Transcript 2013 Benefit Open Enrollment

2015 Benefit Open Enrollment
 November 1st through November 21st
Jason Dempster
Bob Graf
Associate Director, Compensation & Benefits
Director, Employment Services
Welcome!
Health
Insurance
Wellness
Dental
Insurance
TimeAway
Long-Term
Care
Life
Insurance
Benefits
Disability
Insurance
Flexible
Spending
Accounts
Retirement
Plans
MetLaw
Employee
Assistance
Program
Today’s Focus
 Affordable Care Act Update & Implications for Macalester
 Review Changes to:
 Dental Plan
 Health Plan
 FSA Plan
 Wellness Program Updates and Upcoming Opportunities
 Overview and Action Items for Benefits
 Time for Q & A
Guiding Principles
Congruent with
changing
delivery models
Congruent with
the market
Eye on
Wellness or
Wellbeing
User friendly
and ease in
understanding
Administrative
Efficiency
Cost efficiency
or savings for
both
faculty/staff &
Macalester
Affordable
Care Act
Supports
Macalester’s
transition to
self-insurance
A Little Trivia
Q: What percentage of employees elect Comprehensive Dental?
A: 65% of dental participants elect Comprehensive Dental
35% of dental participants elect Preventative Dental
Q: Have prescription drugs costs increased?
A: Yes, Pharmacy spend increased 10.5% over the course of the last year
Q: Do FSA (Flexible Spending Account) funds roll over from year to year?
A: Yes and No. Earlier this year, the IRS provided additional guidance to soften the
“use it or lose it” provision. We subsequently updated our FSA plans to allow
up to $500 to be automatically carryover from year to year.
 The rollover provision only applies to health FSA
 The carryover provision does not prevent participants for spending all of
the funds they have set aside each year.
Q: How many health care claims have we had over $25,000 in the last 18 months
A: 37
Affordable Care Act
Fees (taxes)
•
•
Affordability Standard
• <9.56% of employee’s income
• $3,000 penalty
PCORI Fee
Transitional Reinsurance Fee
Cadillac Tax
• Total plan costs cannot exceed limits
• 40% tax in amounts in excess of limits
Health Insurance
Affordability Standard
•
•
•
•
•
Health plan must cover at least 60% of health care expenses
Coverage must be offered to full-time employees (≥1511.25 hrs.) or
$2,000 per full-time employee penalty
Utilizes the employer’s lowest cost plan (i.e. HDHP)
Employee’s share of the premium must be less than 9.56% of employee’s
household income
Example:
$20,000/yr. – Salary
x 9.56%
$ 1,912.00
$90.18/mo. = HDHP Premium
$1,082.16 = Annualized Premium
Cadillac Tax Provision – 2018
• Plan costs that exceed defined thresholds will be subject
to a 40 percent nondeductible tax on plan costs in excess
of the thresholds: $10,200 for single coverage or
$27,500 for family coverage
• Currently the tax includes all employer and employee
amounts paid for:
o Medical, including pre-tax employee premiums
o Contributions made to health FSAs and HSAs
• Additional guidance will be released over the course of
the next few years
• We will continue to monitor and take action to update
our health plans accordingly
Fees
Transitional Reinsurance Fee
PCORI Fee
Begins in 2014
Began in 2013
$63 per covered member per year
$2 per covered member in 2014
Equates to ~$66,500
Equated to $2,105
Fee can be assigned to employee
100% paid by Macalester
Fee ceases after 2016
$2 + inflation factor through 2019
and then sunsets
Dental Insurance
Comprehensive Dental
Preventative Dental
Service/Feature
Annual Maximum Benefit
Annual Deductible
Diagnostic & Preventive
Exams, cleanings, x-rays, sealants
