July 1, 2012 – June 30, 2013 Benefit Overview

Dysart\2012\Open Enrollment\12 open enrollment presentation 0430.ppt

Annual Open Enrollment

 The Dysart open enrollment period for the 2012 employee benefit plan year will begin May 1, 2012 and conclude on May 18, 2012.  Open enrollment changes will be effective July 1, 2012.

 This is your once a year opportunity to add, drop or change existing coverage.

 Next opportunity to make a change without a qualifying event will be May 2013 for a July 1, 2013 effective date.

Key Changes for 7/1/12 Plan Year

Medical Plan Changes:

– No increase to rates!!!

– HMO $500 and HMO $0 plans will continue to be offered – Current PPO plan will be replaced with $750 PPO Plan that includes a Health Reimbursement Account (HRA) • • District will contribute $250 on 7/1/12 into each employee’s HRA account In addition, each employee may have an additional $250 contribution to the HRA upon successful completion of the Blue Cross online Health Risk Assessment – Continue to offer the $1,500 HSA Saver plan but increase District HSA contribution • • District contribution of $1,000 for 7/1/12 plan year ($500 on 7/1/12 and $500 on 1/1/13) In addition, each employee may have an additional $250 contribution to the HSA upon successful completion of the Blue Cross online Health Risk Assessment

Key Changes for 7/1/12 Plan Year

 

Medical Plan Changes – Wellness/Preventive:

Preventive care – claims as a result of an initial visit with an in network provider are to be paid at in-network level of benefits even if provider/facility are out of network On all “non-HSA” plans (not allowed on HSA plan due to regulations) an additional $250 wellness allowance per participant will be available:  Employees/dependents are able to use the $250 calendar year allowance for any “wellness” procedure that is not on list of approved services under PPACA and, thus, not on the IRS preventive list of procedures. This benefit is available for both in and “out of network” wellness. After the full $250 is used, any amount over $250 is then subject the medical plan deductible and coinsurance.

 Example: Male prostate exam is NOT on the approved list. So for this exam, the participant would have $250 to use toward this exam… If the exam was $300, then the full $250 would be paid in full, then the person would pay $5 (10% of the remaining $50) assuming deductible has been met.

Key Changes for 7/1/12 Plan Year

Medical Plan Changes – Vision Therapy:

 Vision therapy, also known as visual training, vision training, or visual therapy, is a broad group of techniques aimed at correcting and improving binocular, oculomotor, visual processing, and perceptual disorders.

 Vision therapy will be a covered benefit on all medical plans at the Specialist Office Visit copay applicable to each medical plan. It will become a part of the eligible benefits under the Saver HSA plan and paid according to the current benefit structure.

Key Changes for 7/1/12 Plan Year

 Domestic Partners (same and opposite sex) are eligible for Medical, Dental, Vision and Life.

– Affidavit and documentation will be required as proof of Domestic Partnership.

 Health Flexible Spending Account (FSA) maximum election reduced from $3,000 to $2,500 due to health reform. Dependent FSA will remain at $5,000.

Annual District Contributions

 Medical $4,960  Dental $118  Increased Health Savings Account District Contribution  $1,000 + opportunity to earn an additional $250 by completing a health risk assessment!!!

 Implementation of a Health Reimbursement Account with District Contribution  $250 + opportunity to earn an additional $250 by completing a health risk assessment!!!

 100% cost of Basic Life/AD&D for employee coverage

When enrolling in the $1,500 plan you can receive up to $1,250 in your HSA!!!

When enrolling in the $750 plan you can receive up to $500 in your HRA!!!

Medical “26 Pay Period” Employee Contributions 7/1/12

Coverage 26 Pay Period Cost BCBS BluePreferred Saver $1,500 with HSA

Employee Employee + 1 Dependent Employee + 2 or More Dependents

BCBS BluePreferred PPO $750 with HRA

Employee Employee + 1 Dependent Employee + 2 or More Dependents

BCBS Blue HMO $500

Employee Employee + 1 Dependent Employee + 2 or More Dependents

BCBS Select HMO $0

Employee Employee + 1 Dependent Employee + 2 or More Dependents $0.00 $152.00 $273.60 $7.63 $189.25 $340.30 $7.63 $206.03 $364.75 $27.42 $245.60 $420.15

Additional Benefits

Dental, Vision, Life, Optional Life, Short Term Disability, AFLAC, and 457

 No change to plans offered.  Dental PPO rates increased 6%, no increase to Prepaid Dental rates.

