Transcript UPlan Update - University of Minnesota Twin Cities

2010 Open Enrollment Update
& UPlan Changes
For Calendar Year 2011
What’s in this presentation?
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What’s New for 2011
Open Enrollment Basics
UPlan Pharmacy Program Changes
Flexible Spending Accounts
2011 UPlan Rate Information
UPlan Life Insurance Changes and Rates
Wellness Program Highlights for 2011
Other UPlan Information
Open Enrollment Resources
2011 Plan Rates (charts)
What’s New for Open
Enrollment 2010?
What’s new for the
2010 Open Enrollment?
 New Pharmacy Benefit Manager – Prime Therapeutics
LLC
 Changes in eligible expenses for reimbursement in the
Health Care FSA
 Increase in Dental benefits annual per person
maximum from $1,500 to $1,800
 Increase in Life Insurance Rates for optional life
insurance
 Online scheduling for flu shots at campus clinics and
at the Employee Health & Benefit Fairs:
www.bhs.umn.edu/public-health/flu.htm
2010 Open Enrollment Basics
for January 1, 2011
What is Open Enrollment?
 Your annual opportunity to review your
benefit elections: November 1–30, 2010
 Employees make changes online at:
http://hrss.umn.edu/
 Additional information on Employee Benefits
Website at:
www.umn.edu/ohr/benefits/openenroll
What benefits can I change?
 Add or cancel Medical or elect a different
plan option
 Add or cancel Dental or elect a different
plan option
 Add, change, or cancel your dependents
 Elect to participate in the Health Care or
Dependent Daycare Flexible Spending
Accounts
What other benefits
can I change?
 Elect to participate in Voluntary Long-term
Disability coverage (Civil Service and
Represented Staff employees), or
 Increase or decrease your Long-term
Disability benefit amount
What if I do not want to
change anything this year?
 You do not need to go online and change
your elections
 Unless you are an FSA participant and want to
have an account for 2011
 To change your clinic election, call your
health plan directly
2010 is a voluntary Open Enrollment –
no changes required
Who can I cover on my
UPlan Medical & Dental Plans?
 Yourself
 Your spouse or registered same-sex
domestic partner
 Your dependent child or children to age 26
 Unmarried or married
 But not the spouse of a married child
 Click below to review detailed Dependent
Eligibility Definition
www.umn.edu/ohr/benefits/eligibility/index.html
Will we receive Open
Enrollment booklets this year?
 Open Enrollment booklets will be online
 Open Enrollment details will be covered in a
newsletter in late October, mailed to campus
address
 A limited number of booklets will be sent to:
 Employees who do not regularly use a computer for
their jobs
 Employees who are on a leave of absence
 Early Retirees
 Former employees on COBRA
 Former employees on separation agreements
Will I get new cards for 1/1/2011?
 You will receive a new pharmacy card from
Prime Therapeutics that will replace your
RxAmerica/CVS Caremark card. Bring it to the
pharmacy for prescriptions on or after 1/1/2011
 You will receive a new card if you enroll in a new
plan
 Medica, HealthPartners medical plan, and Delta
Dental will issue new cards
 HealthPartners dental plans will not issue new
cards
Will flu shots
be available this year?
 Seasonal Flu Shots will be available this year
 Flu shots will be available at campus flu clinics
and the Employee Health & Benefits Fairs
 Seasonal Flu shots available at MinuteClinic
 No copay for flu shots at your own medical clinic
 Flu shots at retail locations are full price and will
likely not be billed to your medical plan
 On the Twin Cities campus: schedule
appointment for flu shot online at:
www.bhs.umn.edu/public-health/flu.htm
2011 Changes
UPlan Pharmacy Program
What are the pharmacy
changes for 2011?
 Prime Therapeutics LLC, will be the new Pharmacy
Benefit Manager (PBM) on January 1, 2011
 Replaces CVS Caremark (formerly RxAmerica)
 New cards will be mailed in December with
information regarding Specialty Medications and
Mail Order Service, MTM
 Working to transfer all CVS Caremark Mail
Order prescriptions (with open refills) and Prior
Authorizations to Prime Therapeutics
Who is Prime Therapeutics LLC?
 New Pharmacy Benefit Manager chosen in a
scheduled Request for Proposal (RFP) process
 Headquartered in Eagan, Minnesota
 Broad Minnesota and National pharmacy network
 Network of 60,000 pharmacies that include
Walgreens, Target, Walmart, CVS, other chains
and many small retail pharmacies.
