Transcript Document

Open Enrollment
Presentation
January 2010
Agenda
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Changes to BigBand’s Benefit Programs
Overview of Plans
What You Need to Do
Important Paperwork
Life Changes
Overview of Benefits Programs
 The following slides are condensed
overview of BigBand’s benefits
 For details, please consult providers’ plan
documents
Filice Insurance Services/Resources
 Dedicated Account Management team
 Eric Pogue – 925-299-7212; [email protected]
 Chris Kelly – 925-299-7216; [email protected]
 Alaina Kelly – 925-299-7213; [email protected]
 Assistance with claims, eligibility, forms, carrier issues,
etc.
 Customized benefits website:
www.filice.com/benefits/bigband
BCBS MA HMO Plan Design
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BCBS MA HMO
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Deductible:
$1,000 per member ($2,000 family)
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Co-Insurance Limit
$5,000 per member ($10,000 family) Rx co-pays = not included
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Primary Care Physician Visits
$20 (deductible does not apply)
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Routine physicals / well-child
$20 (deductible does not apply)
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No cost for immunizations or routine tests
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Emergency
$150 (Waived, if admitted)
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Outpatient Surgery
Subject to the deductible
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Hospitalization
Subject to the deductible
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Prescription (Mail Order = 2 times these co-pays for up to a 90-day supply)
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Generic
$15 (deductible does not apply)
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Brand Formulary
$30 (deductible does not apply)
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Non-Formulary
$50 (deductible does not apply)
What is a deductible reimbursement plan? (Commonly
referred to as a Health Reimbursement Account)
 A company-sponsored deductible reimbursement plan.
 Reimburses employees and their dependents for any
allowable medical expenses under the company
sponsored plan
 Set up in accordance with IRS Code Section 105: medical
reimbursements to employees are not considered taxable
income to the employees or their dependents.
BCBS MA PPO Plan Design (HRA)
 BCBS MA Blue Care Elect Deductible Plan
 Deductible:
$2,000 / member - $4,000 / family (in or out-of-network combined)
 Co-Insurance Limit
$5,000 / member - $10,000 / family (in or out-of-network combined)
 Co-Insurance
100% in-network – 80% out-of-network
 Office Visit
$20 in-network (after deductible) – 20% out (after deductible)
 Preventive / well-child $20 (deductible does not apply)
 No cost for routine tests
 Emergency
$150 (after deductible) – in or out-of-network
 Outpatient Surgery
$20 in-network (after deductible) – 20% out (after deductible)
 Hospitalization
No charge in-network (after deductible) – 20% out (after deductible)
 Prescription
(Mail Order = 2 times these co-pays for up to a 90-day supply)
 Generic
$15 (deductible does not apply)
 Brand Formulary $30 (deductible does not apply)
 Non-Formulary
$50 (deductible does not apply)
The BigBand Health Reimbursement Account and the
Comparative Costs
SINGLE EMPLOYEE
 Monthly premium costs:
 $53.07 for the HMO
 $82.80 for the PPO (Health Reimbursement Account)
 Annual deductible exposure:
 $1,000 for the HMO
 $1,000 (BigBand will fund up to the first $1,000 via the HRA)
 Office Visits
 $20 (no deductible) for the HMO
 Subject to the deductible for the HRA, but BigBand funds the first $1,000
 Inpatient care exposure:
 $1,000 for the HMO
 $1,000 (BigBand will fund up to the first $1,000 via the HRA)
The BigBand Health Reimbursement Account and the
Comparative Costs
EMPLOYEE + SPOUSE
 Monthly premium costs:
 $148.61 for the HMO
 $159.74 for the PPO (Health Reimbursement Account)
 Annual deductible exposure:
 $2,000 for the HMO
 $2,000 (BigBand will fund up to the first $2,000 via the HRA)
 Office Visits
 $20 (no deductible) for the HMO
 Subject to the deductible for the HRA, but BigBand funds the first $2,000
 Inpatient care exposure:
 $2,000 for the HMO
 $2,000 (BigBand will fund up to the first $1,000 via the HRA)
The BigBand Health Reimbursement Account and the
Comparative Costs (for a family)
FAMILY
 Monthly premium costs:
 $215.07 for the HMO
 $225.08 for the PPO (Health Reimbursement Account)
 Annual deductible exposure:
 $2,000 for the HMO
 $2,000 (BigBand will fund up to the first $2,000 via the HRA)
 Office Visits
 $20 (no deductible) for the HMO
 Subject to the deductible for the HRA, but BigBand funds the first $2,000
 Inpatient care exposure:
 $2,000 for the HMO
 $2,000 (BigBand will fund up to the first $2,000 via the HRA)
Dental Plan Design
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Delta Dental PPO
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Questions ? Call 1-800-765-6003
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Provider Directory = www.deltadentalins.com
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Services
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Deductible *
$50 / individual - $150 / family
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Annual Maximum
$1,500
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Co-Insurance
In
Out (Subject to Usual, Customary & Reasonable)
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Preventive
-
100%
100%
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Basic
-
90%
80%
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Major
-
60%
50%
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Orthodontics (child only)
50%
50% ($1,000 Lifetime Maximum)
Pre-determination Review (Recommended for services > $300)
Dental Plan Design (Buy-up Option)
 Delta Dental PPO
 Questions ? Call 1-800-765-6003
 Provider Directory = www.deltadentalins.com
 Services
 Deductible *
