Transcript Wellness and U - University of Montana

UNIVERSITY OF MONTANA
FY2016 CHOICES
Benefits Presentation
by
Terri Phillips, Associate VP/HRS
TM
Annual Benefit
Election Period
Online Elections:
April 27, 2015
THRU
May 20, 2015
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Agenda for Today
 IMPORTANT CHANGES FOR FY2016
1.
2.
3.
4.
Medical Benefit Improvements
Flexible Spending Account Changes
New Tax Advantaged Accounts (TAA)
Wellness Incentive Program
 Benefit Changes and Your Decisions for FY2016
1. Medical, Dental, and Vision Hardware
2. Rates and Fees
 Time Frame for Making Benefit Change Decisions
April 27, 2015 thru May 20, 2015
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BENEFIT PLAN BASICS
 For FY2016, the employer contribution to health insurance will
remain $887 per month. Any increase to the employer
contribution is a decision that is made by the Montana Legislature
and there is no evidence that will happen this session.
 Our self funded plan has two sources of revenue – the employer
contribution as mandated by the State of Montana and the out of
pocket contributions that are charged to members to cover
children, spouses and adult dependents.
 The provisions of the plan are the same regardless of which
insurance administrator you choose – Allegiance, Blue Cross/Blue
Shield, or PacificSource. The difference between the three is with
the doctors, hospitals and providers who have entered into
discount arrangements with those administrators. (NOTE:
PacificSource does not include St. Patrick’s Hospital as an in-network
provider).
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Our Plan is Operating Under
“Closed Enrollment”
 You
cannot add any spouses or adult dependents
to the mandatory insurance items.
 You
may add children who qualify up to age 26 to
the mandatory insurance plan items.
 You
can delete a spouse or adult dependent from
the plan but you will not be able to add them back
on until such time that we have another open
enrollment period or you have a qualifying event.
 Will
we ever have “open enrollment” again? With
current, on-going changes to health insurance from
the Affordable Care Act, it is hard to predict – not
in the near future.
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ELIGIBILITY
Dependents up to age 26 may be enrolled
annually in Medical, Dental, and/or Vision
hardware benefits. (Does not include spouses).


Your dependents must be eligible according to
criteria in the Summary Plan document.

Mid-year dis-enrollment may only occur with a
“qualifying event” or during a “Special Enrollment
Period.”
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Qualifying Event Information
 New employees will have 30 days to enroll themselves and eligible dependents.
 Within 31days of the birth, adoption, or affidavit of intent to adopt, add a
dependent child. Coverage begins on the date of birth of child(ren).
 For the following Qualifying Events, coverage begins on the 1st
day of the month following the date HRS receives the valid
mid-year change form with appropriate documentation:
1. Within 63 days of a family status change (marriage, divorce, legal separation,
attestation of a domestic partnership, death, etc.) plan members may enroll or
drop a dependent.
2. Within 63 days of the loss of eligibility for reasons other than non-payment of
premiums (e.g. loss of job, elimination of other coverage, becoming ineligible
for programs such as Medicaid or Healthy Montana Kids, or other significant
adverse event), add a dependent.
3. With a child support order or change in support which makes an MUS plan
member responsible for the medical coverage of a dependent child.
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Health Plans and Networks
To receive your best benefits,
STAY IN-NETWORK
with your health plan!!
Allegiance: 1-877-778-8600
Website: www.abpmtpa.com/mus
Blue Cross and Blue Shield: 1-800-820-1674
Website: www.bcbsmt.com
PacificSource: 1-877-590-1596
Website: www.PacificSource.com/MUS
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Health Insurance Facts
 Managed
Care copays (flat dollar amounts that
you pay for services) remain the same – for
example: $15/office visit for “in-network”
providers (these dollars count toward your out
of pocket maximum).
 Managed
Care plans all have networks they work
with for out-of-state (national) coverage.
Allegiance works with Cigna
Blue Cross/Blue Shield works with Blue Card
Pacific Source works with First Health & First Choice
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Balanced Billing and Insurance
Deductibles

When you remain “in-network” you get the best possible use
of your insurance dollars. You could complete the “innetwork” deductible and only have a maximum out of pocket
cost for medical bills of $3,500 (Person) or $7,000 (Family).

When you go “out-of-network” you have a second deductible
and out of pocket maximum that you must meet – the “innetwork” and “out-of-network” costs do NOT add together.

When you go “out-of-network” you could also face the
concept of “balanced billing”. This means the provider has no
agreement with the plan administrator in regard to how much
they can charge for a service. They will charge whatever they
want, the insurance plan will only cover the allowed portion,
and you will pay the rest out of pocket – this can be VERY
EXPENSIVE.
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MEDICAL PLAN CHANGES
 Improvements to Complementary Health
Care Services:
Acupuncture
Chiropractic
Massage Therapy (New!)
Benefits have a $15 co-pay
and each service allows
30 visits per year.
 Naturopathic services have a $15 co-pay, no visit
limit.
 The patient is responsible for any difference between
the allowable amount for a service and the charge.