 Includes HealthPartners pharmacies
 Mail order facility in Irving, Texas
Will there be changes for
Specialty Medications?
 Fairview Specialty Pharmacy will become the
exclusive provider of most specialty medications
 They offer convenient delivery of medications and
additional support for members
 Members in the Twin Cities will be able to use any
Fairview pharmacy in the network, as well as the
home specialty delivery
 Statewide, Fairview will ship medications and in
Duluth, St. Mary’s and St. Luke’s pharmacies will
participate
What is a Specialty
Medication?
 Prescribed for complex or ongoing medical
conditions
 Usually are injected or infused
 Have unique storage or shipment
requirements
 Need education or additional support by a
healthcare professional
 Often not stocked at retail pharmacies
Are there any changes in
pharmacy copays for 2011?
Generic Plus
2010 – 2011
Copays
(No Changes)
$8
Brand Formulary
$25
Non-Formulary
$50
Not Covered
Full Cost
Am I eligible for the Medication
Therapy Management Program?
 Medication Therapy Management
 Members with four or more medications for
chronic conditions
 UPlan-paid consultations with MTM Pharmacist
 $8 copay reductions for all Generic Plus and
Brand medications for six months
 HSA members pay full cost of MTM
consultations
 www.umn.edu/ohr/benefits/
How do I contact
Prime Therapeutics and Fairview
Specialty Pharmacy?
 Prime Therapeutics Customer Service:
 1-800-727-6181
 Fairview Specialty Pharmacy Customer
Service:
 1-877-509-5115 and 612-672-5289
Flexible Spending Accounts
What are Flexible Spending Accounts?
 The UPlan includes:
 Health Care Flexible Spending Account
 Dependent Daycare Flexible Spending
Account
 Your contributions to both accounts are
made with pre-tax dollars
 No Federal, state, or Social Security taxes are
taken
No FSA Enrollment = No FSA for 2011
How much can I contribute to a
Flexible Spending Account?
 Health Care FSA
 Minimum: $100
 Maximum: $5,000
 Dependent Daycare FSA
 $5,000 maximum per family
www.umn.edu/ohr/benefits/openenroll
What else do I need to know about
Flexible Spending Accounts for 2011?
 2011 contributions are made during the
calendar year
 2011 claims can be incurred between
January 1, 2011, and March 15, 2012
 “Use it or lose it”
 Any amount remaining after March 15, 2012, is
forfeited
Note: 2010 claims can be incurred through
March 15, 2011
Are there any changes for Flexible
Spending Accounts for 2011?
 Section 9003 of the Affordable Care Act
established a new uniform definition of qualified
medical expenses effective on January 1, 2011
 Reimbursement will be made only if the medicine
or drug (1) requires a prescription, (2) is available
over the counter (OTC) and individual obtains
prescription, or (3) is insulin
 New rule affects purchases made in the 2½ month
grace period (1/1 to 3/15/11): must have a
prescription for OTC medication beginning 1/1/11
 Note: Insulin does not require a prescription
Are there any other changes for
Flexible Spending Accounts for 2011?
 New rule does not affect reimbursement for OTC
supplies and devices, such as contact lenses and
lens cleaning solutions, eyeglasses, prescription
and office copays, bandages, blood sugar test
kits, and out-of-pocket dental charges
 Be conservative in estimating your health care
account contributions for 2011: do not include
amounts for OTC medications unless you will
have a prescription from your physician
UPlan Rates for 2011
How are rates determined
for UPlan Medical options?
 UPlan: self-insured program
 Actuarial consultant: helps set rates
 Costs reflect actual cost of care: for
employees, early retirees, and dependents
 Costs include: Medical and pharmacy
claims, external administrative fees,
special insurance for high claims, internal
costs, MEDEX, wellness program
How is the Base Plan
the Key to Employee Cost?
 For Medical, employees pay:
 10% of Base Plan for Employee Only
 15% of Base Plan for Family Coverage
 Everything above the U’s Base Plan rate
contribution for “buy-up” (higher cost) plans
 Costs vary by Employee/Family tier
 Rate Information:
 Next section of this presentation.
 U & Your Benefits Newsletter — October 2010
What are the employee
Medical rate changes for 2011?
 Medical Rates
 Increase is 7.5 percent
 Same percent increase applies to all plans
2011 Medical Plan
Options
Are the same Medical Plans
available in 2011?