PPO
Unlimited
$0
Delta Premier Out of Network
Unlimited
$0
Unlimited
$0
Covered at 100% Covered at 100% Covered at 100%
Service/Feature
Delta Premier Out of Network
Annual Max Benefit
Annual Deductible
$1,500
$0/person;
$1,250
$25/person;
$1,000
$50/person;
Not applicable to preventive and
diagnostics
$0/family
$75/family
$150/family
Diagnostic & Preventive
Exams, cleanings, x-rays, sealants
Basic Services
Fillings, Emergency treatment for pain
Endodontics, Periodontics
Root canals
No change in plan design for 2015
PPO
Oral Surgery
Extractions
Prosthetics
Denture adjustments, repairs
Major Restoratives
Dentures, Resins, Crowns
Orthodontics
$1,000 lifetime max per child
Covered at 100% Covered at 100% Covered at 100%
Covered at 80% Covered at 50% Covered at 50%
Covered at 75% Covered at 50% Covered at 50%
Covered at 75% Covered at 50% Covered at 50%
Covered at 50% Covered at 50%
Not Covered
Covered at 50% Covered at 50%
Not Covered
Covered at 50% Covered at 50%
Not Covered
Dental Insurance
With more mature claims data we are able to more accurately determine
the costs by coverage level
Current Preventative Dental Rates
2015 Preventative Dental Rates
Per EE Premium Annual Expense % Change
$
3.32
$
39.82
$
10.08
$
120.92
-
Per EE Premium Annual Expense % Change
$
3.19
$
38.26
-4.08%
$
9.58
$
114.95
-5.20%
$
14.93
$
179.14
2.07%
$
14.62
$
175.43
-
Current Comprehensive Dental Rates
2015 Comprehensive Dental Rates
Per EE Premium Annual Expense % Change
$
25.83
$
309.91
$
56.26
$
675.13
-
Per EE Premium Annual Expense % Change
$
24.15
$
289.77
-6.95%
$
52.44
$
629.33
-7.28%
$
84.00
$ 1,008.00
2.50%
$
81.90
$
982.80
-
If interested in updating your election, contact Employment Services
Health Insurance
COVERAGE FOR:
HDHP (2015)
In-Network*
Out-of-Network
PPO (201)
In-Network*
Out-of-Network
CALENDAR YEAR DEDUCTIBLE
Single
$2,600/person
$5,400/person
Family
$5,200/family
$10,800/family
n/a
n/a
$300
$900
100% of charges incurred
75% of charges incurred
100 % of charges incurred
No coverage
Deductible, then 100%
Deductible, then 75%
The first 3 visits free, then
$10 co-pay per visit
thereafter
No coverage
Deductible, then 100%
Deductible, then 75%
$10 co-pay, then 100%
60% of charges incurred
ALLERGY INJECTIONS
Deductible, then 100%
Deductible, then 75%
No out of pocket cost
60% of charges incurred
PRIMARY CARE OFFICE VISITS
MD Visits (includes ancillary services
received in provider’s office and palliative
care)
Deductible, then 100%
Deductible, then 75%
$30 co-pay, then 100%
60% of charges incurred
BEHAVIORAL HEALTH/SUBSTANCE
ABUSE - Outpatient
Deductible, then 100%
Deductible, then 75%
$30 co-pay, then 100%
60% of charges incurred
URGENT CARE VISITS
Deductible, then 100%
Deductible, then 100%
$50 co-pay, then 100%
$50 co-pay, then 100%
Deductible, then 100%
Deductible, then 100%
$50 co-pay, then 100%
$50 co-pay, then 100%
AMBULANCE SERVICES
Deductible, then 100%
Deductible, then 75%
80% of charges incurred
60% of charges incurred
INPATIENT HOSPITALIZATION
Deductible, then 100%
Deductible, then 75%
80% of charges incurred
60% of charges incurred
Deductible, then 100%
Deductible, then 100%
$100 co-pay, then 100%
$100 co-pay, then 100%
PREVENTIVE CARE SERVICES
Routine Health Exams, Cancer Screening,
Eye and Hearing Exams, Immunizations,
Prenatal & Postnatal Services
E-visits - virtuwell
CONVENIENCE CLINICS
No change
in plan
design for
2015
Minute Clinic
SPECIALTY OFFICE VISITS
Chiropractic, Physical Therapy, Speech
Therapy, Occupational Therapy,
Acupuncture, etc.