Improvements to Miscellaneous Services
Dietary/Nutritional Counseling, Obesity Management,
TMJ and Infertility Treatment now have an out-ofnetwork coinsurance of 35%.

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USE IN-NETWORK PROVIDERS
Be sure to use “In-Network” providers to ensure you
do not incur “balance billing” charges.
 Network participation by providers is
changing in the health care market.

Always check - DO NOT assume
participation - your doctor may have dropped
participation in the network.

Check with your medical plan provider,
the MUS Benefits office, or the UM HRS
office, if you need help finding “in-network”
providers.
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FLEXIBLE SPENDING ACCOUNT CHANGES

Beginning in FY2016, there are significant changes to how
we have processed medical Flexible Spending Accounts
(FSAs) based on federal regulations:
1.
Employees will no longer be permitted to direct their
excess employer contribution (state share) to a flexible
spending account.
2.
The maximum amount an employee can deposit from
their paycheck into a flexible spending account
increases to $2,550 for the FY2016 plan year.
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FLEXIBLE SPENDING ACCOUNT CHANGES

With the limitations on the manner and amount of employer
funds that may be placed in a medical FSA, MUS Choices
will now offer two account options for employees:
1.
Medical FSA option funded only with employee
contributions from paycheck (up to $2,550 per year).
2.
NEW! A Tax Advantaged Account (TAA)
•
$750 employer contribution in FY2016
•
Same allowable expenditures as a medical FSA
•
No “Use-it-or-Lose-it” annual requirement
•
Account balance is portable upon termination of
employment
•
Must be elected during online benefits election – Not
automatic.
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MEDICAL SPENDING ACCOUNTS for FY2016
Tax Advantaged Account (TAA) Things to Know....




Only employer funds can be placed in a TAA--employee
funds cannot be contributed (use the FSA instead).
If your spouse has coverage through a HSA or has a highdeductible health plan, you may wish to consult with a tax
advisor about when you can use the TAA.
The TAA will be funded for FY2016 and MUS Benefits will
review available funds to determine whether contributions
can be made in the future.
Account balances are not “use-it-or-lose-it “and can
continue up to 24 months following the last day of
employment with MUS (for terminating or retiring
employees) and up to 24 months following the date that
MUS Benefits ceases to make employer contributions
(including Wellness Incentive funds).
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MEDICAL SPENDING ACCOUNTS FY2016
NEW Arrangement for Medical Spending Accounts
TAX ADVANTAGED ACCOUNT (TAA)
• $750 Employer Contribution $$
• $250/$500 Wellness Incentive Funds
will be placed in TAA instead of FSA.
TAA
FLEXIBLE SPENDING ACCOUNT
• Up to $2,550 of Employee
contribution $$ from your
paycheck (pre-tax).
Medical
FSA
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MEDICAL SPENDING ACCOUNTS FY2016

WELLNESS INCENTIVE PROGRAM

1.
2.
3.
Benefits Eligible Employees Who Completed in 2014:
A WellCheck in 2014 (biometric screening and blood draw),
Took the Well-Being Assessment on Wellness Incentive
program website,
Reached Explorer level = 406 points during 2014,
You will receive the $250/$500* Wellness Incentive funds to your
TAA on July 1, 2015.

* Employees whose spouses/adult dependents completed a
WellCheck will receive an additional $250 in their employee TAA.

Maximum of $500 per individual household enrolled in the MUS
Plan.
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WELLNESS INCENTIVE PROGRAM



Discover great health with MUS Wellness and blaze a trail to your
best life! Participate in MUS Wellness and earn points towards
rewards. Sign up at https://muswell.limeade.com/Home .
Wellness Incentive “Limeade” program runs the 2015 calendar
year: January1, 2015 to December 27, 2015.
You can earn a Fitbit Health Tracker, a $250/$500* tax advantaged
incentive account distribution, a $150 Amazon Gift Card, a special
Expedition Leader hoodie and plaque to show off your success, and
be entered into a January 2016 raffle to win a $500 REI gift card.
*Note - If a covered spouse/adult dependent participates in the WellCheck Health Screenings,
you can each earn a $250 incentive account contribution ($500 maximum).