All Medical plans remain the same:
 Medica Elect & Essential – Twin Cities &
Duluth (Base Plan in Twin Cities and Duluth)
 Medica Choice Regional – Greater Minnesota
(Base Plan for Greater MN)
 U Classic Plus by HealthPartners
 Insights by Medica (tiered network)
 Medica Choice National (open network)
 Medica Health Savings Account (HSA) Plan
2011 Dental Plan
Options
Are the same Dental
Plans available in 2011?
 All Dental options remain the same for 2011
 The base plan choices are:
 Delta Dental PPO for the Twin Cities and Duluth
 Delta Dental Premier for Greater Minnesota
www.umn.edu/ohr/benefits/openenroll
What other Dental Plan
options are available in 2011?
 All other plans also remain the same:
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Delta Dental Premier
HealthPartners Dental
HealthPartners Dental Choice
University Choice
Check with Delta Dental or
HealthPartners to see whether your
dentist is in the plan you are considering
What are the employee
Dental rate changes for 2011?
 Dental Rates
 There is an increase of 3.4% due to an
increase in the out of pocket maximum. In
2011, the annual maximum benefit will
increase from $1,500 to $1,800
 Same % increase applies to all plans
UPlan Life Insurance
Changes and Rates
Effective January 1, 2011
Are there changes to the
UPlan Life Insurance Rates?
 Rates for Additional Employee and Spouse/Same
Sex Domestic Partner Insurance will increase by
10% in most age divisions on January 1, 2011
 New rates are based on the claims experience of
the University program
 Rates are guaranteed for three years
Wellness Program
Options for 2011
What Wellness Programs
will continue in 2011?
 Wellness Assessment: January through April 2011
 Health Improvement Programs
 Phone-based Health Coaching
 In-person Health Coaching – Twin Cities, Duluth,
and Morris
 Online Healthy Living Programs and 10,000 Steps®
walking program
 $65 Reward for Employee & Spouse/SSDP
 Fitness Rewards Program
 $20 monthly subsidy for health club participants
 Farmers Market: Minneapolis and Duluth
Are the Weight Management
Programs offered again in 2011?
 Weight Management Programs for 2011
 Create your Weight — offered through Fairview on Twin
Cities Campus
 Weight Watchers at Work — offered on The Twin Cities
and coordinate campuses with at least 20 participants
enrolled
 You pay up front: Wellness Program will reimburse you
in full if you attend 80% of sessions (Costs: $180 to $200)
 You can be reimbursed for up to three sessions per
year; six total lifetime reimbursements
 HIP (Health Improvement Program) available at UMD at
no cost-Weight Management Focused Program
 Details available at: www.wellness.umn.edu
Would you like to be a Wellness
Advocate for your Department?
Wellness Advocates Program:
 Looking for Wellness Advocate from each
College, Department
 Lead departmental Wellness initiatives
 Wellness Program to provide support, materials,
and training
 Plus special programs for wellness advocates
 Interested? Email to [email protected]
Disability Coverage
Who can enroll in Long-term
Disability during Open Enrollment?
 Civil Service and Represented Staff
Employees
 May enroll in or change the amount of Longterm Disability during Open Enrollment.
 Maximum Benefit: 60% of salary up to $5,000
per month.
 Pre-existing Condition Limit: Disabilities related
to medical issues during past 12 months will not
be covered for 24 months.
www.umn.edu/ohr/benefits/openenroll
When can I enroll in
Short-term Disability?
 You can enroll or increase your Short-term
Disability at any time during the year
 New Short-term Disability enrollments or
increases will require proof of good health
 See Website for details on how to apply
www.umn.edu/ohr/benefits/disability/shortterm
Additional Items for
Open Enrollment
What else do I need to know
about the UPlan for this year?
 Open Enrollment – November 2010
 Social Security Numbers
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Required for UPlan Members ages 45 & up
CMS / Medicare Requirement
Potential denial of claims if SSN is not provided
Contact the Employee Benefits Service Center
for more information.