 Please log onto the benefitsCONNECT system for payroll deduction information.

Changes You Can Make Online Using benefitsCONNECT



All benefit eligible employees will be required to re-enroll in medical insurance, AND re-elect FSA/HSA contributions. If you do NOT waive or enroll in medical you will be default enrolled in the $750 HRA plan as “employee only” and will have payroll deduction.

 However, the system will assume you will remain in your current selections for dental, vision, life, disability, etc. unless you make a change in the system…

Dysart Employee Benefit Website Provides you with Access to:

 benefitsCONNECT – The District’s online enrollment system  Benefit summaries  Links to search for providers  2012-2013 benefit guide  Open enrollment presentation  All links and tools discussed during the presentation today can be found here!!!

Dysart Employee Benefit Website

Medical Plan Presentation

Worksite Wellness Program

     During 2011, Dysart began to offer a monthly Wellness newsletter to all employees to educate on current health topics and benefit information.

During 2011, Dysart offered on-site flu vaccination clinics for benefitted staff.

Health education classes like Healthy Pregnancy and Nutrition were offered at the District Office for all employees and family for no cost.

Two Weight Watchers At Work meetings were coordinated at one school and the District Office for all employees and family members.

Nutrition class offered for all Dysart Unified staff in March 2012.

Worksite Wellness Program

    A Health Assessment Campaign was promoted to Dysart staff in February/March 2012. Participants were entered to win 1 of 50 $20 Sprouts Gift Cards. A Wellness Interest survey was promoted in February/March 2012, to learn what employees wanted to see offered in 2012 2013 Wellness Program. Participants were entered to win one of twenty $25 Target gift cards.

In March 2012, Dysart Unified coordinated Mobile Onsite Mammography at multiple sites in the district for onsite screenings.

Future class considerations include sexual assault prevention and successful retirement.

Health Reform Update

Health FSA maximum contribution reduced from $3,000 to $2,500.

     

No other major changes for 2012. The changes below were implemented in prior plan years…

Dependent child “up to age 26” on Medical, Dental, Vision and Voluntary Life (this change was made effective 7/1/10 at Dysart) Removal of pre-existing conditions for children up to age 19 No copay/cost for preventive care services Lifetime limits will become “unlimited” FSA/HSA - Prescription required for over the counter medication Health Savings Account (HSA) penalty increased from 10% to 20% + ordinary income tax

HSA vs. HRA vs. FSA

Tax-Advantaged (Contributions Reduce Annual Tax Expenses) Earns Interest $ in Account “Owned” by Employee $ in Account “Owned” by District Employee Can Contribute District Will Contribute Annual Contribution Limit Health Savings Accounts (HSA)

Yes Yes Yes No Yes Yes Yes

Flexible Spending Accounts (FSA)

Yes No No Yes Yes No No

Health Reimbursement Arrangements (HRA)

No No No Yes No Yes Yes

Unused Balances Roll Over Annually $ Stays with Employee (if Retires or Changes Jobs)

$3,100 for individuals (2012) $6,250 for families (2012) Yes $2,500 7/1/12 for health FSA $5,000 for dependent-care FSA No Determined by District annually – for 7/1/12 plan year up to $500 No Yes No No

Medical Definitions

Copayment:

The fixed dollar amount you must pay directly to a physician at the time certain covered services, such as prescription drugs or office visits, are received.

Deductible:

The fixed dollar amount you must pay for covered services each calendar year before BCBS begins to pay benefits.

Coinsurance:

Sharing, between yourself and BCBS, of the cost of covered services.

Out-of-Pocket Maximum:

The maximum dollar amount you have to pay under the terms of the BCBS contract in a calendar year for covered services.

Blue Cross Medical Plan Options Saver HSA $1,500 80/60 In Network Out of Network Benefits Deductible Deductible Calendar Year Deductible

employee only $3,000 if enrolled as employee only $3,000 if enrolled and $6,000 if enrolled covering any dependents and covering any dependents

Coinsurance Out-of-pocket Maximum (Includes Deductible) Calendar Year Calendar Year

80% 60% $3,000 if enrolled as employee only $6,000 if enrolled as employee only $6,000 if enrolled and covering any dependents $12,000 if enrolled and covering any dependents

PPO $750 with HRA In Network

$750 per Member $1,500 per Family 80%

Out of Network

$1,500 per Member $3,000 per Family 60% $2,000 per Member $4,000 per Family $6,000 per Member $12,000 per Family Items in red font indicate changes from the 7/1/11 plan year benefits.

