Transcript Schreiner University Benefits Enrollment
2014 Open Enrollment Meetings
Health, Dental, Flexible Spending, Supplemental Life Insurance
April 2014
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Schreiner Health Plan
Schreiner continues to offer Faculty and Staff an excellent benefit package Our premiums and coverage are better than other comparable schools and also compared to local businesses of similar size Schreiner continues to share the burden of increased costs with employees; Schreiner cannot guarantee that we will always have a plan that is this rich Health Plan and rate adjustments were looked at from all sides • Compared Employee cost to other tiers • • Looked at impact on employees at Schreiner’s entry wage Actuarial analysis
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What’s New?
Premium expenses will increase for both the employer and employee contributions (except for employee only contributions for medical).
Premiums for the HDHP will not increase quite as much as the 70/30 plan.
70/30 plan deductibles and out-of-pocket maximums will increase.
HDHP deductibles will increase, but out-of-pocket maximums remain the same.
Primary PhysicianCare changed names in September to Healthgram.
Our Life, AD&D, Supplemental Life insurance and our EAP is now provided at the same rates through The Principal.
Flexible Spending Accounts will be have a carryover feature that allows up to $500 to be used in the following plan year.
The HSA maximums will increase slightly again for this plan year.
Plan Comparison to Local and Peers
Individual Deductible (in-Network) Family Deductible Coinsurance Single out of pocket max (includes deductible) Family out of pocket max Physician Office Visit SU KISD ActiveCare 3 PRMC Gold Austin College Plan 2 Austin College Plan 3 500 1,000 70% 5,000 300 900 80% 1,300 1,000 3,000 80% 6,350 550 1,100 90% 3,050 950 1,500 80% 5,950 12,500 deductible plus 1,000 per individual 12,700 6,100 11,500 Zero Co-pay; Plan pays 70% after deductible $20 co-pay for primary, $30 co-pay for specialist $30 co-pay for primary, $30 co pay for specialist $20 co-pay for primary, $40 co pay for specialist $25 co-pay for primary, $50 co pay for specialist Plan pays 70% after deductible $150 co-pay, then plan pays 80% after deductible Plan pays 80% after deductible ER Visit Monthly Premiums: Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Annual cost of premium for EE 130.00
260.00
247.00
390.00
1560.00
796.00
1810.00
1269.00
1990.00
9552.00
197.54
325.16
297.21
336.40
2370.48
188.70
632.37
2264.40
116.86
391.65
1402.32
70/30 Consumer Plan Effective 06/01/2014
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Co-Insurance/no change - SU pays 70%/Employee pays 30% after deductible Deductibles
o Increase from $250 to $500 individual o Increase from $750 to $1,000 employee plus one or more
Out-of-Pocket Maximum (includes deductible)
o Increase from $3,750 to $5,000 individual o Increase from $7,750 to $12,500 Family
Flexible Spending Accounts - Optional
o Pre-tax funds, withheld via payroll to pay for medical or dependent care expenses
Pharmacy
o 90 day supply at either the retail location or the mail order
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HDHP 2500 Effective 06/01/2014
Co-Insurance/no change - SU pays 90%/Employee pays 10% after deductible Deductibles
o o Increase from $2,000 to $2,500 individual Increase from $4,000 to $5,000 Employee plus one or more o The increase to the individual deductible allows for imbedded deductibles for Employees with dependents
Out-of-Pocket Maximum (includes deductible)
o o Remains at $5,000 Individual Remains at $10,000 Employee plus one or more
Health Savings Account
o Pre-tax funds, withheld via payroll to pay for deductible and out-of-pocket
Pharmacy
o 90 day supply at either the retail location or the mail order
Plan Comparison
70/30 Consumer Plan In-Network Benefits HDHP In-Network Benefits Deductible
Individual Family
Out-of-Pocket Maximum
Individual Family
Primary Care Physician Specialist Physician Routine Wellness Outpatient Independent Lab
Emergency Care (facility only)
Urgent Care Inpatient Hospital Services Outpatient Hospital Services
Prescription Drug Benefit* (max 90 day supply) Generic Formulary Non-Formulary Contraceptives (generic only) $500 $1,000 $2,500 $5,000 $5,000 $12,500 70% after ded 70% after ded
Schreiner pays 100% ded waived Schreiner pays 100% ded waived
70% after ded 70% after ded 90% after ded 90% after ded 70% after ded 70% after ded $5,000 $10,000 90% after ded 90% after ded 90% after ded 90% after ded 70% after ded 70% after ded 70% after ded Schreiner pays 100% 90% after ded 90% after ded 90% after ded Schreiner pays 100%
Lifetime Maximum Unlimited
Medical Plan Pricing per Month
4-Tier Pricing
Employee Only Employee + Spouse Employee +Child(ren) Employee + Family
70/30 Current
$130 $215 $205 $305
70/30 New $130 $260 $247 $390 HDHP 2000
$130 $215 $205 $305
HDHP 2500 $130 $240 $227 $360
Flexible Spending Account
• • • • • • The maximum pledge amount remains at $2,500 for a Health Flexible Spending Account (FSA) and $5,000 for dependent care FSA. The plan year will be from June 1, 2014 – May 31, 2015. Carryover of $500 will be allowed for use into the next plan year. Use-it-or lose-it for any remaining balance exceeding $500 at the end of the Plan year. Please see Human Resources to complete your flex election form by May 16, 2014. Flexible Spending Accounts are a great way to pay for anticipated medical expenses with Pre-Tax dollars. Check your balances online at https://www.wealthcareadmin.com/default.aspx
Current participants will have a grace period to use remaining funds until August 15, 2014
Health Savings Account
• • • • The annual maximum contribution has increased to $3,300 for a Health Savings Account (HSA) for an individual and $6,550 for a family. If you are currently enrolled, you do not need to do anything at this time, unless you want to increase your monthly.