Enrolling Online
 If hired before December 1, new employees may
make two elections to participate in FSA for 2010
and 2011
 Multiple elections can be made online but not at
the same time; wait a day between enrollments
 Benefits will send an e-mail to affected employees
 Employees with appointments ending prior to
January 1, 2011, cannot enroll online — they are
not anticipated to be active employees in 2011
Open Enrollment
Communications
 Employees with registered same-sex domestic
partners will receive a letter and instructions for
Open Enrollment. Elections can be made online, if
registered, or on paper
 Materials are sent to employees on leave of
absence & to those with no computer access
 An e-mail will be sent on November 1 to
announce the start of open enrollment
 A final reminder e-mail will be sent near the end
of November
Open Enrollment
Communications
 One set of medical & dental directories sent
to each department
 Contact Mo Perry @ [email protected] to
request more for additional locations
 Employee Health & Benefits Fair poster sent
to department
 Note: also contact Mo Perry to update the DEBCP
e-mail list
Benefits Materials for 2011
 U & Your Benefits newsletters
 Guide for UPlan Benefits Enrollment (print copy
for new employees and available online)
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COBRA instructions and rates
Benefits Summaries for prospective employees
Summary of Benefits for Medical Plans
Summary of Benefits for Dental Plans
Check the Manager’s Toolkit on OHR Web site
http://www.umn.edu/ohr/debcp/index.html
When are the
Employee Health & Benefits Fairs?
 Minneapolis: November 2: Coffman Memorial
Union – Great Hall – 10 a.m. to 4:30 p.m.
 St. Paul: November 3: St. Paul Student Center
– North Star Ballroom – 10 a.m. to 4:30 p.m.
 Duluth: November 4: Kirby Student Center –
Ballroom – 10 a.m. to 3 p.m.
 Morris: November 11: Oyate Hall, UMM
Student Center – 11 a.m. to 1 p.m.
Open Enrollment
Resources
What if I need help
with enrollment?
 Telephone: 612-624-9090 or 1-800-756-2363
 Option 2 ̶ General benefits questions
 Option 3 ̶ FSA questions
 E-mail: [email protected]
 Benefit Fairs: Computer help and Employee Benefits
staff available to answer questions
 Computer Labs (Twin Cities): Room 315
Donhowe Bldg.
 November 17: 7 a.m. to 7 p.m.
 November 24, 29, and 30: 8 a.m. to 4:30 p.m.
What if I want to talk
to Employee Benefits?
 Employee Benefits Service Center
612-624-9090 or 1-800-756-2363
 Option 2 ̶ General benefits questions
 Option 3 ̶ FSA questions
Telephone Language Interpretation service available
through Employee Benefits
 Employee Benefits Website
www.umn.edu/ohr/benefits/openenroll
What if I want to talk
to the Health Plans?
 Delta Dental:
 651-406-5916 or 1-800-448-3815
 Fairview Specialty Pharmacy:
 1-877-509-5115 and 612-672-5289
 HealthPartners:
 952-883-5000 or 1-800-883-2177
 Medica:
 952-992-1814 or 1-877-252-5558
 Prime Therapeutics:
 1-800-727-6181
Rates for Plan Year
2011
2011 Medical Rates – Employee Only
2011 Biweekly Rates
Plan
Total
University
Employee
Medica Elect & Essential
– Twin Cities
$ 253.60
$ 228.20
$ 25.40
Medica Elect & Essential
– Duluth
Medica Choice Regional
– Greater Minnesota
U Classic Plus by
HealthPartners
$ 272.30
$ 246.90
$ 25.40
$ 318.10
$ 292.70
$ 25.40
$ 264.20
$ 228.20
$ 36.00
Insights by Medica
$ 271.80
$ 228.20
$ 43.60
Medica Choice National
$ 274.70
$ 228.20
$ 46.50
Medica HSA
$ 253.90
$ 228.20
$ 25.70
2011 Medical Rates – Employee and