Must participate in WellCheck in 2015, take the Wellbeing
Assessment online and reach 1,000 points to be eligible for the
$250/$500 incentive award into the TAA. Award will be available
on July 1, 2016.
Email notification of FitBit will come after 2015 WellCheck points
are added to your profile--may take up to 8 weeks. Continue to
earn points while you wait!
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MEDICAL SPENDING ACCOUNTS FY2016
$500 Annual FSA Roll-Over
If you have funds remaining in your FSA account as of
June 30, 2015, the rollover provision is:

1.
These funds will be placed in your FSA sometime in
October 2015 after FY2015 accounting reconciliation is
completed by Allegiance Flex.
2.
You may incur expenses against these funds
beginning July 1, 2015. However, the funds to pay
expenses from the roll-over will not be available until
they are deposited in to your FSA sometime in October
2015.
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LIFE INSURANCE ELECTIONS


Evidence of Insurability Now Required When:
1.
An Active employee wishes to add Optional
Supplemental Life Insurance in an amount above
$300,000 or increase existing coverage more than
one increment of $25,000 annually.
2.
Adding Optional Supplemental Dependent Life
for a spouse if not enrolled during the new hire
election.
Optional Supplemental Life and Optional AD&D
Coverage premiums are paid on an after-tax
basis.
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VISION HARDWARE BENEFIT
Optional Vision Hardware now covers ONLY
hardware (frames, lenses, and contacts).


Eye Exam is provided as part of the medical plan.
(Bring your medical card to your eye exam).

No need to use a network for purchasing
hardware – simply select a place to purchase
and then submit claim form to Blue Cross & Blue
Shield.

Claim form copies are available in the HRS office in
Lommasson 252 or on the HRS website at:
www.umt.edu/hrs/benefits/insurance
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Healthy Montana Kids is available for
qualifying MUS employees!
 The State of Montana allows the children of Montana
University System (MUS) and State of Montana employees to
participate in the Healthy Montana Kids program.
 This is a graduated program based on household income and
number of dependents – it could provide savings for your
family.
 You can decide to keep your child(ren) on the MUS insurance
plan.
 For more information, contact your campus HRS office or go to
ww.hmk.mt.gov or call 1-877-543-7669.
 The MUS Hardship Waiver for coverage for children is still
available – you must apply for HMK and be denied before
applying for the MUS waiver. This must be applied for
every year.
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Why is it important to complete
Annual Benefit Election?





Dependent children are eligible until age 26 – if you have
children you previously had to drop, you can now add them
back on until age 26.
The medical plan monthly costs have increased – the plan you
were in last year may no longer be the best plan for you.
The health care providers that you use may or may not still be
“in network” for the plan you were in last year- providers do
change.
Your goal is to stay “in network” to make the best use of
your money – going “out of network” will cost you more.
Flexible spending accounts for both medical and dependent
care DO NOT ROLL FORWARD – you must ELECT that
option every year.
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CHANGES to CHOICES
 You MUST make a positive election for the TAA. Sign on to
your CyberBear account during Annual Benefits Election, click on
“Benefits Enrollment” to make your elections. Failure to do so
will result in you not receiving the $750 dollars or your Wellness
Incentive award in your TAA.
 Reminder - Closed enrollment for spouses in FY2016 (qualifying
event required to add spouses – children to age 26 may be added).
 If you do not submit any changes, then you will be re-enrolled
in the prior year benefit elections (except for FLEX or TAA).
 FLEX PLAN ENROLLMENT and TAA ELECTION
1. You must re-enroll in Flex each year and specify the dollars you
wish to go into your account from your paycheck.
2. Remember that Flex is “USE IT OR LOSE IT”! Rollover provision
permits up to $500 to carry forward to the following year.
3. WellCheck Incentive awards of up to $500 per household is
available with the funds deposited into a TAA.
4. TAA MUST BE ELECTED BY EMPLOYEE ANNUALLY.
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Annual Benefits Elections
Online Facts
 Online
Annual Benefits Election opens on April
27, 2015 and closes on May 20, 2015.
 Come
to LA139 Computer Lab for online
election assistance – check the emailed
schedule.
 Please
follow the instructions for using online
enrollment that will be available on the HRS
website – it WILL make the process easier.
 You
will log on to CyberBear using your
NetID and password. Most likely, you may be
required to change your password.
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Be sure to do these things 
Online annual benefit election process – hit the SUBMIT
button when you are done.

No signature page so be sure to print the “Calculate Cost”
page for your records. If it isn’t what you elected, check it
and/or contact HRS.

If you want to contribute your own paycheck funds (pre-tax)
to a Flexible Spending Account you must ELECT it each year –
it is not automatic.

Check covered dependents and provide correct SSN
and birthdate.

Make sure to ELECT the TAA so you receive the $750
contribution and any Wellness Incentive funds to that
account.
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QUESTIONS?
Thank you for your time!
HUMAN RESOURCE SERVICES
Office: 406-243-6766
Email: [email protected]
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