EMERGENCY ROOM VISITS
(coverage for emergency conditions only)
ANNUAL OUT-OF-POCKET MAX
Single - Medical
$2,600/person
$10,400/person
$2,600/person
$10,400/person
Family Medical
$5,200/family
$20,800/family
$5,200/family
$20,800/family
PRESCRIPTION DRUGS
Generic Formulary Drugs
- 31 day supply
Brand Formulary Drugs
- 31 day supply
Specialty Drugs - Brand Non-Formulary
- 31 day supply
Mail Order - Generic Formulary Drugs
- 90 day supply
Mail Order - Brand Formulary Drugs
- 90 day supply
OTHER COVERED SERVICES
LIFETIME MAXIMUM
$12 co-pay and then 100%
thereafter
$35 co-pay and then 100%
thereafter
20% co-pay up to $300 per
perscription, 100%
covered thereafter
$24 co-pay and then 100%
thereafter
$70 co-pay and then 100%
thereafter
Deductible, then 100%
Deductible, then 75%
60% of charges incurred
Deductible, then 100%
Deductible, then 75%
Deductible, then 100%
Deductible, then 75%
Deductible, then 100%
Deductible, then 75%
Deductible, then 100%
Deductible, then 75%
Deductible, then 100%
Deductible, then 75%
80% of charges incurred
60% of charges incurred
Unlimited
$1,000,000
Unlimited
$1,000,000
60% of charges incurred
60% of charges incurred
60% of charges incurred
60% of charges incurred
Health Insurance
Average Expense
$500
$200
$0.00
$45
$79
$120
$150
Employee Assistance Program
Macalester provides cost-free professional consultation and referral services for
employees who are experiencing work and personal-related difficulties


Staffed by experienced clinicians with professional degrees
Available 24 hours a day, seven days a week
Confidential consultation is provided including:

Work relationships
Conflict resolution
Mental health
Interpersonal relationships
Family
Loss and bereavement
Alcohol/substance abuse
Finding child or elder care
Financial information, resources
and tools
Legal information, resources and
consultations
Access to our Employee Assistance Program is either
 online at guidanceresources.com or
 by phone at (877)327-4753
 Macalester’s Company ID is: ZB3042Q
Health Savings Account (HSA)
What is a Health Savings Account (HSA)?
 Contributions are made on a “pre-tax” basis through payroll deductions
 Health Savings Accounts are only available to those who have elected the
High Deductible Health Plan (HDHP)
 Macalester highly funds HSA’s through employer contributions to your HSA
account
 A HSA is a true savings account
 Does not have the “use it or lose it” clause
Health Savings Account (HSA) Contributions
2015 HSA Contributions
Mac Monthly
EE Monthly
Contribution
Contribution
Level 2
Level 2
Mac Monthly
Contribution
Level 1
EE Monthly
Contribution
Level 1
Employee Only
$100.00
$0.00
$121.75
Employee + (1)
$200.00
$0.00
Employee + (2+)
$200.00
$0.00
Full-Time
.75 FTE and above
Mac Monthly
Contribution
Level 3
EE Monthly
Contribution
Level 3
$21.75
$143.50
$43.50
$243.50
$43.50
$287.00
$87.00
$243.50
$43.50
$287.00
$87.00
Maximum annual combined matched contribution of:
 $2,244 for Employee Only
 $4,488 for EE+1 & Family
Employee Only
Family
Annual
Max Amount for
Out-of-Pocket
2015
Unmatched
Maximum
IRS Limits Contribution
$2,600
$3,350
$750
$5,200
$6,650
$1,450
Open enrollment is an ideal time to review and update your
HSA contributions
Prescription Drugs
Q: Do prescription drug costs vary by pharmacy?
A: Yes. Each pharmacy has negotiated a different cost for each prescription with
HealthPartners
Q: Where is the most expensive pharmacy to get a prescription filled?
