Transcript EHA Bookkeeper Meetings - Educators Health Alliance

Early Retiree Plan
Benefit Options
2013 - 2014
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Statewide, Nationwide, and Around the
World
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Blue Plans represents the nation’s
largest and most experienced health
care benefit companies.
Blue Plans cover 100 million people—
nearly one-third of all Americans—in
all 50 states, the District of Columbia
and Puerto Rico.
Blue Cross and Blue Shield of
Nebraska insures or provides
benefit administration for more
than 700,000 people.
Members have access to:
92%
Physicians
96%
Hospitals
BLUE CROSS AND BLUE SHIELD OF NEBRASKA
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Introductions
NSEA-Retired President - Roger Rea
Union Bank - Bobbi Hanigan
EHA Field Representative - Greg Long
Blue Cross Blue Shield of Nebraska
Kent Trelford-Thompson
Sue Warner
Tara Stevenson
Linda Farahani
Nick Stoysich
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Agenda
Plan and Rates
Benefit Plan Options
$750 Deductible PPO
$1,650 Deductible PPO
$3,100 Deductible High Deductible Health Plan
$4,000 Deductible High Deductible Health Plan
Health Savings Accounts
How to Enroll
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2013 – 14 Rates for Early Retirees
EHA Early Retiree Rates
Benefit Option
Employee
Employee +
Children
Employee +
Spouse
Family
$750 Deductible
$566.28
$1,003.86
$1,189.19
$1,503.22
$1,650 Deductible $477.79
$846.98
$1,003.35
$1,268.30
$3,100 Deductible $477.79
$846.98
$1,003.35
$1,268.30
$4,000 Deductible $424.71
$752.90
$891.89
$1,127.41
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Early Retiree Rate Comparison
EHA Early Retiree Rates
Benefit Option
Employee
Employee +
Children
Employee +
Spouse
Family
$750 Deductible
$566.28
$1,003.86
$1,189.19
$1,503.22
$1,650 Deductible $477.79
$3,100 Deductible
$846.98
$1,003.35
$1,268.30
Premium
Difference to
$750 Plan
$156.88
$185.84
$234.92
$4,000 Deductible $424.71
$752.90
$891.89
$1,127.41
Premium
Difference to
$750 Plan
$250.96
$297.30
$375.81
$88.49
$141.57
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$750 Deductible PPO Option
Deductible:
$750 Employee only or $1,500 Family
Coinsurance 80% - 20%:
$2,250 Employee only or $4,500 Family
Office Visit Copay:
$30 – Primary Care Physician
$50 - Specialist
$50 – Ded & Coins - Urgent Care
$75 – Ded & Coins - Emergency Room
Routine Care Benefit:
Expanded Benefits due to Affordable Care Act
Pharmacy Benefit:
Generic 25% Coinsurance ($5 Min - $25 Max)
Formulary Brand 25% Coinsurance ($30 Min - $60 Max)
Non-Formulary Brand 50% Coinsurance ($60 Min - $90 Max)
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$1,650 Deductible PPO Option
Deductible:
$1,650 Employee only or $3,300 Family
Coinsurance 70% - 30%:
$3,250 Employee only or $6,500 Family
Office Visit Copay:
$45 – Primary Care Physician
$65 - Specialist
$65 – Ded & Coins - Urgent Care
$90 – Ded & Coins - Emergency Room
Routine Care Benefit:
Expanded Benefits due to Affordable Care Act
Pharmacy Benefit :
Generic 30% Coinsurance ($7 Min - $30 Max)
Formulary Brand 30% Coinsurance ($35 Min - $70 Max)
Non-Formulary Brand 50% Coinsurance ($60 Min - $90 Max)
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$3,100 Deductible: High Deductible Health Plan
Deductible:
$3,100 Employee or $6,200 Family
Coinsurance 100% - 0%:
$0 Employee only or $0 Family
Office Visit Copay:
Primary Care Physician – Applies to Deductible
Specialist - Applies to Deductible
Urgent Care – Applies to Deductible
Emergency Room – Applies to Deductible
Routine Care Benefit:
Expanded Benefits due to Affordable Care Act
Pharmacy Benefit :
Generic – Applies to Deductible
Formulary Brand - Applies to Deductible
Non-Formulary Brand – Applies to Deductible
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$4,000 Deductible : High Deductible Health Plan
Deductible:
$4,000 Employee only or $8,000 Family
Coinsurance 70% - 30%:
$2,350 Employee only or $4,700 Family
Office Visit Copay:
Primary Care Physician – Applies to Deductible & Coinsurance
Specialist - Applies to Deductible & Coinsurance
Urgent Care – Applies to Deductible & Coinsurance
Emergency Room – Applies to Deductible & Coinsurance
Routine Care Benefit:
Expanded Benefits due to Affordable Care Act
Pharmacy Benefit :
Generic – Applies to Deductible & Coinsurance
Formulary Brand - Applies to Deductible & Coinsurance
Non-Formulary Brand – Applies to Deductible & Coinsurance
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What is a Health Savings Account
A health savings account (HSA) is a tax-advantaged
medical savings account available to taxpayers in
the United States who are enrolled in a high
deductible health plan (HDHP). The funds
contributed to an account are not subject to federal
income tax at the time of deposit. HSA’s are owned
by the individual and funds may be used to pay for
qualified medical expenses.
