
Guaranteed Issue
$10,000
Employee: $100,000
Spouse: $20,000
This is a true open enrollment period for the Supplement Life: You
may elect up to $100,000 on yourself or increase the Vol Life you
already have on yourself up to $100,000 with no questions. You
may also now elect Spousal Life up to $20,000
and Child Life of $10,000 with no questions.
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Voluntary Short-Term Disability
** new benefit Reliance Standard
Monthly Benefit
Benefits Begin
60% of your salary to a maximum
weekly benefit of $1,250/week
31st day after injury or illness
Maximum Benefit Period
180 days
This is a true open enrollment period for
Voluntary Short-Term Disability
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Voluntary Long-Term Disability
** now Reliance Standard
Monthly Benefit
Benefits Begin
60% of your salary to a maximum
monthly benefit of $3,000/month
6-months after injury or illness
Maximum Benefit Period
ADEA (retirement)
This is a true open enrollment period for
Voluntary Long-Term Disability
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Flexible Spending Accounts
** now Stanley Benefits
A flexible spending account (FSA) allows you to set aside pretax dollars for out-of-pocket medical, dental, vision and
dependent care expenses
We are talking about money you are already spending,
so let’s avoid some taxes!!
● Dependent Care FSA
– Maximum – $5,000
– Funds are only available as they are taken out of your paycheck
– Everyone is eligible to participate
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Flexible Spending Accounts
** now Stanley Benefits
● Health Care FSA
– Maximum – $2,500
Lower 2013 Max
– Full amount is available at the beginning of the plan year
● “Use It or Lose It” Rule
● Debit Card – gives you immediate access to your spending account
without paying out of pocket and waiting for reimbursement
● Card will track receipts but always good idea to keep your receipts
anyway
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Flexible Spending Accounts
Stanley Benefits
Health Care FSA: You are eligible if you enroll in the
Traditional Plan or waive coverage

Eligible expenses include:
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
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


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Doctor office visit co-pays
Prescription drug co-pays
Dental services
Orthodontia
Eye glasses
Contacts and lens solution
Eye surgery
Personalized Enrollment Form
Everyone will receive a Personalized Open Enrollment Form which will be
pre-filled with your current 2012 elections
All you will need to do is check “Keep my election the same” under each
benefit, medical, dental, etc, or check the box to “Change my Election”
and indicate the coverage you wish to have for 2013.
These forms must be turned in by Friday, December 7th!
H&H employees turn in to Amanda Harton.
HBT employees turn in to Christine Flowe.
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Things to remember:
● Everyone must turn in their personalized Open Enrollment Form by Friday,
December 7th. (H&H to Amanda and HBT to Christine)
● If moving to HSA Plan, you should open an HSA bank account so that you
can contribute but also receive the Hoffman & Hoffman, Inc. monthly
contribution. See Amanda or Christine for details.
● If you are on the Traditional plan, utilize FSA through Stanley Benefits
● Everyone must turn in a 401(k) election form by Friday, December 14th.
● This has been a summary overview of employee benefits provided/offered
by Hoffman & Hoffman, Inc. – See Plan Documents for details
● Call Senn Dunn if you have any questions 800-598-7161, Teresa Long
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● Questions ???????