A: On average, the most expensive pharmacy is Walgreens, then CVS
Q: Where can I find out where to get my prescription filled at the lowest cost?
A: Go to www.healthpartners.com and log into your account
 Once logged in, click on the “Pharmacy Tab” and
 Scroll down and click on the “Drug Cost Calculator”
Health Insurance - Premiums
In determining our premiums for 2014, consideration provided to:
 Regression analysis of 14 years of health plan expenses
 Health plan reserve funding
 ACA implications
 Health care trends and utilization
Current HDHP Rates
Per EE Premium
$
$
$
2015 HDHP Rates
Annual Expense % Change
84.00 $ 1,008.04
252.62 $ 3,031.44
368.94 $ 4,427.30
-
Per EE Premium
$
$
$
$
$
$
Annual Expense % Change
127.13 $ 1,525.51
386.53 $ 4,638.32
565.69 $ 6,788.33
90.19 $ 1,082.31
271.69 $ 3,260.30
396.90 $ 4,762.81
% Change
7.37%
7.55%
7.58%
2015 PPO Rates
Current PPO Rates
Per EE Premium
Annual Expense
-
Per EE Premium
$
$
$
Annual Expense
134.35 $ 1,612.20
408.85 $ 4,906.17
598.44 $ 7,181.33
% Change
5.68%
5.77%
5.79%
If interested in updating your election, contact Employment Services
Flexible Spending Accounts
 Change to “Use-it or Lose-it”
 The IRS amendment designed to soften the “use it or lose it” provision
 For the convenience account holders, Employment Services will
automatically assume that the $500 carryover be implemented with each
account
 May “opt out” by completing Carryover Opt Out Provision form
 The carryover provision does not prevent participants from spending all the
money they have set aside each year
 Any dollars over and above the $500 limit as of the end of the plan year, will
be forfeited in the traditional manner associated with these accounts, per
IRS regulation
 This change only applies to health care reimbursement accounts.
 It does not apply to money set aside for dependent care reimbursement
accounts
Flexible Spending Accounts
Health Care Expense Reimbursement
 The annual limit for Health FSA for 2015 is $2,500
 Remember, you cannot utilize FSA funds for over-the counter items
 Elections from $120 up to $2,500 per year
Dependent Care Reimbursement
 Elections from $120 up to $5,000 per year
 All participants must reenroll annually during open enrollment
 You can elect to enroll or change coverage levels during open enrollment through
the online open enrollment system
Flexible Spending Accounts
Important Facts:
 The flex plan year runs from January 1st through December 31st
 Plan year contributions cannot be changed unless there is a “qualifying
life event” (QLE). Changes must be made within 30 days of event
 Claims for reimbursement must be submitted by March 31, 2015
 Elect Conservatively – The “use it or lose it clause”


(Note: This is the primary difference between an FSA and an HSA.)