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Please Welcome
Bobbie Hanigan
Union Bank
Presented by:
Bobbi Hanigan
Union Bank & Trust Company
Benefits of an HSA
• You see the true cost of medical care and have better
control over how your dollars are spent
• Funds roll over from year to year
• There is no “use it” or “lose it”
• Funds belong to you - regardless
Who Can Open a
Health Savings Account?
• Age Requirement: 18 or older
• Must be enrolled in a qualifying High Deductible Health Plan
(HDHP)
• Cannot be covered by any non-qualified HDHP Health
Insurance
• Account is owned by the insured
• Unused Funds may roll over to next plan year and beyond
• Cannot be enrolled in Medicare
• Cannot be claimed as a dependent on another individual’s tax
return
2013 HSA Contributions
• Maximum annual contribution amount for 2013 is:
- $3,250 Individual coverage
- $6,450 Family Coverage
• 2013 Catch-up Contributions for HSA owners ages 55+
- $1,000 for 2009 and thereafter
****if the account owner has a spouse who is covered
under the HDHP, and they are 55+ ---they qualify to make
the catch-up contribution – this contribution would need to
be into their own account!
2014 HSA Contributions
• Maximum annual contribution amount for 2014 is:
- $3,300 Individual coverage
- $6,550 Family Coverage
• 2014 Catch-up Contributions for HSA owners ages 55+
- $1,000 for 2009 and thereafter
****if the account owner has a spouse who is covered
under the HDHP, and they are 55+ ---they qualify to make
the catch-up contribution – this contribution would need to
be into their own account!
HSA Contributions (continued)
• Contributions can be made as late as April 15 of the following
year
• Anyone can contribute to an HSA for you
• Contributions are Tax deductible (unless made by your
employer)
• Tax-Free earnings through investments/interest
• Excess Contributions must be withdrawn and taxed as
ordinary income plus an additional 10% excise tax
HSA Distributions
• Distributions for qualified medical, dental or vision expenses
are not taxed
• Non-qualified expenses are taxable as ordinary income plus
an additional 20% penalty
(exceptions: individual’s death, disability or reaching age 65)
• Distributions for non-qualified expenses taken after age 65
are taxed current tax rate and are NOT subject to the 20%
penalty
What Medical Expenses Qualify?
• Prescriptions and qualified deductible expenses
• Qualified long-term care services and a percentage of long
term care insurance premiums
• COBRA premiums
• Health insurance for those on unemployment compensation
• Eye Exams
• Dental Exams
Advantages of HSAs
• Triple Tax Savings:
Tax deductions when you contribute to your account
Tax-free earnings through investments/interest
Tax-free withdrawals for qualified medical expenses
• Portability-accounts are completely portable if you:
Change your medical coverage
Move to another state
Change your marital status
HSA Beneficiaries
• Surviving spouse becomes the owner of the account and can
use it as if it were their own HSA
• No surviving spouse? The account is no longer treated as an
HSA. The account passes to your beneficiary, or becomes
part of your estate (and is subject to any applicable taxes)
Two Types of Accounts to Meet Your
Savings and Investment Needs
Deposit HSA
Mutual Fund Account
• Variable Balance
• Growth-oriented account
• High Activity
• Low level of activity
• Easily Accessible
• Higher balances
• Online Bill Pay
• Online Management
• FDIC Insured Account
• Not FDIC Insured!