HMO $500 In Network

$500 per Member $1,000 per Family 80% $2,500 per Member $5,000 per Family

HMO $0 In Network

$0 $0 100% $1,500 per Member $3,000 per Family

Medical Plan Options

Benefits Inpatient Hospital Saver HSA $1,500 80/60

In Network Out of Network 80%* 60%*

PPO $750 with HRA

In Network 80%* Out of Network 60%*

Outpatient Hospital Emergency Room

80%* 60%* $150 fee per person per day, then 80%* 80%* 60%* $200 copay per day then 80%*

Urgent Care Preventive Care Office Visit Specialist Visit

80%* 100% 80%* 80%* 60%* Not Covered 60%* 60%* $50 copay 100% $25 $45 60%* 60%* 60%* 60%*

HMO $500

In Network 80%* 80%* $200 copay; then 80%* $50 copay 100% $20 $45

HMO $0

In Network $250 copay* $125 copay per visit* $200 copay $50 copay 100% $25 $45 Items in red font indicate changes from the 7/1/11 plan year benefits.

* = subject to deductible

Pharmacy Benefits

Benefits Deductible Level 1 Level 2 Level 3 Mail Order (90 day supply) Saver HSA $1,500 80/60

In Network Out of Network Yes - Plan Deductible 80%* 60%* 80%* 80%* 80%* 60%* 60%* N/A

PPO $750 with HRA

In Network Out of Network $15 $30 None Copay + difference between IN contracted rate and billed rate $50 2.5x Copay

HMO $500

In Network None $15 $25 $45 2.5x Copay

HMO $0

In Network None $15 $30 $50 2.5x Copay

Examples of Preventive Care Services

Benefits are available for the following services on a preventive basis, as appropriate for your age and gender and as recommended by your provider:

 Preventive physical examination, i.e. routine physical examination, including the following services when done for screening purposes only: – – – – – Annual well child Mammogram Bone density testing for osteoporosis Screening - colonoscopy Routine gynecologic exam including pap test and other cervical cancer screening tests

Refer to Dysart employee benefit website for complete list of preventive services

Provider Network BlueCross BlueShield of Arizona (BCBSAZ)

 All 4 Dysart medical plans have access to over 15,000 BCBSAZ contracted Physicians and Specialists  Referrals to specialists

are not

required

Nurse On Call 866-422-2729

Speak with an experienced registered nurse anytime, day or night.

Online Services  Ask a Nurse   Health News Online Health Videos

HSA Presentation

Who is Eligible for an HSA?

 Must be covered under the BCBS BluePreferred Saver $1,500 Deductible plan 

Cannot

also be covered under a health plan that is not a high deductible health plan (specific illness/accident policies are okay)  Not enrolled for benefits under Medicare or Tricare  Not covered as a dependent under another person’s tax return

Why Enroll in the BCBS BluePreferred Saver $1,500 Deductible with the HSA?

 Pre-Tax contributions via payroll deduction and tax free distributions for eligible expenses  Lower premiums offer an affordable cost option to cover dependents vs. the $750 plan and 2 HMO plans  District will contribute $500 to your savings account on 7/1/12 and again on 1/1/13 this year

AND

you have the opportunity to earn an additional $250 by completing the health risk assessment  Once enrolled, you will receive a debit card to pull money from the savings account to pay for qualified medical expenses 

You own

the savings account and the money stays with you  The balance rolls over from one year to the next (no use-it-or-lose-it rule)  Long-term savings for healthcare expenses after retirement

Participant pays the Doctor with Health Equity HSA debit card

HSA “How To” – Doctor Visits

Participant goes to the doctor No co-pays participant pays the DEDUCTIBLE first Doctor sends bill to participant Blue Cross adjusts price based on discounts and processes the claim Doctor sends Blue Cross the bill

Blue Cross applies amount of the Rx to the participant’s deductible – no paper work required