Spouse or Same-Sex Domestic Partner
2011 Biweekly Rates
Plan
Medica Elect & Essential
– Twin Cities
Medica Elect & Essential
– Duluth
Medica Choice Regional
– Greater Minnesota
U Classic Plus by
HealthPartners
Total
University
Employee
$543.70
$ 462.10
$ 81.60
$ 584.00
$ 502.40
$ 81.60
$ 681.90
$ 600.30
$ 81.60
$ 568.10
$ 462.10
$ 106.00
Insights by Medica
$ 582.50
$ 462.10
$ 120.40
Medica Choice National
$ 588.80
$ 462.10
$ 126.70
Medica HSA
$ 544.30
$ 462.10
$ 82.20
2011 Medical Rates – Employee and
Child/Children
2011 Biweekly Rates
Plan
Total
University
Employee
Medica Elect & Essential
– Twin Cities
Medica Elect & Essential
Duluth
Medica Choice Regional
– Greater Minnesota
U Classic Plus by
HealthPartners
$ 440.30
$ 374.30
$ 66.00
$ 473.00
$ 407.00
$ 66.00
$ 552.10
$ 486.10
$ 66.00
$ 458.50
$ 374.30
$ 84.20
Insights by Medica
$ 471.70
$ 374.30
$ 97.40
Medica Choice National
$ 476.70
$ 374.30
$ 102.40
Medica HSA
$ 441.30
$ 374.30
$ 67.00
2011 Medical Rates – Employee and
Spouse/SSDP and Child/Children
2011 Biweekly Rates
Plan
Total
University
Employee
Medica Elect & Essential
– Twin Cities
Medica Elect & Essential
– Duluth
Medica Choice Regional
– Greater Minnesota
U Classic Plus by
HealthPartners
$ 728.90
$ 619.60
$ 109.30
$ 783.90
$ 674.60
$ 109.30
$ 915.10
$ 805.80
$ 109.30
$ 757.70
$ 619.60
$ 138.10
Insights by Medica
$ 780.90
$ 619.60
$ 161.30
Medica Choice National
$ 789.40
$ 619.60
$ 169.80
Medica HSA
$ 729.60
$ 619.60
$ 110.00
2011 Dental Rates – Employee Only
2011 Biweekly Rates
Plan
Total
University
Employee
Delta Dental PPO – Twin
Cities and Duluth
Delta Dental Premier –
Greater Minnesota
University Choice
$ 15.75
$ 14.15
$ 1.60
$ 18.75
$ 17.15
$ 1.60
$ 21.20
$ 14.15
$ 7.05
Delta Dental Premier
$ 18.75
$ 14.15
$ 4.60
HealthPartners Dental
HealthPartners Dental
Choice
$ 17.20
$ 14.15
$ 3.05
$ 18.50
$ 14.15
$ 4.35
2011 Dental Rates – Employee and
Spouse or Same-Sex Domestic Partner
2011 Biweekly Rates
Plan
Total
University
Employee
Delta Dental PPO – Twin
Cities and Duluth
Delta Dental Premier –
Greater Minnesota
University Choice
$ 33.45
$ 20.05
$ 13.40
$ 39.50
$ 26.10
$ 13.40
$ 44.85
$ 20.05
$ 24.80
Delta Dental Premier
$ 39.55
$ 20.05
$ 19.50
HealthPartners Dental
HealthPartners Dental
Choice
$ 36.80
$ 20.05
$ 16.75
$ 39.45
$ 20.05
$ 19.40
2011 Dental Rates – Employee
and Child/Children
2011 Biweekly Rates
Plan
Total
University
Employee
Delta Dental PPO – Twin
Cities and Duluth
Delta Dental Premier –
Greater Minnesota
University Choice
$ 38.15
$ 22.90
$ 15.25
$ 45.20
$ 29.95
$ 15.25
$ 51.20
$ 22.90
$ 28.30
Delta Dental Premier
$ 45.15
$ 22.90
$ 22.25
HealthPartners Dental
HealthPartners Dental
Choice
$ 42.65
$ 22.90
$ 19.75
$ 45.75
$ 22.90
$ 22.85
2011 Rates for Additional Employee and
Spouse/SSDP Life Insurance
Age
Under 30
Per $5,000 per Biweekly pay period
30-34
$ 0.11
35-39
$ 0.13
40-44
$ 0.15
45-49
$ 0.24
50-54
$ 0.40
55-59
$ 0.62
60-64
$ 1.00
65-69
$ 1.60
70-74
$ 2.57
75-79
$ 4.12
80-84
$ 6.66
85+
$ 13.29
$ 0.09
2011 Dental Rates – Employee and
Spouse/SSDP and Child/Children
2011 Biweekly Rates
Plan
Total
University
Employee
Delta Dental PPO – Twin
Cities and Duluth
Delta Dental Premier –
Greater Minnesota
University Choice
$ 53.40
$ 32.05
$ 21.35
$ 63.40
$ 42.05
$ 21.35
$ 71.85
$ 32.05
$ 39.80
Delta Dental Premier
$ 63.45
$ 32.05
$ 31.40
HealthPartners Dental
HealthPartners Dental
Choice
$ 58.35
$ 32.05
$ 26.30
$ 62.60
$ 32.05
$ 30.55
Thank you for attending
and for helping employees