Accessibility
The balances in your Deposit HSA Account are
immediately accessible using your:
• HSA Debit Card
• Online BillPay
• Checks-you may choose to purchase checks for
your account!
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Online Bill Pay
http://www.onlinebanktours.com/oec/?b=209&c=15657
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HSA Enrollment Process for
Deposit HSA Account
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Union Bank & Trust is excited to announce…….
E-Signature!!!!
Simply log onto www.ubt.com
Select “Open Account Online” (middle of left side)
Select Health Savings Account (bottom of left side)
Complete application as instructed
Remember to Select “EMPLOYER SPONSORED PLAN”
Account is opened and you will receive your account number
at this time! Remember to record it for future reference.
Health Savings Accounts
Encourage Healthy Living
• Preventative care is not a deductible expense and is
covered at 100% by your CDHP
• Proactive approach to health care
• The money that you do not use in the account is yours to
keep – an incentive to live a healthy lifestyle
Account Owner Responsibility
• If you have specific tax questions, please consult your tax
professional
• Union Bank & Trust is not responsible for monitoring the
account for proper usage
• Please remember that when used properly, the Health
Savings Account offers Triple Tax Savings!! Tax-Free
Contributions, Tax-Free Earnings, and Tax-Free Qualified
Distributions
• It is the Account Owner’s responsibility to maintain all records
and receipts for the account
Union Bank & Trust HSA Contact
Bobbi Hanigan
Heather Poysa
(402) 323-1482
[email protected]
(402) 323-1351
[email protected]
Toll Free: 1-800-297-2837
[email protected]
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Examples of Out-of-Pocket Cost’s
Hypothetical
Out-of-Pocket
Expense
$750
PPO
$1,650
PPO
$3,100
HDHP
$4,000
HDHP
Allowable
Charge is
$750
Members Cost
Share
$750
Members Cost
Share
$750
Members Cost
Share
$750
Members Cost
Share
$750
Allowable
Charge
is
$1,650
Ded = $750
20% of $900=
$180
$930
Members Cost
Share
$1,650
Members Cost
Share
$1,650
Members Cost
Share
$1,650
Allowable
Charge is
$35,000
Ded = $750
Coins = $2,250
$3,000
Ded = $1,650
Coins = $3,250
$4,900
Ded = $3,100
Ded = $4,000
Coins = $2,350
$6,350
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Not Another Knee Injury
Hypothetical follow-up to $35,000 Inpatient Hospital Claim
Hypothetical
Expense
$750 Deductible
$1,650 Deductible
$3,100
HDHP
$4,000
HDHP
Inpatient Expense
$3,000
$4,900
$3,100
$6,350
Follow-up Specialist
Office Visit (2)
($50 x 2)
$100
($65 x2)
$130
Ded
Ded & Coins
Prescription
Formulary
Brand-Name
($200 x 25%)
$50
($200 x 30%)
$60
Ded
Ded & Coins
Physical
Therapy
6 Visits
Ded & Coins
Ded & Coins
Ded
Ded & Coins
Follow-Up
Office Visit
PCP
$30
$45
Ded
Ded & Coins
Total Out
Out-ofPocket
$3,180
$5,135
$3,100
$6,350
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Key Points to Remember
• To request an application please contact the Lincoln BCBSNE office at
(402)458-4800
• Application Deadlines:
– For January 1, 2014 effective date; all applications due to the Lincoln
BCBSNE office no later than Monday December 2, 2013.
• Single Dental coverage is required with all plans.
• If you move to on of the higher deductible plans, you must stay on that
option for 3 years or until you reach age 65, which ever comes first.
• Health Savings Accounts provide a Triple Tax Savings.
• If a member elects to move to the Federal Market Place, the member
would not be able to return to Direct Bill Coverage.
• Member Service Number 1-877-721-2583.
• Once you have sent your application to BCBSNE all question should be
referred to Member Services.
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QUESTIONS