Reminder: You can change your HSA contribution at anytime by notifying payroll of the increase or decrease, but always keep in mind the annual maximum allowed by the IRS.
Your HSA Account is a great way to save for future medical expenses with Pre-Tax dollars.
Pre-certification Reminder
Pre-certification Example
$5,000 $4,000 $3,000 $2,000 $1,000 $0 Colonoscopy (CPT - 45378, 45385, 45380) Hospital ASC
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Dental
There will be no changes to dental benefits.
• There will be a slight increase in Premium.
• You can go to any dental provider, no network.
• Deductibles and $2,000 plan year maximums restart June 1, 2014.
• You will have one ID card for Medical, Dental, and Prescription.
• You may enroll in Dental coverage without enrolling in Medical coverage.
4-Tier Pricing
Employee Only Employee + Spouse Employee +Child(ren) Employee + Family
Dental Plan Pricing
Current Employee Contribution
$10.80 / month $34.10 / month $42.70 / month $73.20 / month
New Employee Contribution $11.34 / month $35.82 / month $44.84 / month $76.86 / month
Changes to monthly premiums only; no changes to plan provisions $2,000 plan year maximum per person on the plan, With additional $1,000 lifetime orthodontia benefit for covered dependents under 19 The Schreiner portion will continue to be $15 per month per employee regardless of coverage level
Online Open Enrollment
https://www.healthgram.com/openenrollment .
Healthgram Website
• Create/access your own account in order to: o o o o o o o o o Complete online enrollment Access claims activity View deductibles and out-of-pocket information View prescriptions Print EOB’s Print claim forms Email customer service Wellness tools And much more!
• If you have any questions or need technical support, please email [email protected]. www.healthgram.com
Personal Health Record
Health Library
Wellness Resources
Vision
• VSP through Assurant Vision Care is our vision provider. In FY 2015 we will continue with the same premium and coverage. To find in-network providers please visit, www.vsp.com
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Coverage Type Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Monthly Employee Contribution
$6.04
$12.08
$11.09
$18.04
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Basic Life and AD&D
Coverage provided by Principal Financial Group (formerly The Hartford) Current Benefits Include: o o Basic Life and Accidental Death and Dismemberment (AD&D) insurance is an plan that is 100% Employer paid. The plan covers eligible employees for One times your basic annual earnings to a maximum of $100,000 with a minimum of $25,000. Upon termination of employment, life insurance may be converted to an individual policy.
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Voluntary Life Coverage
Coverage provided by Principal Financial Group (formerly The Hartford) Current Benefits Include: o o o o Employee coverage - includes $10,000 increments to a maximum of $500,000, not to exceed 5 times annual earnings. Spouse coverage - includes $5,000 increments up to a maximum of $100,000.
Employee must enroll in supplemental life and have 50% more coverage to allow dependents to be eligible for coverage.
Child coverage - includes $5,000 increments up to $10,000 and does not require medical evidence. • Child coverage starts on day 1 and ends at age 26.
Voluntary Life Coverage
• • • • During Annual Enrollment – you will now have the opportunity to update or increase Voluntary Life coverage for you and your dependents.
Employees and Spouses are allowed a 1x increment increase without medical evidence this year as long as it does not exceed the guaranteed issue amount.
Any increases over 1x increment or over the guarantee issue amount will require medical evidence. Guaranteed Issue Amounts at time of employment are: o $200,000 for Employee o $50,000 for Spouse o $10,000 for Children • Upon termination of employment, Voluntary life insurance may either be converted or ported to an individual policy.
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Voluntary Life and Accidental Coverage Rates
Supplemental Life Rates Supplemental AD&D $0.02/$1,000 (for Employee and Dependents)
Employee & Spouse
<25 $0.059/$1,000 25-29 $0.059/$1,000 30-34 $0.059/$1,000 35-39 $0.084/$1,000 40-44 $0.117/$1,000 45-49 $0.174/$1,000
Child: $0.19/ Per $1,000 Unit
50-54 $0.28/$1,000 55-59 $0.489/$1,000 60-64 $0.681/$1,000 65-69 $1.27/$1,000 70-74 $2.068/$1,000 75> $2.068/$1,000
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Long Term Disability
60% of your monthly earnings to a maximum of $7,000 per month Minimum is the greater of $100 or 10% of monthly income loss 2 Year Own Occupation with Any Occupation after that Elimination Period is 90 days Benefit Duration to Social Security Normal Retirement Age
Discounts and Services
Type Travel Assistance
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How to Access www.principal.com/travelassistance Will & Legal Document Center Identity Theft Kit Beneficiary Support Employee Assistance Program
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www.ARAGwills.com/Principal Group policy number: 1041923
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www.ARAGwills.com/Principal Group policy number: 1041923 Communications sent directly to the beneficiaries on how to access
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www.MagellanHealth.com/member 800-588-8412
Discounts and Services
How to Access Type Laser Vision Correction
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www.principallasik.com
888-647-3937 Hearing Aid Program
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www.americanhearingbenefits.com
866-925-1287
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www.principal.com/weightwatchers Weight Loss Oral HealthCare
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www.epicdental.com
866-920-4200 Promo code: PR25FT
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www.principal.com/diabeticliving Magazine Program
Reminder
o o o Schreiner continues to provide a competitive benefit package HRS will assist you through the open enrollment process Want a sample check to see the impact of changes on your budget? HRS can provide this!