All participants must reenroll annually during open enrollment
Healthcare Expenses - Sample
PPO
HDHP
Difference
Family Coverage
Family Coverage
Family Coverage
12 Months of Premiums
Maximum Out-of-Pocket
No HSA Contributions
Total
$7,181.33
$5,200.00
$0.00
$12,381.33
12 Months of Premiums
Maximum Out-of-Pocket
12 Months EE Contributions
12 Months Mac Contributions
Total
$4,762.81
$5,200.00
$1,044.00
-$3,444.00
$7,562.81
12 Months of Premiums
Maximum Out-of-Pocket
EE HSA Contributions
Mac HSA Contributions
Total
-$2,418.51
$0.00
$1,044.00
-$3,444.00
-$4,818.51
 Illustration reflects a “worst-case scenario” such as hospitalization or expensive
treatment and is based on “In-Network” provider utilization
 PPO participants could elect to participate in Health Flexible Spending Account
(FSA) to offset Out-of-Pocket expenses
Open Enrollment might be an ideal time to review your
individual health needs and explore which health plan
best fits your needs
Wellness & Well-being
Activity from the past year
 3 incentives were available; (1) Blood pressure check, (2) Know your
numbers and (3) Health Assessment with activity
 Movember
 Numerous educational offerings
 Weight No More groups
 Wellness Walkers group
 Farmers Market
 Cooks of Crocus Hill class
 Retirement Planning
Coaching
 Averages 24 people per month with 1-2 visits per person
 Available 3 days a week on campus
Health Assessment Results
2014
Health Factor
Percent at high risk or
diagnosed
High Blood Pressure
40.7
High Cholesterol
23.9
Depression
24.3
Low Fruits & Veg Servings Daily
71.7
Low Physical Activity
23.0
Overweight
53.1
Tobacco Use
6.2
Insufficient Sleep
28.3
Unhealthy Stress
11.5
Moderate or High Risk of
Diabetes or Heart Disease
53.3
Health Assessment Results
2014
Health Factor
Percent at high risk or diagnosed
Emotional Health Concerns
54.9
Back Pain
39.8
Verbal, Emotional or Physical
Abuse
25 individuals
Health Assessment
Working with Kelly
Health Factor
Percent Change
Normal Blood Pressure
2.5 increase
Missed Work Due to Health
4.5 decrease
Feeling More Productive
3 increase
Emotional Health Concerns
2.5 decrease
Stress
2 decrease
Back Pain
6 decrease
Insufficient Sleep
8 decrease
The Year of YOU
Give yourself permission to put
yourself first
Establish one goal that’s focused on your
personal well-being
Wellness Incentive
Take the Health Assessment
+
Complete an Eligible Well-being Activity
$50
Deadline is April 30, 2015
Wellness Incentive
 Complete the Health Assessment November 1st through
November 21st
 Weekly Drawing for Fitbit
Complete your Health Assessment early for
more chances to win!
Health Assessment
Online access through healthpartners.com/wellbeing
Quick, easy and confidential
Goal Setting and Action Plan feature
• allows you to set a personal health goal
• receive a personalized action plan that identifies programs
based on your areas of improvement and readiness to change
Eligible Well-being Activities
Onsite Wellness Coaching with Kelly Fang
Completion criteria: meet with Kelly at least once to
discuss your HA results and well-being goal.
Coaching topics include:
•
•
•
•
•
•
•
Weight loss
Quitting smoking
Stress & Work/life balance
Exercise
Nutrition
Back health
Sleep
Eligible Well-being Activities
Online and MePlus Mobile Tracking Programs
Completion criteria: track once per week for 8 weeks
Tracking is now available via the
mobile application
for the iPhone, iPad, or Android device.
•
•
•
•
•
10,000 Steps® (Can now sync your MePlus App with your FitBit!)
Sleep program
Stress program
Tobacco program
Weight eProgram (online only)
Eligible Well-being Activities
Regular use of the
Leonard Center
Completion criteria:
Workout or participate in
WHAM classes at least
12 times a month for a
minimum of two months
between November 1,
2014 and April 31, 2015
Basic Life and AD&D Insurance
Macalester provides both Basic Life and Accidental Death and Dismemberment
(AD&D) life insurance to all benefit eligible faculty and staff for free

Please note payroll taxes will be deducted on premiums for basic life
amounts over $50,000 per IRS regulations

Everyone is encouraged to review and update life insurance beneficiaries

Visit Employment Services to update your life insurance beneficiaries
Supplemental Life Insurance
Macalester offers benefit eligible faculty and staff voluntary life insurance and AD&D
 This plan is paid by you and intended to supplement the provided Basic Life and
AD&D Insurance
 Faculty and staff may purchase up to 5x their salary in increments of $10,000
 New enrollments or amounts elected above $200,000 are subject to an evidence
of insurability determination
 You can elect to enroll or change coverage levels during open enrollment