HSA “How To” – Pharmacy Prescriptions

Participant goes to the pharmacy Participant shows Blue Cross ID card Pharmacy sends claim to Blue Cross Participant pays with Health Equity HSA debit card Pharmacy applies discount

Example

BluePreferred Saver $1,500 Deductible with Health Savings Account (HSA)

HSA Example

Why this employee selected the Saver HSA $1,500:  Opportunity to save on taxes and save for future health care expenses  Preventive care covered at no cost Annual deductible $1,500 District funds HSA $1,250 Maximum HSA contribution enrolled as employee only (District + Employee contribution) $3,100 Medical benefits in-network 20% coinsurance $3,000 out of pocket maximum (as enrolled as employee only)

District funds HSA Employee funds HSA $1,250 $ 250 Total HSA Balance $1,500 Preventive care

Non-preventive care:

3 Prescriptions 1 Urgent care visit

Total to be paid

$200 $ 70 $225

$295

HSA covers $ 295 HSA balance – year two $1,205 Assumes all network care – different coinsurance levels on non-network care apply.

Year One

HRA Presentation

Who is Eligible for a HRA?

Benefits of the HRA?

 Must be covered under the BCBS BluePreferred $750 Deductible plan  Contributions to the HRA by Dysart are excluded from your gross income  Use money from the account to pay for eligible medical expenses that go toward your deductible, coinsurance and out of pocket maximum  Lower premiums offer an affordable cost option to cover dependents vs. the 2 HMO plans

(but more expensive than the HSA Saver plan)

 District will contribute $250 to your HRA

AND

you have the opportunity to earn an additional $250 by completing a health risk assessment  Once enrolled, as you incur qualified medical expenses that go toward your deductible, coinsurance, and out of pocket maximum (no reimbursement for copays…) Health Equity will mail checks to your home address to reimburse you up to the amount you have in your HRA account  Please note ‘unlike’ the HSA, the HRA balance will “not” roll over from one year to the next

HRA Example

Why this employee selected the $750 HRA plan:  District contribution of $500 to the HRA  Preventive care covered at no cost Annual deductible $750 District funds HRA $500 Medical benefits in network 20% coinsurance $2,000 out of pocket maximum (as enrolled as employee only)

District funds HRA $500

Non-preventive care:

Hospital visit 3 Prescriptions 1 Office Visit $900 $ 45 $ 25

Total to be paid $970

HRA covers $500 Employee pays this amount out of pocket $470

Year One

Health Equity Help Line

Member services call center open 24 hrs a day / 7 days a week / 365 days a year: 1.866.960.8026

Medical ID Card

 All employees will receive new ID cards. The cards will be shipped to your home mailing address.

 Continue to use your current ID cards until 6/30/12. Use the new ID cards effective 7/1/12.

Online Tools & Resources

The tools listed below can be found under the “Medical” tab on the Dysart employee benefit website

 Medical plan evaluator tool  BCBSAZ cost & quality comparison tool  Health Equity tool which allows you to schedule payments to providers, schedule electronic funds transfer & more

Medical Plan Evaluator Tool Demonstration

Age, Gender, Health Status Entry

Side by Side Comparison of Premium Cost & Benefits

Side by Side Comparison of Premium Cost & Benefits

Side by Side Comparison of Premium Cost & Benefits

(Takes District HSA/HRA Contribution Into Account)

Healthcare Claims Projection

Final Output – Best Option Saver HSA for this Individual’s Family

Total Dental Administrators

You can select from 2 dental plans

Dental A500S – Lower Cost Dental Option

Routine Office Visit Oral Exam - Periodic Complete Series X-rays Routine Cleaning Amalgam Restoration Porcelain Crown Root canal-4 No Charge No Charge No Charge No Charge $12 - $26 $455 $395  District pays $118.06 annually toward either Dental plan option  No annual maximum  Must use dentist within the network

Annual Deductible Individual Family Annual Plan Maximum Orthodontia Maximum

Benefits

Type I - Diagnostic & Preventive Type II - Basic Service Type III - Major Services Type IV - Orthodontia (child only) Periodontic Coverage Endodontic Coverage Waiting Periods (timely

entrants)

Major Orthodontia $50 $150 $1,000 $1,000 In-Network / Out-of-Network 100% / 100% 90% / 80% 60% / 50% 50% / 50% 90% 90% 12 months 12 months