$50 / individual - $150 / family
 Annual Maximum
$2,000 in-network / $1,500 out-of-network
 Co-Insurance
In
Out (Subject to Usual, Customary & Reasonable)
 Preventive
-
100%
100%
 Basic
-
90%
80%
 Major
-
60%
50%
50%
50% ($1,500 Lifetime In & $1,000 Lifetime Out))
 Orthodontics (adult & child)
 Pre-determination Review (Recommended for services > $300)
Vision Plan Design
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Vision Service Plan
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Questions ? Call 1-800-877-7195
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Provider Directory = www.vsp.com
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Services
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Co-pay
$25 (does not apply to contacts)
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Exams:
Once every 12 months
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Lenses:
Once every 12 months
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Frames ($120 allowance)
Once every 24 months
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Contact Lenses ($120 allowance) Once every 12 months
*** Laser Vision Correction Discounts ***
* See fee schedule for out-of-network benefits
Life/AD&D and Disability
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Sun Life
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Questions ? Call 1-800-247-6875
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Website = www.sunlife-usa.com
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Life Insurance
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1.5 times basic annual salary to a maximum of $375,000
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Voluntary Life up to 5 times salary (maximum benefit = $500,000)
Disability
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STD = 66 2/3% of weekly earnings to a maximum of $2,309 per week
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7-day elimination period
LTD = 66 2/3% of monthly pay to maximum monthly benefit of $10,000
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90-day elimination period
Employee Assistance Program
 Employee Assistance Program
 Need Assistance ? Call 1-877-327-4753
 Website = www.guidanceresources.com
 Company ID # ZB3042Q
 Assistance with the following:
 Confidential Counseling on Personal Issues
 Legal Information, Resources and Consultation
 Financial Information, Resources and Tools
 Information, Referrals and Resources for Work-Life Needs
 Online Information, Tools and Services
 The Importance of Having a Will
Assist America Travel Assistance)
 Provides medical assistance when traveling more than 100 miles from home
 Need Assistance ? Call 1-800-872-1414 in the United States
 Need Assistance ? Call 301-656-4152 outside of the United States
 Assistance with the following:
 Medical Consultation and Evaluation
 Hospital Admission Guarantee
 Emergency Evacuation
 Critical Care Monitoring
 Medically Supervised Repatriation
 Prescription Assistance
 Care for minor children
 Legal and Interpreter Referrals
 Return Mortal Remains
Pension Dynamics (Flexible Spending)
 Questions ? Call 800-888-1998
 Website = www.pensiondynamics.com
 Medical Expenses
 Medical Reimbursement Limit = $3,000
 Eligible Expenses
 Non-Eligible Expenses
 Over-the-Counter Reimbursements
 Dependent Care
 $5,000 limit
 Educational versus Custodial
 Day Camp versus Overnight Camp
Voluntary Pet Insurance
 VPI Pet Insurance
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Nation’s largest & oldest provider
Plan is completely portable
Discounts (5% core policies / 10% for 2-3 pets)
Low deductible of $50
Vaccination & Routine Care coverage available
Easy Enrollment
 www.petinsurance.com/nbg
 866-332-7620
 Customer Care
 my.petinsurance.com
 800-USA-PETS
Pre-Paid Legal
 Pre-Paid Legal plan
 Telephone Conversations (unlimited)
 Letters/Phone Calls on your behalf (one per subject)
 Unlimited Document Review (10-pages per document)
 Identity Theft Shield (Kroll Background America)
 Detailed Credit Report (Experian / FICO Score / Analysis
 Continuous Credit Monitoring (Daily)
 Safeguard for Minors
 Children under age 18
 Continuous Credit Monitoring
Liberty Mutual Auto & Home
Voluntary Benefits
 Car Insurance
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Liability
Medical Payments / Personal Injury
Uninsured / Underinsured Motorists
Collision
Comprehensive
Mechanical Parts Replacement
Car Windshield Repairs
New Car Replacement
 Homeowners Insurance
 Your Home
 Your Possessions
 Your Liability
Maximizing Health Benefits
 Utilize benefits that provide for preventive coverage
 Semi-annual dental cleanings and exams
 Annual eye exam
 Be a savvy consumer – can save you $$$
 Choose plans that fit your situation best
 Familiarize yourself with spouse’s/partner’s plan
 Question doctor regarding procedures and necessity,
generic prescriptions, billing rates, joining carrier’s innetwork listing, referrals to in-network specialists
Open Enrollment - BeneTrac
 BeneTrac: We will notify you when you can access the system for
enrollment.
 BCBS MA / Delta Dental & VSP – If you are enrolled and you do not
want to make any changes, you do not need to do anything but you
should review your BeneTrac account and click “finalize”.
 Group Life/AD&D and Disability - You are automatically enrolled for
the group benefits.
 Voluntary Life – If electing to increase your Voluntary Life, or enroll for
the first time, please complete an application. If you are adding to
existing coverage, or a new enrollment exceeding the Guarantee
Issue amounts, you will also need to complete an Evidence of
Insurability Form.
 Flexible Spending Accounts for 2010 – If you are enrolling, you must
re-elect your contributions in BeneTrac, even if you were enrolled last
year.
Life Changes
Must be done within 31 days from Qualifying Event
 Birth or adoption of a child or dependent change
 Marriage, divorce, or domestic partner
 Child(ren) – Full-time students between the ages of 19
and 25
 Spouse’s change of employment
 Temporary assignment outside of coverage area