 You can also change life insurance beneficiaries during open enrollment
 Visit Employment Services to:
 Enroll, change or end your supplemental life insurance election
 Update your life insurance beneficiaries
Dependent Life Insurance
Macalester offers benefit eligible faculty and staff voluntary Dependent Life Insurance
 For a flat rate of $4.50 per month
 Spouses are covered by $25,000 of term life insurance
 Children 6 months to age 25 are covered by $10,000 term life insurance
 Children from birth to 6 months old are covered by $1,000 of term life insurance
 You can elect to enroll or change coverage levels during open enrollment
 Visit Employment Services to enroll or end dependent life insurance
Long-Term Disability Insurance
Macalester provides faculty and staff with an FTE of 0.75 or greater
Long-Term Disability (LTD) Insurance
 Long-Term Disability begins after 90 days
 Beginning at day 90 of a disability, LTD pays
o 60% of monthly earnings for faculty and staff
o 66.67% of monthly earnings for CBU employees
 There is no action for you to take during open enrollment to elect this benefit
Short-Term Disability Insurance
Macalester offers benefit eligible staff (no faculty) Short-Term Disability Insurance
which may provide coverage between day one and day 90 of a disability
 Short-Term Disability Insurance is paid by you and intended to cover qualifying
disabilities
 Rates are dependent on age, waiting period and coverage level
 Staff can enroll in this benefit during open enrollment by completing a Sun Life
Short-Term Disability Enrollment form available online and through Employment
Services
 Election amounts do not change automatically each year as your pay changes.
All Staff are encouraged to review and update their election amount annually
 Visit Employment Services to update or enroll
MetLaw
 MetLaw is a voluntary legal services benefit available to all faculty and staff at a
.5 FTE and above
 Employees who elect this benefit are responsible for paying all premiums ($18/mo.)
 MetLaw offers employees unlimited telephone advice and office consultations on
virtually any personal legal matter. Plus a wide variety of fully covered legal
services, including:
 Civil litigation defense
 Debt matters and identity theft defense
 Purchase, sale, or refinancing of your home
 Traffic ticket defense
 Wills, living wills, powers of attorney and trusts
 And much more
 You can enroll in this benefit during open enrollment through the online open
enrollment system, but it does require a one-year commitment
Retirement
Supplemental Retirement Plan:
 All faculty and staff are eligible to contribute to their retirement
 There is no waiting period
 Can contribute any amount up to the IRS limits
 Contributions can be made on a pre-tax or post-tax basis
 The minimum annual election is $200
 You can elect to enroll or change election levels at any time and during open
enrollment through the online open enrollment system
Retirement
Regular Retirement Plan:
 Available to all faculty and staff (excluding CBU) who have completed one year
of service with Macalester & have appointed hours of 1,000 or greater
 Macalester contributes 10% of your regular salary to your retirement plan
 There is no action for you to take during open enrollment to elect this benefit
Long-Term Care Insurance
 Long-Term Care Insurance is designed to pay for a variety of in-home, assisted
living and nursing home services, should you be unable to care for yourself
due to an accident, illness or the effects of aging
 You are responsible for paying all premiums for this benefit
 Full medical underwriting required
 Learn more by visiting the Benefits webpage
 Enroll by calling 1-855-558-1726 or visiting the dedicated webpage
Benefits Fair
 This year we are sponsoring the Macalester College Benefit Fair on:
 Tuesday, November 4, 2014
 10:00 AM to 4:00 PM
 Kagin Commons, Alexander G. Hall Ballroom
 When attending the Benefits Fair, you can meet and talk directly with
representatives from our benefit vendors and obtain answers to your benefits
questions
 While at the Benefits Fair, Register to win an iPad Mini at the Employment
Services table
 Register to win
 Prizes from our benefit vendors including an iPod
 Gift cards/gift certificates from local merchants and vendors around Macalester
Online Open Enrollment
Process:
1. Log onto the 1600grand portal -- http://1600grand.macalester.edu/
2. Click on the Employment/My Job tab
3. Look for the “Employment Details” channel; click on the Open Enrollment
link
4. Follow the written or video directions
 YOU MUST click on the “Complete” button to finalize your benefit elections
 Open Enrollment is November 1st through November 21st
Questions?
Open Enrollment is November 1st through November 21st