Dental PPO – Higher Cost Dental Option

 Larger network of dentists  May pay less “out of pocket” for certain procedures vs. lower cost option  Predetermination of benefits is recommended for treatment over $300

Avesis Vision

In-Network

(note out of network reimburses you “up to” a certain amount….)      $10 copay for exam $10 copay for single, bifocal, trifocal or lenticular lenses $130 contact lens allowance Exam, lens, contacts - 12 month benefit frequency Frames - 24 month benefit frequency

Avesis Vision

Assurant

Short Term Disability

Short Term Disability (STD)

      Benefit up to 66 2/3% of your regular monthly salary Waiting period: 5th day injury, 5 th day sickness 6 Month Duration Up to $5,000 guarantee issue if you enroll when you are first eligible. Should you enroll at a later date you will be required to complete a health statement.

During this open enrollment you can increase coverage up to a total of $2,500 without a health statement. Should you wish to increase coverage for an amount over $2,500 a health statement is required. A health statement is a series of medical questions the insurance company will review and base your approved amount upon the conditions.

PRE ‐ EXISTING CONDITIONS No benefits are payable for disabilities that commence within 12 months of your effective date if you received medical treatment, consultation, care or services, including diagnostic measures, or took prescribed drugs or medicines for the disabling condition in the 12 months just prior to your effective date.

MHN

Employee Assistance Program (EAP)

MHN Employee Assistance Program (EAP) – 100% Paid by Dysart!!!

Your EAP provides 3 face-to-face counseling sessions, 24/7 counseling over the phone, and a wide range of emotional health, family and work issues, including:

         

CONFIDENTIAL

Marriage, relationship and family problems Domestic violence Alcohol and drug dependency Stress and anxiety Depression Grief and loss Childcare and eldercare assistance Financial services Legal counseling

800-977-7593 Note: Any employee or anyone in your household may use the EAP.

Aetna

Flexible Spending Account

Flexible Spending Account

    Contribute up to: – $2,500 per year to the Health FSA (down from $3,000 due to healthcare reform) – $5,000 per year to the Dependent FSA Money is deducted from your paycheck on a “before tax” basis to cover the cost of eligible items such as: copays, glasses, dental work, prescriptions, daycare for your children, etc.

Don’t forget the use-it-or-lose-it rule If you enroll in the $1,500 HSA medical plan the IRS requires you use the HSA savings account for medical expenses. Keep in mind the HSA can also be used for dental and vision. You have the option to enroll in the FSA and HSA but you can only receive reimbursement for dental and vision under the FSA….

MetLife

Life Insurance

Basic & Supplemental Life/AD&D

 

Basic Life/AD&D

1 x your base annual salary up to $100,000 maximum (100% paid by Dysart!!!) Under the Basic Life/AD&D you have the option to elect Basic Dependent Life Spouse coverage in the amount of $1,000 and Child coverage in the amount of $100 for children 15 days old to 6 months and $1,000 for children 6 months and older.

  

Supplemental Life

Employee

: 1 to 5 times your basic annual earnings, to a maximum of $500,000

Spouse/Domestic Partner:

$5,000 to $250,000 in $5,000 increments, up to 50% of your Supplemental Life coverage amount

Children:

15 days to 6 months = Flat $100, 6 months up to age 26 = choice of $1,000, $5,000, or $10,000 *If you do not enroll when you are first eligible you will be required to complete a series of medical questions (Evidence of Insurability aka EOI) and your requested amount will be reviewed and approved by the insurance company based on medical conditions.

 Election is made using BenefitCONNECT during May’s benefit enrollment period;

not during the month of August as in the past.

 The benefit period is from July 1, 2012 to June 30, 2013.

 Employees can donate 1 to 5 days to the bank.

Dysart Sick Leave Bank

AFLAC

AFLAC Products Offered

 Hospital protection plan  Specified health protection plan  Accident plan  Cancer Plan

Don’t forget to contribute to supplement your retirement!

457/403b

Annual Open Enrollment

 The Dysart open enrollment period for the 2012 employee benefit plan year will begin May 1, 2012 and conclude on May 18, 2012.  Open enrollment changes will be effective July 1, 2012.

 This is your once a year opportunity to add, drop or change existing coverage.

 Next opportunity to make a change without a qualifying event will be May 2013 for a July 1, 2013 effective date.

Questions?